The client with a hemiparesis refuses to transfer from the bed to the chair with the nurse's help. Which should the nurse implement first to accomplish the provider's prescription?
1. Explain how the nurse can transfer the client safely.
2. Ask questions about how the client usually transfers.
3. Document that the client declined help for the transfer.
4. State that the provider's prescription mandates a transfer.
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2. By applying the nursing process, the nurse probes gently to gather information about the client's reluctance to transfer, including the methods used to complete other transfers, how many transfers have occurred, and events during the transfers that left the client fearing or dreading further transfers. The nurse takes these data and plans nursing care in response.
1. The nurse documents that the client declined the opportunity to transfer.
3. By stating that the prescription mandates a transfer, the nurse passes responsibility for transferring to the physician. This is unprofessional. In addition, saying that the transfer is mandated implies that the client has no choice implies and disrespect and lack of value for the client. The client can feel coerced to transfer by the nurse's im-plying that the client is powerless; this is a legally tenuous position for the nurse to assume.
4. The nurse explains how to transfer a client safely to help assuage client fears; however, if this is not the problem, the nurse remains without the information neces-sary to resolve this issue.
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