The nurse manager is performing an annual professional practice evaluation for a staff nurse who has received multiple patient complaints about effective communication. What action should the nurse manager take as the most appropriate initial step?

The most appropriate initial step in a performance evaluation when a staff nurse has received multiple patient complaints about communication is to discuss the complaints directly with the nurse and invite self-reflection on their communication style. This approach is grounded in the principles of constructive performance management: before escalating to disciplinary action, the manager should engage the nurse in a conversation that promotes insight and professional growth. Self-reflection allows the nurse to identify patterns in their behavior and take ownership of needed changes. Reporting the nurse to the board of nursing would be a disproportionate and premature response to communication complaints that have not yet been fully investigated or addressed through proper channels. Board referrals are appropriate for violations involving unsafe practice or ethical misconduct, not as an initial response to communication difficulties. Immediately placing the nurse on a performance improvement plan skips the essential step of dialogue and would not give the nurse an opportunity to understand the concerns or respond to them before formal corrective action is initiated. Transferring the nurse to another unit avoids addressing the problem altogether and does not resolve the underlying issue, potentially placing other patients at risk. Opening a reflective dialogue is both fair and clinically sound as a first step.