A newly graduated nurse has been assigned a client who has a chest tube following a thoracotomy. The new nurse is not experienced with chest tube management. Which action by the nurse is most appropriate regarding this assignment?

  1. ask for a different group of clients
  2. ask to be floated to another area in the facility
  3. refuse the assignment, since she is not familiar with chest tubes
  4. accept the assignment and ask for another nurse to help her with the chest tube
Number 4 is correct.
Rationale: If the client is stable, the nurse should accept the assignment and ask for another nurse with knowledge of chest tubes to educate him on chest tube management. The licensed nurse should be open to learning new skills when there is someone on staff who can assist him. The nurse should learn how to position the tube, mark drainage, chart output, and understand troubleshooting, such as what to do if an air leak develops. Chest tube management is an expected skill set in critical care settings. Stable clients may be on medical floors; training on equipment common to a care area of the facility should be readily available for new nurses. Asking for a different group of clients prevents the nurse from learning a valuable new skill set. Asking to be floated may disrupt staffing in other areas of the facility if no additional staff is needed. Refusing the assignment should be reserved for situations such as performing hemodialysis, which is not something quickly learned at the bedside. If the nurse is in an area where no other nurses have chest tube experience, the nurse manager should be notified. In cases like this, a nurse may be able to come from the ICU every 2 hours or so to round on the client, check the chest tube, and show the new nurse how to manage the tube.