A nurse on a medical-surgical unit is caring for a client who states that she plans to leave the facility against medical advice. For which of the following actions by the nurse should the charge nurse intervene?

Rationale:

A. A colleague who uses assertive communication: Assertive communication is a positive professional skill that promotes clarity and mutual respect. It involves expressing needs and opinions confidently while respecting the rights of others, not bullying behavior.

B. A colleague who is mindful of the personal space of other colleagues: Respecting personal space reflects professional courtesy and helps maintain a comfortable work environment. It does not represent any form of bullying or intimidation.

C. A colleague who negotiates with others for a win-win situation: Negotiation aimed at mutual benefit demonstrates collaboration and problem-solving, which are constructive workplace behaviors, not bullying tactics.

D. A colleague who finds fault with other colleagues: Habitually criticizing or fault-finding without constructive intent is a form of workplace bullying. This behavior undermines morale, creates a hostile environment, and can damage professional relationships.

Rationale:

A. Wear a gown while providing personal hygiene: Contact precautions are required for clients with Clostridium difficile to prevent transmission via contaminated surfaces or direct contact. Wearing a gown during personal care protects the nurse’s clothing and skin from spores.

B. Place the client in a room with negative airflow: Negative airflow rooms are required for airborne infections such as tuberculosis or measles. C. difficile is spread via the fecal–oral route and does not require airborne isolation measures.

C. Apply a mask when providing care: Masks are necessary for droplet or airborne pathogens, but C. difficile spores are transmitted through direct or indirect contact, not respiratory droplets, so masks are not routinely required unless there is another indication.

D. Wipe the stethoscope with alcohol after leaving the client's room: C. difficile spores are resistant to alcohol-based disinfectants. Cleaning equipment requires soap and water or a sporicidal disinfectant to effectively remove spores and prevent spread.