After implementation of new policies related to client identification prior to medication administration, the frequency of medication errors remains unchanged. Which should be the nurse manager's next action?

Choice A reason: Transcription of the healthcare provider's treatment plan is not a task that can be delegated to a PN, as it requires nursing judgment and documentation. The charge nurse should perform this task and verify the orders with the provider.

Choice B reason:A subclavian catheter dressing change is a sterile procedure involving central line care, which is considered an advanced skill typically performed by an RN. Many facilities do not allow PNs to perform this due to the risk of infection and complications.

Choice C reason: The admission assessment is not a task that can be delegated to a PN, as it involves collecting and analyzing data from multiple sources. The charge nurse or the registered nurse should perform this task and document the findings.

Choice D reason: PNs are trained and authorized to insert Foley catheters, which is within their scope of practice. Although the patient has septicemia, catheter insertion is a task-based procedure that does not require critical decision-making, making it an appropriate assignment for a PN.

The correct answer is B. Encourage the nurse to share her concerns and discuss ways to prepare for such emergencies.

Choice A: Ask the nurse why she thinks there is no need for an in-service program about these emergencies.

This response might come across as confrontational and could potentially escalate the situation. It puts the nurse on the defensive and does not foster a collaborative environment. Instead of addressing the nurse’s concerns, it questions her judgment, which might not be the most effective way to manage the situation.

Choice B: Encourage the nurse to share her concerns and discuss ways to prepare for such emergencies.

This approach is the most constructive and supportive. It opens a dialogue, allowing the nurse to express her concerns and feel heard. By discussing the importance of bioterrorism preparedness and finding ways to address any issues she might have, the nurse-manager can foster a more positive and cooperative atmosphere. This method aligns with effective communication and conflict resolution strategies in healthcare management.

Choice C: Choose to send another nurse who is more receptive because the older nurse is not interested.

This option avoids addressing the underlying issue and could be seen as dismissive. It does not resolve the nurse’s concerns and might lead to further dissatisfaction or disengagement. Additionally, it does not promote a culture of continuous learning and improvement, which is crucial in healthcare settings.

Choice D: Inform the older nurse that in-service is not optional and her scheduled attendance is mandatory.

While this response is direct and enforces the rules, it lacks empathy and does not address the nurse’s concerns. It might lead to resentment and a negative work environment. Effective management involves understanding and addressing employees’ concerns, not just enforcing rules.