The nurse is assisting in the care of the client who is on the behavioral health unit.

Exhibits

Select words from the choices below to fill in each blank in the following sentence (Separate using commas).

The nurse should plan to

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and

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Choice A rationale:

Wave hands to attract the attention of law enforcement. Rationale: This is not recommended during an active shooter situation. Waving hands to attract attention may draw the shooter's focus towards you. It's generally safer to stay quiet and hidden rather than trying to signal law enforcement.

Choice B rationale:

Move wounded clients to a safe area before finding shelter. Rationale: While it's important to provide assistance to wounded clients, moving them during an active shooter situation may not be advisable. It can put both the wounded and those attempting to help them at risk. The priority is to find a safe place and take cover while awaiting law enforcement.

Choice C rationale:

Turn cellular phones to silent mode. Rationale: This is the correct action to take. Turning cellular phones to silent mode helps maintain silence and prevent the phone from ringing or vibrating, potentially alerting the shooter to your location. It's essential to maintain silence and avoid drawing attention during an active shooter situation.

Choice D rationale:

Attempt to bargain with the shooter. Rationale: Attempting to bargain with the shooter is not a recommended action. Engaging with the shooter can escalate the situation and put lives at risk. The best course of action is to hide, stay quiet, and await law enforcement intervention.

The correct answer is Choice D.

Choice A rationale: Documenting the event in the client’s progress notes is not the most appropriate action in this situation. The client’s progress notes should contain information about the client’s health status and care, not about staff behavior. Furthermore, documenting this incident in the client’s notes could potentially violate the client’s privacy if the notes are accessed by individuals who do not need to know about the incident.

Choice B rationale: Submitting an incident report to the risk manager is not the most appropriate action in this situation. Incident reports are typically used for events that have caused or have the potential to cause harm to a client, such as medication errors or falls. In this case, while the APs’ behavior is inappropriate, it has not caused harm to the client.

Choice C rationale: Informing the client of the APs’ actions is not the most appropriate action in this situation. Doing so could unnecessarily worry or upset the client. The nurse’s role is to advocate for the client and protect their privacy and dignity, which includes not sharing information about inappropriate staff behavior with the client.

Choice D rationale: Telling the APs to stop the conversation is the most appropriate action in this situation. The nurse has a professional responsibility to address inappropriate behavior by other healthcare team members. Discussing a client in a public area, such as the nurses’ station, is a breach of client confidentiality. The nurse should remind the APs of the importance of maintaining client confidentiality and direct them to stop the conversation.