A charge nurse observes a nurse with unsteady gait, slurred speech, and a breath smell of alcohol after lunch. What is the priority action?

• A. Document for performance review
• B. Relieve the nurse of assigned clients
• C. Call the nurse's physician
• D. Have the nurse continue working under supervision

Answer: (B)

When impairment is suspected, patient safety comes first. Signs like unsteady gait, slurred speech, and a breath odor suggest the nurse may be unfit to provide safe care, so the immediate priority is to remove the nurse from direct patient contact to prevent harm. Relieving the nurse of assigned clients ensures that patients receive care from someone who is fully capable of monitoring, administering medications, and responding to emergencies, reducing the risk of medication errors, falls, or delayed interventions.

After ensuring safety, follow proper procedures by reporting the observation to a supervisor, documenting objective signs (without accusations), and reassigning duties per policy to keep patients protected while the situation is addressed. Actions like continuing to work under supervision or contacting a physician do not resolve the immediate safety risk. Documentation and escalation are important next steps, but the first priority is immediate patient safety through removal from assignments.