A newly hired unlicensed assistive personnel (UAP) expresses fear to the charge nurse about collecting a sputum specimen from a client who is HIV positive. Which action should the charge nurse take first?

A) This action is not the best because it does not directly evaluate the PN's wound care skills in practice. A skill checklist may not reflect the current or actual abilities of the PN, especially if it is outdated or based on self-
reporting. The charge nurse should observe the PN's performance in person to ensure that she follows the proper procedures and protocols for sterile wound care.
B) This action is the best because it allows the charge nurse to verify the PN's wound care skills and provide feedback or guidance if needed. The charge nurse has a responsibility to ensure that the PN delivers safe and effective care to the clients on the unit. By watching the PN perform sterile wound care, the charge nurse can assess her competence, confidence, and compliance with standards of practice.
C) This action is not the best because it is disrespectful and discouraging to the PN. The charge nurse should not dismiss or undermine the PN's past experience, which may have contributed to her wound care skills. The charge nurse should acknowledge and appreciate the PN's expertise, but also verify her skill level through direct
observation.
D) This action is not the best because it exposes the client to potential harm and liability. The charge nurse should not delegate a task that requires assessment and evaluation to a PN without first confirming her skill level and competency. The charge nurse should also not ask the PN to perform a task while she is busy with other duties, as this may compromise the quality and safety of care.

Choice A Reason: This is not the best action because it does not address the conflict between the client and the healthcare provider. The nurse should advocate for the client's wishes and seek a resolution that respects them.

Choice B Reason: This is not an appropriate action because it disregards the client's request and may give false hope. The nurse should respect the client's autonomy and dignity.

Choice C Reason: This is not a sufficient action because it does not ensure that the healthcare provider will comply with the client's request. The nurse should also involve other resources to help resolve the ethical dilemma.

Choice D Reason: This is the best action because it involves an impartial group of experts who can help mediate the situation and protect the client's rights. The nurse should seek ethical consultation when there is a disagreement about end-of-life decisions.