What consideration should the nurse-manager prioritize when creating a program to deal with the issue of substance abuse by employees?

A. This task is appropriate for UAP to perform, as it involves basic hygiene and does not require nursing judgment or clinical assessment. UAP can assist with routine oral care under the direction of the RN.
B. Assisting with position changes is a basic care activity that UAP can perform. This task helps prevent pressure ulcers and maintains client comfort, and it does not require the clinical judgment of a nurse.
C. Administering IV medications or fluids is a nursing task that requires specific training and knowledge of nursing assessments, potential complications, and monitoring. This task should only be performed by a licensed nurse, not by UAP.
D. UAP can document basic measurements such as urine output, as this is a straightforward task that does not require clinical judgment. However, the RN should ensure that the UAP understands how to accurately measure and record this information.
E. While UAP can observe and report general changes, monitoring for clinical indications of dehydration requires nursing assessment skills and judgment. This task should be performed by an RN.
F. While UAP can weigh clients, the assessment of weight trends requires clinical judgment and interpretation of data, which falls under the responsibilities of a licensed nurse. The RN should evaluate and interpret the data regarding the client's health status.

A. While state boards of nursing do have regulatory authority over nursing practice and can take action against nurses who abuse substances, this does not negate the need for an internal program. Organizations should proactively address substance abuse to support employee health and safety, rather than relying solely on external authorities.
B. While safety is a critical concern, emphasizing punishment can create a culture of fear and may discourage employees from seeking help. A punitive approach may lead to further issues, such as hiding problems rather than addressing them.
C. While confidentiality is important, the involvement of the personnel department alone may not be sufficient to address the complexities of substance abuse. A comprehensive program should include input from healthcare professionals, mental health experts, and employee assistance programs to effectively manage and support affected employees.
D. This is the most appropriate consideration. A program focusing on screening, prevention, and early intervention can help identify issues before they escalate, support employees in getting the help they need, and create a healthier workplace culture.