A staff nurse may be exhibiting manifestations of a substance use disorder and is diverting controlled medications while at work. Which of the following actions should the nurse manager take first?

Choice A reason: Confronting the nurse immediately without objective evidence can lead to defensiveness, denial, or legal complications. Managers must avoid premature confrontation because it lacks the foundation of documented proof and may compromise the integrity of the investigation. Choice B reason: Asking the nurse to sign an action plan assumes guilt before evidence is collected. This step is appropriate only after data has been gathered and a formal process initiated. Implementing corrective measures prematurely undermines fairness and due process. Choice C reason: Documentation is essential but should follow systematic data collection. Recording suspicious behavior without first gathering objective evidence risks bias and incomplete reporting. Documentation becomes meaningful only when supported by collected data. Choice D reason: Collecting data is the first and most critical step. Objective evidence ensures that any subsequent actions—documentation, confrontation, or disciplinary measures—are based on facts rather than assumptions. This protects both patient safety and the nurse’s rights, while also meeting regulatory and legal standards.