The nurse is concerned about possible substance abuse by a coworker. Which behavior warrants further investigation?
1. The coworker frequently wastes medications.
2. The coworker frequently requests the largest patient care assignment for the shift.
3. The coworker prefers not to be the "medication nurse" on the shift.
4. The coworker declines to take scheduled breaks.
1
Rationale 1: Excessive waste of medications could be a sign that a nurse is using or diverting drugs.
Rationale 2: Requesting a large patient care assignment would not be characteristic of a nurse who is abusing substances. The nurse who is unable or unwilling to manage a patient care assignment could be a substance abuser.
Rationale 3: Requesting not to be the medication nurse would reduce access to drugs subject to abuse.
Rationale 4: Taking frequent or lengthy breaks might signal substance abuse. Declining scheduled breaks is not consistent with substance abuse.
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