The nurse witnessed a more senior nurse make six unsuccessful ...

[Pea0909berry]

The nurse witnessed a more senior nurse make six unsuccessful attempts at starting an intravenous (IV) line on a client. The senior nurse persisted, stating, I refuse to admit defeat. This resulted in unnecessary pain for the client.
 
  How should the first nurse best respond to this colleague's incompetent practice?
 
  A) Report the nurse's practice and have the nurse manager address the matter.
  B) Encourage the nurse to attend an in-service on IV starts.
  C) Reassure the nurse that this is a difficult skill and give her feedback on her performance.
  D) Document an unmet outcome in the client's plan of care.

Question 2

Nurses have identified the following outcome in the care of a client who is recovering from a stroke: Client will ambulate 100 feet without the use of mobility aids by 12/12/2011.
 
  Several nurses have evaluated the client's progression towards this outcome at various points during her care. Which of the following evaluative statements is most appropriate?
 
  A) 12/12/2011 - Outcome partially met. Patient ambulated 75 feet without the use of mobility aids
  B) 12/12/2011 - Outcome unmet. Patient's ambulation remains inadequate.
  C) 12/10/2011 Outcome met, but with the use of a quad cane to assist ambulation.
  D) 12/14/2011 Outcome met.

[lorealeza77]

Answer to Question 1

Ans: A

According to the study Silence Kills: The Seven Crucial Conversations for Healthcare (Maxfield, Grenny, Patterson, McMillan, & Switzler, 2005), an appropriate response to incompetence is to report the matter and enlist the manager to conduct follow-up. Reassuring the nurse and encouraging education are not sufficient responses to incompetence. This action does not constitute an unmet outcome on the part of the client.

Answer to Question 2

Ans: A

An evaluative statement should include both the decision about how well the outcome was met along with data that support this decision. Characterizing the client's ambulation as inadequate is not sufficiently precise. Stating that this outcome was met with the use of a cane contradicts the original terms of the outcome.

[Pea0909berry]

Excellent

[recede]

TYSM