After months of heavy patient loads and staffing issues in the Emergency Department, a natural disaster brings in many seriously injured individuals. A staff nurse appears to neglect some injured patients and is rude to two older adults. Upon noting this behavior of the staff, which of the following should the nurse manager suspect?

Choice A Reason:

Activate the fire alarm. The nurse’s top priority in this situation should be to activate the fire alarm. This action ensures that the entire facility is alerted to the fire, allowing for a coordinated and timely response. Activating the fire alarm initiates the emergency protocols, including evacuation procedures and the arrival of the fire department. This step is crucial because it addresses the safety of all individuals in the facility, not just those in the immediate vicinity of the fire. By activating the fire alarm, the nurse ensures that everyone is aware of the danger and can take appropriate action to protect themselves.

Choice B Reason:

Move any clients in the immediate vicinity. While moving clients in the immediate vicinity is important, it is not the top priority. This action addresses the safety of those closest to the fire but does not alert the rest of the facility to the danger. Without activating the fire alarm first, other staff members and clients may remain unaware of the fire, potentially putting more people at risk. Therefore, while moving clients is a necessary step, it should follow the activation of the fire alarm to ensure a comprehensive response to the emergency.

Choice C Reason:

Use a fire extinguisher to put out the fire. Using a fire extinguisher to put out the fire is a valid action, but it should not be the nurse’s top priority. Attempting to extinguish the fire without first alerting others can be dangerous, especially if the fire spreads quickly or if the nurse is unable to control it. Activating the fire alarm ensures that help is on the way and that evacuation procedures are initiated. Once the fire alarm is activated, the nurse can then attempt to use a fire extinguisher if it is safe to do so.

Choice D Reason:

Close the fire doors on the unit. Closing the fire doors is an important step in containing the fire and preventing it from spreading. However, this action should come after the fire alarm has been activated. Closing the fire doors without alerting others to the fire may delay the overall response and evacuation efforts. By activating the fire alarm first, the nurse ensures that everyone is aware of the fire and can take appropriate actions, including closing fire doors as part of the containment strategy.

Choice A Reason:

Displaying the client’s medical diagnosis on a message board within the client’s room is a violation of patient privacy and confidentiality. According to the Health Insurance Portability and Accountability Act (HIPAA), patient information must be kept confidential and only shared with individuals directly involved in the patient’s care. Displaying such information publicly could lead to unauthorized access and breaches of confidentiality.

Choice B Reason:

Sharing her password with a new nurse during orientation to enable the new nurse to input her client’s vital signs is inappropriate. Password sharing is a significant security risk and violates hospital policies designed to protect patient information. Each healthcare worker should have their own login credentials to ensure accountability and maintain the integrity of the electronic health record system.

Choice C Reason:

Signing out of the computer system after recording a client’s intake and output measurements is an appropriate action. This practice ensures that patient information is secure and that the system is not left open for unauthorized access. It also helps maintain the accuracy and integrity of patient records by ensuring that only authorized personnel can make entries.

Choice D Reason:

Disposing of her nursing activity worksheet in a trash bin near the elevator at the conclusion of the shift is inappropriate. Nursing activity worksheets often contain sensitive patient information, and disposing of them in a public trash bin can lead to breaches of confidentiality. Proper disposal methods, such as shredding, should be used to ensure that patient information is securely destroyed.