A case manager is planning an interprofessional conference for a client who is 3 days postoperative following an open reduction and internal fixation of the right hip. Which of the following concerns is the priority for discussion at the conference?

Choice A rationale:

Documenting client tasks at the end of the shift is not the most effective time-management skill. While documentation is important, it should be done in a timely manner to ensure accuracy and continuity of care. Waiting until the end of the shift might lead to missed details or inaccuracies.

Choice B rationale:

Gathering supplies as needed while completing an activity is a reasonable approach to time management. However, it is not the most effective skill listed. It's often more efficient to gather all necessary supplies before starting a task to minimize interruptions and maximize focus on the activity.

Choice C rationale:

This is the correct choice. Grouping tasks that are in the same location allows the nurse to minimize unnecessary movement and maximize efficiency. By completing tasks in close proximity, the nurse can save time and reduce the need for multiple trips back and forth.

Choice D rationale:

Skipping breaks throughout the day to complete work on time is not a recommended time-management strategy. Adequate breaks are essential for nurses to recharge, prevent burnout, and provide safe and effective care. Skipping breaks can lead to decreased performance, increased stress, and potential errors in patient care.

The correct answer is Choice D: Review the client's request with the family.

Choice D rationale: Reviewing the client's request with the family respects the client's autonomy and the directives stated in their living will. It allows the nurse to communicate and clarify the client's wishes with the family, helping them understand the decisions made by the client when they were competent. This action promotes open communication and may facilitate resolution of the conflict.

Choice A rationale: Inserting the tube and beginning feedings per the family's request disregards the client's living will, which explicitly declines the use of artificial enteral nutrition as a life-sustaining measure. This action goes against the ethical principle of autonomy and could have legal implications.

Choice B rationale: While asking the provider to discuss the issue with the family could be a subsequent step, it is not the primary action to take in this situation. The nurse should first review the client's request with the family to emphasize the importance of the living will and facilitate understanding between the parties involved.

Choice C rationale: Reporting the dilemma to the facility's dietitian does not address the ethical and legal concerns at hand. The dietitian's role is to manage nutritional needs, not to resolve ethical dilemmas or interpret legal documents such as living wills. Involving the dietitian may not be helpful in addressing the conflict between the client's wishes and the family's request.