Question

The charge nurse is observing a new graduate performing all the following skills. Which observation requires further instruction? ? A. The graduate nurse holds the baby cradled in her arms during feeding. ? B. The graduate nurse obtains blood for a dextrose stick by pricking the tip of the heel. ? C. The graduate places a drape over the scale prior to weighing the baby. ? D. The graduate measures the infant using a paper tape measure.

Short answer

Answer: Option B: Obtaining blood for a dextrose stick by pricking the tip of the heel.

Step-by-step solution

Option A: Holding the baby cradled in arms during feeding

Holding the baby cradled in the arms during feeding is a proper way to support and provide comfort to the infant. It helps the baby feel secure and promotes bonding between the caregiver and the baby. This practice is appropriate and does not require further instruction.

Option B: Obtaining blood for a dextrose stick by pricking the tip of the heel

Pricking the tip of the heel for obtaining blood for a dextrose stick is not the most appropriate method. The proper technique is doing a heel stick on the side of the infant's heel to reduce the risk of injury to the underlying nerves and bone. This option requires further instruction.

Option C: Placing a drape over the scale before weighing the baby

Placing a drape or a clean paper liner over the scale before weighing the baby is a good practice. It helps maintain cleanliness and hygiene as the baby's skin does not come in direct contact with the scale. This practice is appropriate and does not require further instruction.

Option D: Measuring the infant using a paper tape measure

Using a paper tape measure to measure the infant is appropriate. It is a non-invasive and accurate method to measure the baby's length. The paper tape measure can be easily disposed of after use, ensuring good hygiene practices. This practice is appropriate and does not require further instruction. Based on our evaluation, Option B requires further instruction for the graduate nurse.

Key concepts

Nursing Skills Assessment

The assessment of nursing skills is pivotal in ensuring that nurses deliver competent and safe care to patients.
During a nursing skills assessment, various competencies are evaluated, such as clinical decision-making, technical abilities, communication, and patient education. To accurately gauge a nurse's proficiency, the assessment typically encompasses direct observation, simulation scenarios, and possibly written or oral examinations.

For instance, when a charge nurse observes a new graduate, as in the exercise, they pay close attention to critical skills, such as obtaining blood samples. Proper technique is vital to avoid complications, such as nerve or bone injury. An incorrect approach, such as pricking the tip of the heel for blood collection, points to a need for further instruction and underscores the importance of thorough assessments in identifying areas where nurses require additional guidance and training.

New Graduate Nurse Training

As new graduate nurses transition from theoretical learning to practical applications in clinical settings, comprehensive training programs are essential.
These training programs often include orientations, preceptorships, and mentorship initiatives that provide real-world experience under supervision and support. A significant component of such training is mastering fundamental nursing skills. These can encompass a variety of tasks, from safely cradling a baby during feeding, as in option A of the exercise, to accurate measurements of an infant's length using a paper tape measure.

It is imperative for training to address any skill gaps early on, promoting confidence and competence in new nurses. Structured feedback and continuous learning opportunities foster professional growth and ensure that novice nurses become valuable members of the healthcare team.

Pediatric Nursing Care

Pediatric nursing care requires a set of specialized skills to address the unique needs of infants and children.
It encompasses a wide range of tasks—from providing appropriate feeding support to accurately measuring and weighing infants, as highlighted in options A, C, and D. Pediatric nurses must be knowledgeable about the developmental stages of children and tailor their care accordingly.

Moreover, employing age-appropriate techniques is crucial to prevent harm and facilitate the child's comfort during medical procedures. For example, using a paper tape measure for infants, as per option D, is favored over other methods as it's gentle and non-invasive. Careful attention to these details ultimately contributes to the provision of safe, effective, and compassionate care for the pediatric population.