The registered nurse (RN) charge nurse observes the unlicensed assistive personnel (UAP) turning the jaundiced client who has just had a liver biopsy to the supine position, which action should the charge nurse implement first?

Rationale:

A. While initially this may reduce immediate stress, it is not the most effective long-term strategy. Limiting exposure to complex clients does not teach time management or prioritization skills and may delay skill development.

B. This is highly effective. Mentorship provides guidance, feedback, and modeling of organizational and prioritization strategies. A mentor can help the new nurse develop safe, efficient workflows and build confidence in managing patient care.

C. Ongoing supervision and feedback are critical for a new nurse struggling with prioritization. Frequent check-ins allow the manager to correct unsafe practices early, provide advice on patient care sequencing, and reinforce time management techniques.

D. This is inappropriate for a nurse who is struggling. Without guidance, the new nurse may continue to use ineffective strategies, risking patient safety and incomplete care.

E. Formal training on prioritization, delegation, and workflow management equips the nurse with practical tools to organize patient care, handle multiple tasks, and improve efficiency.

Rationale:
A. Functional nursing is the most appropriate care delivery system in a situation where staffing is limited, such as during a winter storm. In functional nursing, tasks are divided among staff based on roles and skills rather than assigning care to specific patients. For example, one nurse might administer medications, another might handle vital signs, and UAPs may assist with hygiene and basic patient care. This method maximizes efficiency when there are fewer licensed nurses available to provide care to many patients.

B. Case management focuses on coordinating comprehensive care for patients across the continuum of care, often involving complex discharge planning, referrals, and collaboration with multiple disciplines. It is not practical in an acute staffing shortage because it requires more time and individualized attention than is feasible under minimal staffing conditions.

C. Primary nursing assigns one RN to oversee the total care of a patient from admission to discharge, with accountability for all aspects of care. This system requires adequate staffing and cannot be effectively implemented with only one RN and multiple patients, as continuity of care would be compromised.

D. Team nursing involves dividing patients among a team led by an RN, with LPNs and UAPs assisting. While normally effective, team nursing requires sufficient staff to form functional teams. In this scenario, the limited number of licensed staff (only one RN and two LPNs) makes true team nursing difficult to implement effectively.