A night shift nurse who usually works in labor and delivery is floated to a 30-bed inpatient

Question

psychiatric unit to be charge nurse.

The staff consists of a licensed practical nurse and two aides.
The nurse believes she is not competent to ensure safe client care because several clients are on
suicide precautions, one is in seclusion, and an admission is arriving from the emergency
department. Rank the actions the nurse should take in the order they should be performed.
A. Perform to the best of her ability with available resources.
B. Remain on duty until replaced.
C. Inform the immediate supervisor of the lack of experience and skills to provide safe care.
D. Ask for a replacement.
E. Document that she is working under protest and state the reasons.

Answer 1

ANS:
C, D, B, E, A
Rationale: The nurse has a duty to provide safe care according to American Nurses Association
standards. If the nurse's experience is insufficient to allow her to provide safe interventions, her duty
to clients is breached. The nurse must communicate this through the nursing chain of command and
seek relief from unsafe working conditions. Option C communicates by using the chain of command.
Option D requests replacement as remediation of the unsafe situation. Option B would leave clients
in the hands of another professional who can provide safe care and avoids a charge of abandonment.
Option E: The nurse has a duty to document in writing unsafe conditions for client care and her
actions to remediate the situation. Option A: Performance according to the nurse's best judgment
until replaced is required. This includes seeking clarification and validation.