I am taking all my end of the year tests...ugh. There are a couple of questions that I got wrong and I don't understand the reason behind them, can anyone help? One went something like this "A nurse came into report with alcohol on her breath what should the charge nurse do?" the answer the teacher told me was to confront the nurse, the same with the question "What should you do if you witness a nurse not following wasting procedures". I couldn't find anything in 217.11, 217.12, or 217.13 Rules and Regulations about who you should report these situations to. I always thought you should go to the charge nurse. Does anyone know the proper procedure in these matters. Is it true that you should confront the nurse first?

We were taught to bring it to the charge nurse's attention. However, in question #1, it states "what should the charge nurse do?" So, the question is wanting to know from that position, not from a staff nurse position. In that case, you would address the nurse.

are these questions relating to leadership? if you are in a leadership position the buck stops with you. i have no idea what 217.11, 217.12, or 217.13 rules and regulations are. are those state laws? they would not pertain to specific job duties. when you are in a position of leadership or supervision you are responsible for making sure that people in subordinate positions are performing their job duties as per their job descriptions and then following the facility disciplinary policy when they don't. intoxication on the job and wasting procedures would come under rules of the job not your state nursing law.

Remember these questions reside in 'nursing land' where all theory comes before reality. That being said, don't look beyond the information given. The RN is breaking a law dealing with proper narcotic disposal and if the question deals with drugs or breaking the law the correct pathway is going straight up the chain of command.

i believe the reason it goes under the confrontation part in the first one is that it is the charge nurses responsibility, it would probably end up having the nurse having an alcohol screen. just wondering if there are other things that can cause alcohol smell on the breath-would the acetone in ketoacidosis smell alcoholish? i know when my husband was in rehab for alcoholism the machine they used read listerine mouthwash as alcohol.

in the second case if you're not the charge nurse, you would confront the person, allowing them the opportunity to turn themself in to the charge nurse. if you are the charge nurse, you'd confront and follow your company's procedures, and bon regs.