A medical-surgical unit has implemented a policy change.
The nurse manager notices that one of the nurses, who has a history of being resistant to change, is not delivering care according to the new policy.
What action should the nurse manager take?

Explain the importance and rationale of implementing the new policy to the nurse.

Encourage the nurse to verbalize the reasons for resistance to the change.

Indicate that there will be disciplinary consequences if the nurse does not implement the new policy.

Ignore the resistance and allow peer pressure to facilitate a change in the nurse’s behavior.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

While explaining the importance and rationale of the new policy may be helpful in some cases, it may not be sufficient for nurses who are resistant to change. This approach assumes that the nurse's resistance is due to a lack of understanding, which may not be the case. It's possible that the nurse understands the rationale but has other concerns or objections.

Focusing solely on explaining the rationale can make the nurse feel they are not being listened to or that their concerns are not being valued. This can further contribute to resistance.

Choice B rationale:

Encouraging the nurse to verbalize their reasons for resistance allows the nurse manager to understand the root cause of the resistance. This could include:

Concerns about the effectiveness of the new policy

Belief that the new policy will create more work or make their job more difficult

Feeling that they were not adequately consulted or involved in the decision-making process Personal factors such as fear of change or a preference for established routines

Once the nurse manager understands the nurse's concerns, they can work together to address them and find ways to facilitate acceptance of the new policy. This approach fosters open communication, collaboration, and shared decision-making, which are essential for successful change management.

Choice C rationale:

Indicating disciplinary consequences may be necessary in some cases, but it should be a last resort. It can create a negative and hostile work environment, further alienate the nurse, and potentially lead to resentment and decreased morale among other staff members.

It's important to prioritize understanding and addressing the underlying reasons for resistance before resorting to disciplinary measures.

Choice D rationale:

Ignoring the resistance and relying on peer pressure is a passive and ineffective approach. It does not address the nurse's concerns and may even exacerbate the situation. This can lead to conflict among staff members, create a divide between those who support the change and those who resist it, and potentially compromise patient care.

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Correct Answer is D

Explanation

The correct answer is choiceD.

Choice A rationale:

Assisting the client back into bed is not the initial action.Moving the client without assessing their condition could potentially cause harm.

Choice B rationale:

Notifying the client’s provider is important, but it should be done after assessing the client’s condition to provide accurate information.

Choice C rationale:

Informing the client’s family member is not the immediate priority.The nurse should first ensure the client’s safety and assess their condition.

Choice D rationale:

Obtaining the client’s vital signs is the initial action.This helps assess the client’s current condition and determine if there are any immediate medical needs.

A. “I can arrange for a male AP to assist with your personal hygiene care.” B. “Could you explain why you prefer not to have a female AP assigned to your care?” C. “The AP assigned to you is highly competent and has experience caring for male patients.” D. “I will inform the charge nurse about your request to have only male staff members assigned to your care.”

Correct Answer is A

Explanation

Choice A rationale:

Respects patient autonomy: This response directly addresses the patient's preference and demonstrates respect for their right to make decisions about their own care. It empowers the patient by offering a solution that aligns with their stated wishes.

Promotes patient comfort: By accommodating the patient's preference, the nurse can help to create a more comfortable and trusting environment, which can lead to better patient outcomes.

Protects patient privacy: Personal hygiene care often involves exposure of sensitive body parts and can be a source of embarrassment or anxiety for some patients. Ensuring that the patient is comfortable with the gender of the caregiver helps to protect their privacy and dignity.

Demonstrates cultural sensitivity: While not explicitly stated in the question, it's possible that the patient's preference is rooted in cultural or religious beliefs. Being sensitive to these factors is essential for providing culturally competent care.

Provides a practical solution: This response offers a concrete solution that can be easily implemented, ensuring that the patient's needs are met in a timely and efficient manner.

Choice B rationale:

May be perceived as intrusive: Asking the patient to explain their reasoning could make them feel uncomfortable or defensive. It's important to respect the patient's right to privacy and not pressure them to disclose personal information.

Could delay care: While understanding the patient's reasons may be helpful in some cases, it's not essential for providing appropriate care. Delaying care to gather this information could potentially compromise the patient's well-being.

Choice C rationale:

Dismisses patient's concerns: This response fails to acknowledge the patient's preference and could make them feel unheard or disrespected. It's important to validate the patient's feelings and concerns, even if you don't fully understand them.

May not address underlying issues: The patient's preference may be based on factors that are not related to the AP's competence or experience. Simply stating the AP's qualifications is unlikely to resolve the patient's concerns.

Choice D rationale:

Defers responsibility: While informing the charge nurse may be necessary for logistical reasons, it's important for the nurse to take ownership of the situation and address the patient's concerns directly. Deferring to another staff member could make the patient feel like their concerns are not being taken seriously.

May delay care: Involving additional staff members could potentially delay the patient's care. It's more efficient to address the patient's preference directly, if possible.

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A medical-surgical unit has implemented a policy change.The nurse manager notices that one of the nurses, who has a history of being resistant to change, is not delivering care according to the new policy.What action should the nurse manager take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse enters a client’s room to answer the call light and finds the client on the bathroom floor. What should be the nurse’s initial action?

Correct Answer is D

Explanation

A male patient informs the nurse that he prefers not to have female assistive personnel (AP) involved in his care. Which response should the nurse provide?

Correct Answer is A

Explanation

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A medical-surgical unit has implemented a policy change.
The nurse manager notices that one of the nurses, who has a history of being resistant to change, is not delivering care according to the new policy.
What action should the nurse manager take?