A nurse manager observes a licensed practical nurse who has a strong odor of alcohol on their breath. Which of the following actions should the nurse manager take?

a. Document an objective description of the situation:

It is important to start by documenting the observed behavior objectively. This documentation can serve as a factual record of the incident.

b. Schedule a formal meeting with the LPN within 48 hours:

While addressing the issue promptly is important, scheduling a formal meeting should come after documenting the situation. The initial step is to gather information and document observations.

c. Interview clients about the nurse’s actions:

Interviewing clients may be necessary later in the investigation process, but the immediate action should be to document the observed behavior and then proceed with a more formal investigation if needed.

d. Check the unit narcotic records for discrepancies:

The issue at hand appears to be related to alcohol use rather than narcotics. While discrepancies in narcotic records might be a concern, it may not be the most relevant action based on the situation described.

a. "You must choose a member of your family to serve as your health care proxy":

This response is not accurate. While family members are often chosen as healthcare proxies, the client is not required to select a family member. The most important consideration is choosing someone who understands the client's healthcare wishes and is willing and able to advocate for them. The nurse should emphasize the importance of selecting a trusted individual, whether they are a family member or not.

b. "A health care proxy can make decisions for you when you are unable to do so":

This response is accurate. A healthcare proxy is a legal document that allows an individual to appoint someone else to make healthcare decisions on their behalf if they become unable to do so due to illness or incapacity. The nurse should explain the role of a healthcare proxy in advocating for the client's wishes and ensuring that their healthcare preferences are honored.

c. "You should appoint a health care proxy before undergoing an invasive procedure":

While it is advisable for clients to have advance directives, including a healthcare proxy, in place before undergoing any medical procedure, this response does not fully address the client's question. The timing of appointing a healthcare proxy should not be limited to specific medical procedures but should be based on the client's readiness to make such decisions and their recognition of the importance of having a designated advocate for their healthcare needs.

d. "It is necessary for an attorney to approve your health care proxy":

This response is not accurate. While it may be helpful to seek legal advice when creating advance directives, including a healthcare proxy, it is not a requirement for an attorney to approve the document. The client can typically complete a healthcare proxy form themselves, following the legal requirements of their jurisdiction. However, consulting with an attorney can provide additional guidance and ensure that the document is properly executed.