A nurse is performing a physical assessment of a newborn whose mother used cocaine throughout the pregnancy.
Which of the following findings should the nurse expect?

A. Instructing a staff member to maintain a log of emergency care provided is not the first action that the nurse should take. This is an important task, but it can be done later, after ensuring the safety of the staff and children and providing immediate care to those who need it.

B. Applying cervical spine collars to children who have suspected neck trauma is not the first action that the nurse should take. This is a priority intervention, but it can only be done after surveying the scene for potential hazards and making sure that it is safe to approach and touch the children.

C. Notifying guardians of the emergency and injuries to their children is not the first action that the nurse should take. This is a necessary step, but it can be delegated to another staff member or done after providing initial care to the children.

D. Surveying the scene for potential hazards to staff and children is the correct answer. This is the first action that the nurse should take, according to the principles of emergency care. The nurse needs to assess the situation and ensure that there are no dangers such as fire, electricity, gas, or falling debris that could harm anyone at the scene. The nurse also needs to determine how many children are injured, how severe their injuries are, and what resources are available to help them.

The correct answer is Choice A.

Choice A rationale:

Forming a committee of staff members to investigate current staffing issues is the first step the nurse manager should take. This is because it is important to understand the root cause of the problem before implementing any changes. The committee can gather data, identify patterns, and provide insights into why staffing for weekend shifts is a challenge. This could involve surveying staff members, reviewing shift patterns, and analyzing workload and patient acuity data. By involving staff members in the process, the nurse manager can ensure that the perspectives and experiences of those directly affected by the staffing issues are taken into account. This approach aligns with the principles of shared governance and participatory management, which have been shown to improve staff satisfaction and retention.

Choice B rationale:

While providing support to staff members who are resistant to staffing changes is an important part of change management, it is not the first step that should be taken. Resistance to change is often a symptom of deeper issues, such as lack of trust, poor communication, or perceived lack of fairness or respect. By first forming a committee to investigate the staffing issues (Choice A), the nurse manager can gain a better understanding of these underlying issues and address them directly. This can help to reduce resistance when changes are implemented.

Choice C rationale:

Scheduling a staff meeting to present different options to staff members is a key part of the change process, but it should not be the first step. Before presenting options, it is important to fully understand the problem and consider various possible solutions. This involves investigating the current staffing issues (Choice A) and potentially developing and evaluating different scheduling options. Once this has been done, the options can be presented to staff members for feedback and discussion.

Choice D rationale:

Giving staff members advance written notice of staffing changes is a crucial part of transparent and respectful communication. However, it is not the first step in addressing staffing issues. Before any changes can be announced, the nurse manager needs to understand the problem (Choice A), consider possible solutions, and involve staff members in the decision-making process (Choice C). Once a decision has been made, it should be communicated clearly and promptly to all staff members.