Case Study: New Nurses Delegation

Under the regulations of the California Nurse Practice Act, a Licensed Vocational Nurse has the ability to delegate tasks to unlicensed assisted personnel (UAP) according to individual facility policy. Delegation as stated in Hill & Howlett is defined as, “transferring the authority to perform nursing duties that are in the job description of the LVN charge nurse.” Prior to carrying out this important nursing duty, it is important for the LVN to recognize the difference between assigning tasks and delegating tasks. As explained in an article in the Journal of Nursing regulation titled; National Guidelines for Nursing Delegation. Assigning tasks would involve performing “routine care, activities, and procedures that are within the authorized scope or practice of the LVN or part of the routine functions of the UAP. Delegating tasks on the other hand is defined as “allowing a delegate to perform a specific nursing

The National Council of State Boards in Nursing defines delegation as “transferring to a competent individual the authority to perform a selected nursing task in a selected situation” (National Council of State Boards of Nursing, Resources section, 4). When delegating, the registered nurse (RN) assigns nursing tasks to unlicensed assistive personnel (UAP) while still remaining accountable for the patient and the task that was assigned. Delegating is a management strategy that is used to provide more efficient care to patients. Authorizing other individuals to take on nursing responsibilities allows the nurse to complete other tasks that need tended to. However, delegation is done at the nurses’

Nursing tasks delegated should be considered routine care for a specific patient, pose little potential harm, performed with a predictable outcome, and administered according to the plan of care. There should be an assessment of nursing needs including the frequency of nursing care and, the stability of the patient (UT Admin Code R156-31b. Nurse Practice Act Rule, 2013).

Leadership is encountered in every occupation and in everyday life. In nursing, leadership is not only prevalent; it is crucial to patient care and employee satisfaction. The nurse leader that was interviewed was a nurse at the Newport Hospital in Newport, Washington. This is a small hospital in a rural community. She is a charge nurse in the acute care unit, as well as in charge of leading infection control in the hospital. With these roles comes a lot of responsibility, and tasks that must be completed in a timely manner to create a workflow for the rest of the staff. There is a lot of juggling and balancing everything that is included in all of those positions.

When needed, nurses can ask for assistance from their peers or delegate patient care tasks to increase their productivity. Implementing either strategy requires an understanding that with either task there are specific responsibilities and accountability. Nurses must have an understanding

Even though the assignment is delegated to another person does not mean the nurse is free from the task assigned. The nurse is responsible for the patient even if he or she is not completing the task. The nurse must ensure safety to the patient while assigning the task. The nurse must be knowledgeable what part of the task can be delegated and what part of the task is not within the job description of the person he or she is delegating the task too. Delegation is taking place all day long on the Pediatric Unit.

If okay with Randy, can the morphine sulfate 10mg/ml be removed from the PACU Omnicell and replaced with morphine 2mg/ml syringes in order to avoid wasted and for patients’ safety. Although rarely used, the Nurses have to dilute the 10mg in 5 ml normal saline prior to administration to Comer patients.

I was privileged to have the opportunity to meet and talk with Patricia Kelly, Manager of Informatics Adoption in the Information Technology Department of Methodist Healthcare. She is truly proficient and self-motivated as these traits were observed during our discussion. Ms. Kelly provided intriguing information and identified her leadership style with support from her past and present work experience. During the interview, Ms. Kelly demonstrated and supported the importance of effective leadership and how it makes a difference in the workplace.

As floor nurses in a hospital setting it is easy to become overwhelmed and too busy to provide adequate patient care. Especially in times of increased illnesses, such as flu season, and times when our community experiences nurse shortages. Unfortunately, when this happens the nurses are given higher nurse/patient ratios. As health care providers, it is instinctual to want to care for every patient that walks through the door. However, in these cases, the patient may not receive the care they need. Provision 4 discusses the importance of the nurse’s responsibility and accountability for their assigned patient group (Code of Ethics for Nurses with Interpretive Statements Provision 4 , 2014). As previously stated it is the nurses’ responsibility

Then afterward graduation and registration, nurses further expand and refine their communication skills as independent experts working within healthcare teams in unique settings. (Brown & Crookes, 2016). Developing these skills is an ongoing development as newly graduated nurses combine undergraduate training into experiences throughout clinical practice. Understanding the views of newly graduated nurses throughout the initial six months following graduation informs undergraduate educating pedagogies and ongoing education to prepare nurses as skilled, confident communicators with other healthcare staff, patients

The concept of shared governance was introduced late 1970s and begun implemented in nursing organization throughout US. It was proposed to be essential in improving quality patient care, retaining of staff, containing cost. The rate of change affecting the delivery of health services is almost overwhelming. Nursing leaders are struggling to keep up with the demands of a constraining and changing health care system.

This story is an example of how hectic things can get on our floor and how our charge nurse is made to be available to help the floor nurses and delegate care. There have been upsides and downsides to the charge nurse role. I would like to focus on the charge nurses relating to functional model, team nursing model, and delegating.

The fewer RNs available, the more important it is to use other care staff wisely and to make quick decisions about when and what to delegate. All nurses must be aware of their ability to delegate care. Furthermore, all nurses should be familiar with hospital policies regarding delegation so that they know what tasks other care staff are permitted to do (Murphy, 1989). More importantly, the nurse must insure that the care provider performing the task is accountable and competent in performing the delegated task as the safety of the client should not be compromised when substituting a less qualified worker to provide the care. (Laskowski-Jones & Touslon, 2007). Effective delegation between licensed and unlicensed staff reduces the fatigue of one person, reduces overall negativity, and it enhances morale (Laskowski-Jones & Touslon, 2007). Nurses should involve the family in patient care activities. This reduces the work load, and it can positively increase their involvement(Murphy,

Provision 4: The nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation of tasks consistent with the nurse’s obligation to provide optimum patient care (“American Nurses Association, 2011”).

The first question asks what key issues to consider about when delegating and assigning care to the patient. First, the staff to patient ratio seems precariously high for only two licensed nurses. The scenario states there are nine patients on the unit that require care. For a newly hired staff nurse, caring for four to five patients, that require elevated levels of care, may give a new nurse increased stress and may compromise the delivery of high quality patient care. If these nurse to patient ratios are in fact routine for the unit, nurse James should be adequately trained before he takes on the large patient care load the unit requires. As the charge nurse, Sherry should delegate the patients according to