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Zorluk: ZorLegal and Ethical Practice

A practical nurse (PN) working in a subacute care facility observes a colleague exhibiting an unsteady gait, slurred speech, and an odor of alcohol while preparing oral medications. The colleague states, 'I just need to finish passing these medications.' Arrange the following actions the PN should take in the correct order of priority.

  1. 1Intervene immediately to prevent the colleague from administering the prepared medications to clients.
  2. 2Notify the nursing supervisor or the facility administrator on call about the immediate situation.
  3. 3Verify that another qualified nursing staff member has assumed care of the colleague's assigned clients.
  4. 4Document the factual, objective observations of the colleague's behavior in a facility incident report.

Cevap

The correct priority sequence is to first intervene to prevent the administration of medications, then notify the nursing supervisor, followed by verifying that another nurse has assumed client care, and finally documenting the objective observations in an incident report.
The correct sequence follows standard nursing prioritization frameworks: immediate physiological safety of the client comes first (stopping the medication administration). Once safety is secured, the nurse must utilize the chain of command to manage the impaired staff member. Following this, the unit must ensure safe continuity of care (reassigning clients). Finally, detailed legal documentation is completed once the clinical situation is stabilized.

Adım Adım Çözüm

1
Assess the immediate risk to clients and intervene directly with the colleague.
The colleague is prevented from interacting with clients or administering potentially fatal incorrect medications.
According to Maslow's hierarchy of needs and basic safety principles, protecting clients from immediate physical harm is always the absolute highest priority.
2
Escalate the situation through the appropriate chain of command.
The nursing supervisor is alerted to the impaired nurse.
Facility management must be involved immediately to formally remove the impaired nurse from the premises and arrange for mandatory drug/alcohol screening.
3
Ensure continuity of care for the affected clients on the unit.
Medication administration and treatments are reassigned to a competent nurse.
Clients cannot be left without care; ensuring a safe handoff prevents legal liability for client abandonment.
4
Complete formal administrative documentation.
An objective, factual incident or variance report is filed.
Legal and ethical guidelines require non-judgmental documentation of the event for internal investigation and potential mandatory reporting to the State Board of Nursing.

Anahtar Kavram

Prioritization in Mandatory Reporting of Impaired Practice
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