Question

The nurse overhears the patient care assistant speaking harshly to the client with dementia. The charge nurse should: A. Change the nursing assistant's assignment B. Explore the interaction with the nursing assistant C. Discuss the matter with the client's family D. Initiate a group session with the nursing assistant

Short answer

Answer: The most appropriate action for the charge nurse to take is to explore the interaction with the nursing assistant, as it directly addresses the issue and allows for personalized guidance and improvement in patient care.

Step-by-step solution

Analyze Option A

Change the nursing assistant's assignment: This option involves moving the nursing assistant to a different client, perhaps to avoid any further conflicts or inappropriate behavior. However, this doesn't address the issue and might repeat with other clients. Therefore, this is not the most suitable approach.

Analyze Option B

Explore the interaction with the nursing assistant: In this option, the charge nurse takes a more proactive approach by discussing the situation with the nursing assistant and trying to understand the reasons behind their behavior. This allows the charge nurse to assess the nursing assistant's actions and provide feedback and guidance to improve their patient care skills. It also helps to create an open dialogue between the charge nurse and the nursing assistant, which may prevent similar issues from occurring in the future. This approach seems to be more appropriate compared to Option A.

Analyze Option C

Discuss the matter with the client's family: Informing the client's family about this incident may not be a useful course of action. It could cause unnecessary stress and worry for the family, and it doesn't directly address the cause of the problem nor provide a solution to prevent it from occurring again. Thus, this option is not ideal.

Analyze Option D

Initiate a group session with the nursing assistant: This option suggests that the charge nurse arranges a group meeting where the issue is addressed collectively. While this approach may help to raise awareness about the importance of appropriate patient care, it does not specifically address the individual nursing assistant's behavior, their reasons for acting in that manner, or provide personalized guidance for improvement. This option may make the nursing assistant feel targeted and singled out, and it might not be the most effective way to resolve the issue in the long term.

Choose the most appropriate option

Based on our analysis in steps 1-4, Option B – exploring the interaction with the nursing assistant – seems to be the most suitable and effective course of action. It directly addresses the problem and allows the charge nurse to provide personalized guidance to the nursing assistant, promoting better patient care in the future. So, the charge nurse should choose option B: Explore the interaction with the nursing assistant.

Key concepts

Patient Care Communication

Effective communication is a cornerstone in providing high-quality care to patients, especially those with dementia. Dementia patients often have difficulty expressing themselves clearly or understanding others.
Therefore, caregivers need to use simple words and a calm tone when speaking.

• Be patient and give them time to process what you're saying.
• Use non-verbal cues like gestures or facial expressions to help convey your message.

Creating a trusting environment is crucial. When caregivers communicate effectively, patients feel more comfortable and secure, which can lead to better health outcomes.
Frequent check-ins to ensure the patient understands and to re-evaluate their needs can make a big difference in their day-to-day experience.

Nursing Assistant Training

Proper training is essential for nursing assistants, particularly when caring for patients with complex needs such as those with dementia. Training programs usually cover a variety of topics including patient care communication, empathy, and recognizing non-verbal cues.

• Core skills taught include understanding patient behavior and responding appropriately.
• Training also addresses how to handle challenging situations calmly.

Continuous education and hands-on experience are necessary to keep skills updated and relevant.
Role-playing exercises or shadowing experienced professionals can be very beneficial.
As the healthcare field evolves, nursing assistants need to adapt to new methods and technologies that can improve patient care even further.

Ethical Nursing Practice

Ethical nursing practice is a fundamental aspect of healthcare, ensuring that all actions taken prioritize patient well-being and respect for their rights. For nursing assistants, this means understanding and adhering to ethical guidelines in every interaction.

• Respect for patient privacy and confidentiality is paramount.
• Maintaining professionalism, even in challenging situations, is essential.
• Ethical practice involves advocating for patients who are vulnerable and ensuring they receive proper care.

A solid understanding of ethical principles helps in making informed choices in difficult situations.
Reflection on one’s actions and seeking guidance when unsure are good practices for maintaining ethical standards in nursing. With strong ethical foundations, nursing assistants can contribute to a safe and supportive care environment.