A nurse is teaching a class about the interlocking principles of shared governance. Which of the following principles should the nurse include?

(Select All that Apply.)

A. Advocacy involves supporting and defending a patient's interests. While evaluating pain medication is important, it doesn't directly demonstrate advocacy.
B. By checking the effectiveness of pain medication, the nurse is fulfilling their responsibility to provide optimal care and manage patient pain.
C. Confidence is important for nurses, but it's not directly demonstrated in this specific action.
D. Fairness is a broader concept related to treating all patients equitably. Evaluating pain medication is a standard of care for all patients experiencing pain, regardless of their background or circumstances.

A. The hospital supervisor is responsible for overseeing the day-to-day operations of the hospital, including staff management. However, in the immediate chain of command, the supervisor might not be the first point of contact for specific unit issues unless the concern escalates beyond the unit level.
B. The charge nurse is the immediate supervisor on the unit and is usually the first point of contact for issues related to staff behavior or performance. Reporting the concern to the charge nurse is appropriate because they have the responsibility to oversee the staff on the unit, address concerns, and ensure the safety and well-being of both patients and staff. The charge nurse can assess the situation and take appropriate action, such as further investigation or reporting to higher authorities.
C. The unit director is responsible for overall management and administration of the unit, including staff issues. While the unit director is a higher level of authority than the charge nurse, it is often appropriate to first report to the charge nurse, who is closer to the situation and can address it more immediately.
D. The Chief Nursing Officer (CNO) is a top executive responsible for nursing practices across the entire hospital or healthcare system. Reporting directly to the CNO is generally not the first step in the chain of command for concerns about a coworker’s impairment.