Assigning Delegating, Supervising and Prioritizing Care

Assigning Delegating, Supervising and Prioritizing Care

Delegation and assignment of duty can be defined as an authoritative transfer of duty from one individual to another while closely monitoring them. In the nursing profession, duty delegation is an important factor because it helps save time and also prioritizes patients from those who are very ill to those who are stable without any form of negligence ( Lacharity et al., 2021). In a clinical setting where there are Licensed practice nurses (LPN) and certified nursing assistants (CNA), it is the responsibility of the registered nurse to assign duties and supervise them. However, it is important to understand the capabilities of the licensed practice nurse and the certified nursing assistant before delegating tasks to them.

Patients to be Assigned to the LPN

Before assigning tasks to licensed practice nurses, the registered nurse should assess the patient’s needs and note the level of care the client needs. It is also important for registered nurses in charge of delegation to ensure that they are assigning duties that are within the scope of the licensed practice nurse (Haugen & Galura, 2019). The roles of licensed practical nurses include the admission of new clients, assisting clinicians during ward rounds, and performing procedures such as chest tube care in a patient with a chest tube in situ (Lacharity et al., 2021). For instance, in this case, study patients who appear stable and don’t require urgent attention should be delegated to the licensed practical nurse. Examples of the Clients that could be delegated to licensed practice nurses include:

Client number 1, who had normal vitals

Client number 5, who was diagnosed with new dementia and is awaiting lab results,

Client number 6, who was getting discharged,

Client number 3, who was post-surgery and was in pain

Client number 1 was stable, and his outcome was predictable; therefore, he did not require special attention. Client number 5, with newly diagnosed dementia awaiting result, was not an emergency case but required close monitoring. However, Client number 3, who is post-surgery, needs close monitoring and urgent administration of analgesic, which the licensed practical nurse can do under the supervision of the registered nurse.

Nursing Care to be Delegated to LPN and CAN

As stated above, delegation refers to the direct transfer of responsibility from one individual to the other. According to the National Council of State Boards and the American Association of Nurses, delegation should be done using the five rights of delegation, which include the right task, appropriate circumstance, the right person, right communication and direction, right supervision, and evaluation (NCSBN & NCSBN, 2017). The right task to be delegated to licensed practical nurse and certified nurse assistant should meet the following criteria: the care should be within the nurses’ scope, they should be tasks that often recur in daily client care, the task should have a sequence of steps to be followed, should not require modification from one client to another, should have a predictable outcome, should be safe to the client and lastly, the tasks should not require frequent assessment, interpretation or critical decision making (Haugen & Galura, 2019). It is important to ensure that the nurses are well-equipped with the skills and knowledge to perform the delegated duties. Even though the nurses might be meeting the above outlined criteria, accountability remains the duty of the registered nurse.

From the case study, the tasks that meet the criteria include wound dressing of Client number 2 because the change of dressing is a task that might have been daily recurring care for the Client. Secondly is the care for Client Number 1, who had stable vitals because his outcome is predictable. Thirdly is the discharge of Client number 6, the patient discharge has steps that can be followed, and therefore it would not be complex for a licensed practical nurse and certified nurse assistant. Lastly, Client Number 3 has pain after fracture repair because pain is expected in patients post-surgery, and the intervention required is the administration of analgesics. The registered nurse can direct the licensed practical nurse on what to do. For Clients 5 and 4, their care might be a bit complex because it will require urgent decision-making and interpretation, respectively.

Supervised Interventions

Supervision can be defined as the process of following up on the delegatee’s performance after duty delegation. To ensure accountability, the registered nurse delegating duties should do close monitoring of the delegated task. As stated in the previous paragraph, tasks that require supervision are tasks that either have unpredictable outcomes or require interpretation or clinical decision-making. For instance, in the case study, interventions that would require interventions include a change of dressing for the client with a burn wound (Client number 2), analgesics administration for the client with pain (Client number 3), interpretation of lab results of the client with new-onset dementia (Client number 5), and management of the client with wheezing that is unrelieved with an inhaler (Client number 4). Additionally,  Client number 4 requires urgent intervention with skilled personnel.

Priority of the Clients

Priority is based on the client’s need for care. In the case study, the priority of the clients is as follows:

Client number 4 with wheezing that is unrelieved by inhaler;

Client number 3 with pain post-surgery;

Client number 5 with new-onset dementia, awaiting lab results;

Client number 2 with full-thickness burns;

Client number 1 with stable vital signs after placing of stents

Client number 6 was awaiting discharge.

Conclusion

In sum, the duty of a registered nurse in a clinical setting is the assigning and delegation of duties. Before delegation, the registered nurse should assess the clients to determine their level of needs and assign duties based on the licensed practical and certified assistant nurses. After delegation, the registered nurse must supervise the tasks and evaluate the junior nurses’ performance. However, besides assigning and delegating, accountability remains the responsibility of the registered nurse.

References

Haugen, N., & Galura, S. J. (2019). Ulrich & Canale’s Nursing Care Planning Guides E-Book: Prioritization, Delegation, and Clinical Reasoning. Elsevier Health Sciences. https://books.google.co.ke/books?hl=en&lr=&id=bN3WDwAAQBAJ&oi=fnd&pg=PP1&dq=Assigning,+delegating,+supervising+and+Prioritizing+care

LaCharity, L. A., Kumagai, C. K., & Bartz, B. (2021). Prioritization, Delegation, and Assignment-E-Book: Practice Exercises for the NCLEX-RN® Exam. Elsevier Health Sciences. https://books.google.co.ke/books?hl=en&lr=&id=QMEsEAAAQBAJ&oi=fnd&pg=PP1&dq=Assigning,+delegating,+supervising+and+Prioritizing

National Council of State Boards of Nursing (2017). Retrieved on 14^th Oct 2021. Available from:  https://www.ncsbn.org/

ORDER A PLAGIARISM-FREE PAPER HERE

We’ll write everything from scratch

Assigning, Delegating, Supervising, and Prioritizing Care

Competency

Integrate leadership and management principles and attributes in nursing practice.

Scenario

You are assigned to six patients on the medical-surgical unit, working with an LPN/LVN and sharing a CNA with another RN. You are receiving reports for your patients and need to identify what activities you will be assigning, delegating, supervising, and prioritizing for the shift.

Assigning Delegating, Supervising and Prioritizing Care

Instructions

Client number 1: 50-year-old male who had a heart attack and stent placed with normal vital signs
Client number 2: 46-year-old female with full-thickness burns to the leg who needs to have dressings changed
Client number 3: 33-year-old male firefighter who has fallen and broken his right femur after surgery with pain in his leg
Client number 4: 18-year-old male with wheezing and labored respirations unrelieved by an inhaler
Client number 5: 74-year-old female with new onset dementia awaiting lab results
Client number 6: 52-year-old female who has been recently diagnosed with type 2 diabetes and is getting discharged

Describe the patients you will be assigning to the LPN
Describe the care that you will be delegating to the LPN and CNA
List the interventions that you would want to supervise for the LPN and CNA
List the clients and care from the highest to lowest priority
Provides stated ideas with professional language and attribution for credible sources with correct APA citation, spelling, and grammar.