An assistive personnel (AP) tells a charge nurse that it is unfair that they have to take care of all the clients who are incontinent. Which of the following responses should the charge nurse make?
"I delegate tasks to personnel based on their job descriptions.”
"Everyone working here has to care for clients who are incontinent.”
"Let's talk about organizing the workflow so you care for fewer of these clients.”
"Why do you not want to care for clients who are incontinent?”
The Correct Answer is A
The correct answer is choice A: "I delegate tasks to personnel based on their job descriptions."
Choice A rationale:
The response "I delegate tasks to personnel based on their job descriptions" is appropriate in this situation. Charge nurses are responsible for delegating tasks based on the scope of practice and job descriptions of the staff members. This response emphasizes the importance of adhering to established roles and responsibilities within the healthcare team.
Choice B rationale:
The statement "Everyone working here has to care for clients who are incontinent" may be true, but it does not address the specific concern raised by the assistive personnel (AP). It's important to provide a more focused response that addresses the AP's feelings and concerns.
Choice C rationale:
While discussing workflow organization to reduce the number of incontinent clients (Choice C) might be a potential solution, it doesn't directly address the AP's statement about fairness. The charge nurse's response should prioritize explaining the delegation process and addressing the AP's concerns about fairness.
Choice D rationale:
The response "Why do you not want to care for clients who are incontinent?" could be perceived as confrontational and defensive. It's essential to maintain a respectful and supportive tone when addressing staff concerns. This response does not effectively address the situation or provide a solution.
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Correct Answer is D
Explanation
The correct answer is Choice D: Review the client's request with the family.
Choice D rationale: Reviewing the client's request with the family respects the client's autonomy and the directives stated in their living will. It allows the nurse to communicate and clarify the client's wishes with the family, helping them understand the decisions made by the client when they were competent. This action promotes open communication and may facilitate resolution of the conflict.
Choice A rationale: Inserting the tube and beginning feedings per the family's request disregards the client's living will, which explicitly declines the use of artificial enteral nutrition as a life-sustaining measure. This action goes against the ethical principle of autonomy and could have legal implications.
Choice B rationale: While asking the provider to discuss the issue with the family could be a subsequent step, it is not the primary action to take in this situation. The nurse should first review the client's request with the family to emphasize the importance of the living will and facilitate understanding between the parties involved.
Choice C rationale: Reporting the dilemma to the facility's dietitian does not address the ethical and legal concerns at hand. The dietitian's role is to manage nutritional needs, not to resolve ethical dilemmas or interpret legal documents such as living wills. Involving the dietitian may not be helpful in addressing the conflict between the client's wishes and the family's request.
Correct Answer is D
Explanation
Choice A rationale:
A podiatrist specializes in foot-related issues. Osteoarthritis primarily affects joints, so referring the client to a podiatrist would not directly address their difficulty in buttoning clothes.
Choice B rationale:
A social worker typically addresses psychosocial needs, including emotional and financial concerns. While important, this role wouldn't directly address the client's physical difficulty with buttoning clothes due to osteoarthritis.
Choice C rationale:
Paramedical technologists are skilled in various diagnostic tests and procedures. However, they are not directly involved in assisting clients with activities of daily living or improving physical function.
Choice D rationale:
An occupational therapist (OT) specializes in helping clients regain and enhance their ability to perform daily activities, such as dressing, grooming, and self-care. For the client with osteoarthritis struggling to button clothes, an OT would assess their physical limitations and provide strategies or adaptive tools to improve independence in these activities.
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