In Don Miguel’s “The Four Agreements,” a collection of agreements is outlined to foster personal development and consciousness. Which of the following is NOT among the four agreements?

Choice A Reason:

I believe I am rightly following our agency’s scheduling policies. Could you elaborate on your concerns? This response demonstrates assertiveness by acknowledging the nurse’s concerns and inviting further discussion. It shows that the nurse manager is confident in their actions but is also open to understanding the staff nurse’s perspective. This approach fosters open communication and problem-solving, which are key components of effective leadership.

Choice B Reason:

Why do you think I am being unfair? Your emotions are clouding your judgment. This response is dismissive and confrontational. It invalidates the staff nurse’s feelings and implies that their concerns are not legitimate. Such a response can escalate the conflict and damage the working relationship between the nurse manager and the staff nurse.

Choice C Reason:

You shouldn’t make accusations or imply your own shortcomings too. This response is defensive and accusatory. It shifts the focus from the issue at hand to the staff nurse’s behavior, which is not constructive. Effective communication should address the concerns directly without making personal attacks.

Choice D Reason:

I’m sorry, I will try to be more fair from now on. While this response shows a willingness to change, it lacks assertiveness. It implies that the nurse manager agrees with the accusation of unfairness without seeking to understand the specific concerns. Assertiveness involves standing by one’s decisions while being open to feedback and discussion.

Choice A Reason:

Making a copy of the incident report for the provider is not necessary. Incident reports are typically used for internal documentation and risk management purposes. They are not part of the patient’s medical record and should not be shared with the provider in this manner. The provider should be notified of the incident through appropriate channels, but a copy of the report is not required.

Choice B Reason:

Documenting in the chart that an incident report has been filed is inappropriate. The patient’s medical record should contain factual, objective information about the patient’s condition and care. Mentioning that an incident report has been filed can be seen as an admission of liability and is not recommended. The focus should be on documenting the patient’s condition and any care provided as a result of the fall.

Choice C Reason:

Placing the incident report in the client’s chart is incorrect. Incident reports are not part of the patient’s medical record and should be kept separate. They are used for internal purposes to improve patient safety and care processes. Including them in the patient’s chart can lead to legal complications and is against best practices.

Choice D Reason:

Submitting the incident report to the risk manager is the appropriate action. The risk manager is responsible for reviewing incident reports to identify potential risks and implement measures to prevent future occurrences. This process is crucial for maintaining patient safety and improving healthcare quality.