Which of the following is correct when comparing the United States healthcare system with other high-income countries? The United States:

A. Deterioration in relationships with colleagues is correct. Substance abuse can impact a nurse's behavior, leading to mood swings, irritability, and interpersonal conflicts with colleagues. This can result in a breakdown in relationships and teamwork.
B. Changes in physical appearance, such as unkempt appearance is correct. Nurses struggling with substance abuse may exhibit poor hygiene, an unkempt appearance, and weight changes due to neglect of personal care. These changes are often visible signs of the physical and emotional toll of substance abuse.
C. Consistent improvement in work performance and productivity is incorrect. Substance abuse typically leads to decreased work performance and increased errors due to impairment in concentration, judgment, and decision-making. Improved performance is not a common indicator of substance abuse.
D. Increased incidents of medication errors is correct. Substance abuse can lead to impaired judgment and inattention to detail, which can contribute to an increase in medication errors. Nurses under the influence may struggle to follow protocols and maintain focus on patient safety.
E. Frequent unexplained absences from work is correct. Frequent absences, arriving late, or leaving early can be signs of substance abuse, as the individual may be seeking time to recover from the effects of substance use or to obtain substances.

A. Improved workplace satisfaction is incorrect. Patient-to-nurse violence is likely to lead to decreased job satisfaction and burnout among nurses, rather than improvement.
B. Decreased quality of patient care is correct. Patient-to-nurse violence can lead to emotional distress, anxiety, and physical injury for nurses, which may negatively affect their ability to focus on patient care. Stress and trauma can impair a nurse's concentration, decision-making, and overall job performance, ultimately decreasing the quality of care provided to patients.
C. Enhanced patient-nurse communication is incorrect. Violence or aggression from patients typically leads to communication breakdowns, not improvements. Nurses may become less willing to engage or communicate effectively with patients, especially after experiencing violent incidents.
D. Increased nurse retention rates is incorrect. Patient-to-nurse violence generally contributes to increased nurse turnover rather than retention. Nurses who experience violence may choose to leave their positions due to safety concerns or emotional strain.