A preceptor is helping a newly licensed nurse understand what distinguishes responsibility from accountability.
Which of the following characteristics clarify the concept of responsibility? (Select all that apply.)

Choice A rationale

This response demonstrates respect for the client's autonomy and their right to make informed decisions about their healthcare. Acknowledging their decision and committing to communicate it to the appropriate personnel upholds ethical principles of patient self-determination, even if the decision deviates from the recommended treatment plan, ensuring their wishes are honored.

Choice B rationale

This response is confrontational and uses a "why" question, which can make the client feel defensive. It also imposes the nurse's perspective on the client's treatment choices by emphasizing survival, potentially invalidating the client's feelings of fatigue and their right to refuse treatment, thereby undermining their autonomy in the decision-making process.

Choice C rationale

This response is dismissive of the client's stated feelings and attempts to coerce them into continuing treatment by minimizing their concerns. It fails to acknowledge their distress and implies that their desire to stop treatment is irrational, thereby disrespecting their emotional state and their right to make personal choices about their care.

Choice D rationale

While involving family can be part of the decision-making process, asking if they have discussed it with their family yet can be perceived as deferring the client's individual autonomy. The primary focus should be on the client's wishes first, and this question might imply that the client's decision is not valid without family consultation, which is not always the case.

Choice A rationale

Adopting attitudes and habits of coworkers, especially during reality shock, can lead to assimilation into potentially negative or unhealthy work cultures. This might hinder the development of independent critical thinking and professional identity, potentially perpetuating the negative aspects of reality shock rather than resolving them constructively by integrating diverse perspectives.

Choice B rationale

Volunteering for extra shifts when experiencing reality shock can exacerbate burnout and stress. This action often leads to increased workload and less time for self-care or reflection, making it more difficult for the newly licensed nurse to adapt to the demands of the profession and integrate their learning effectively, intensifying the shock.

Choice C rationale

Integrating nursing school and work environment values involves critically evaluating and synthesizing the theoretical knowledge and ideals learned in academia with the practical realities and expectations of the clinical setting. This process helps reconcile discrepancies, build a more comprehensive professional identity, and reduce the cognitive dissonance associated with reality shock.

Choice D rationale

Seeking mentorship from an experienced nurse provides valuable guidance, support, and practical insights. While beneficial, this choice focuses on a single supportive relationship rather than the broader process of internalizing and reconciling different value systems, which is central to overcoming reality shock through a holistic integration of values and practices.