A charge nurse is observing a newly licensed nurse who is caring for a client who has pulmonary tuberculosis. The charge nurse should expect the newly licensed nurse to take which of the following actions?

Answer is b. Frequent use of restroom.

a. Spends free time conversing with other staff at the nurses' station: Socializing with colleagues during free time at the nurses' station is a common and acceptable behavior in many healthcare settings. While excessive socializing could potentially interfere with productivity, it does not necessarily indicate impairment. Engaging in conversations with coworkers can serve as a stress-reliever and contribute to a supportive work environment, rather than being a sign of impairment.

b. Frequent use of restroom: Correct. Frequent restroom use can be a red flag for substance abuse or other health issues. Individuals who are working while impaired may frequently visit the restroom to use drugs, manage their effects, or experience side effects of substance use. This behavior may be a tactic to conceal substance abuse from coworkers or supervisors, as frequent restroom breaks could be perceived as a normal bodily function. Therefore, the charge nurse should pay close attention to staff members who exhibit a pattern of frequent restroom use, especially if there are other signs of impairment or behavior changes.

c. Depends on other nurses to administer pain medication to their clients: While relying on other nurses to administer pain medication to clients could potentially raise concerns about the staff nurse's competence or workload management, it does not necessarily indicate impairment. There could be various reasons for a nurse to delegate medication administration tasks, such as being assigned to other critical tasks, adhering to hospital policies, or seeking assistance during busy periods. Without further evidence or observation of impaired behavior, depending on others to administer medications cannot be solely attributed to working while impaired.

d. Delegates tasks to assistive personnel: Delegating tasks to assistive personnel is a standard nursing practice and does not inherently suggest impairment. Nurses often delegate tasks to other healthcare team members, including certified nursing assistants or patient care technicians, to ensure efficient and effective patient care delivery. Delegation is guided by nursing standards, patient acuity, and the scope of practice of assistive personnel. Therefore, observing a nurse delegating tasks alone is not sufficient evidence to suspect impairment.

In summary, the correct answer is b because frequent use of the restroom can be indicative of substance abuse or other health issues, especially when observed in conjunction with other signs of impairment or behavior changes. The charge nurse should carefully monitor and investigate any concerning behaviors displayed by staff nurses to ensure patient safety and provide appropriate support and intervention.

Choice A rationale:

Writing a memorandum emphasizing the importance of attending staff meetings might help remind the staff about the significance of these meetings. However, it does not address the root causes of the poor attendance issue. Exploring the reasons behind the lack of attendance should come before issuing reminders.

Choice B rationale:

Appointing a task force to promote attendance at the meetings is a proactive step. However, it might be premature without understanding the reasons for the poor attendance. The task force's efforts could be more effective if informed by a thorough analysis of the underlying issues.

Choice C rationale:

Exploring the reasons that staff are not attending the meetings is the crucial first step. Understanding the factors contributing to the poor attendance allows the charge nurse to tailor interventions appropriately. Reasons could include scheduling conflicts, lack of engagement, or dissatisfaction with meeting content.

Choice D rationale:

Reducing the number of meetings staff are required to attend might address the attendance issue, but it doesn't address the root causes. It's important to identify the reasons behind poor attendance before making decisions about changing meeting frequency.