A charge nurse is supervising an experienced registered nurse (RN) who is caring for a patient with a chest tube. The charge nurse observes the RN clamping the chest tube while the patient is being transported to radiology. What is the most appropriate immediate action by the charge nurse?
1Document the incident in the new RN's personnel file immediately
2Stop the transport immediately and discuss the safety concern with the new RN✓ 정답
3Allow the transport to continue but plan to address the issue later during shift report
4Contact the physician to report the new RN's unsafe practice
해설
Clamping a chest tube during transport risks tension pneumothorax; immediate intervention is required to stop transport and educate the nurse.
Clinical Judgment
This question is about patient safety and the supervisor's immediate response. Transporting a patient with a clamped chest tube is an extremely dangerous action that can cause a Notify HCP! tension pneumothorax. When a charge nurse witnesses unsafe practice, the most appropriate first action is to immediately stop the danger and educate on the spot. This is a core supervisory role to protect the patient and teach the new nurse correct practice.
Memory Tip:
Stop the action, Educate on the spot, Correct the practice (SEC). When you see a dangerous practice, Stop (S), Educate on the spot (E), and Correct the practice (C).
KR vs US:
In Korea, a senior nurse might indirectly point out a new nurse's mistake due to cultural differences, but in NGN and US-style nursing, patient safety is the absolute priority, and dangerous situations must be corrected openly, directly, and immediately. The option of 'let's talk later' is unacceptable from a patient safety perspective.
Clinical Practice GuideThe core principle of chest tube management is "never clamp for a prolonged period in the absence of an air leak." During transport, do not disconnect the chest tube; instead, keep the thoracic drainage system in a low position with the patient and move together. Be aware of the signs of tension pneumothorax (dyspnea, tachypnea, hypotension, jugular vein distension, tracheal deviation).Caution:In SATA (Select All That Apply) questions asking "what to do during chest tube management," the option "clamp during transport" is never the correct answer. This is a common trap. Also, documentation is an important follow-up action, but it has a lower priority than immediate interventions.
Chest Tube — Chest tube. A tube inserted into the pleural space to drain air, blood, or fluid and help the lung re-expand.
Tension Pneumothorax — Tension pneumothorax. A life-threatening emergency in which pressure within the pleural cavity continuously rises, compressing the vena cava and rapidly reducing cardiac output.
Clamping — Clamping. The act of locking the chest tube with a clamp. Improper clamping can cause tension pneumothorax, so extreme caution is required.
Charge Nurse — Charge nurse. A nurse who supervises a specific unit or shift, guides staff, and ensures patient safety and quality of care.
Thoracic Drainage System — Chest drainage system. A bottle connected to a chest tube that collects drainage, maintains negative pressure, and detects air leaks. Must be moved with the patient during transport.