A practical nurse (PN) in a long-term care facility enters a resident's room and witnesses an assistive personnel (AP) roughly pulling the resident by the arm and yelling at them. Arrange the following actions the PN should take in the correct priority order, from first to last.
- 1Intervene immediately to stop the assistive personnel's actions.
- 2Assess the resident for physical injuries and signs of distress.
- 3Report the incident to the charge nurse or nursing supervisor.
- 4Document the objective observations and the resident's condition in the medical record.
Answer
The correct sequence is to first intervene to stop the action, then assess the resident, next report the incident to the supervisor, and finally document the objective findings.
In any situation involving client abuse or an immediate safety threat, the nurse must prioritize actions based on immediate client safety. The very first action must always be to intervene and stop the active harm. Immediately following intervention, the nurse must assess the client for injuries. Once the client is safe and stable, the nurse must act as a mandatory reporter by notifying the supervisor. Finally, the nurse completes the ethical and legal requirement of factual, objective documentation.
Step-by-Step Solution
Key Concept
Mandatory Reporting and Client Safety Prioritization