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The responsibilities of a nurse
Roles and responsibilities of nurses
The responsibilities of a nurse
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According to the Board of Nursing Delegation Rules, It’s the responsibility of the RN to supervise tasks delegated to unlicensed personnel. It requires the RN to have good clinical judgment and accountability for the patient’s care. Before assigning tasks, the RN should know the UAP’s credentials and experience as well as the patient’s condition before delegating tasks. The UAP should not be put into a situation or given a task that requires them to make any nursing judgments that could cause harm to the patient. Should this occur, it is the responsibility of the RN to intervene and stabilize the patient.
Acceptable delegated tasks, include, but are not limited to, taking vital signs, blood sugar’s, bathing, dressing, changing briefs, feeding,
repositioning, and include documenting and reporting this information. Unacceptable tasks to delegate include any invasive procedures, patient assessments, care plan’s, or dosage calculations of medication.
Additionally, the LPN cannot push medications into a peripheral intravenous line if the patient “weighs less than 80 lbs, is prenatal, pediatric, or antepartum”, although given that the situation is on a general med-surg floor it is unlikely these patients would be under Sarah’s care at this time. (Rules and Regulations of Practical Nurses. 2015) Sarah can delegate the postoperative patients who need dressing changes and ambulating them to the LPN, but Sarah should assess the wounds for complications initially and serve as resource to the LPN if she has questions about the wounds. Additionally, she could help the nursing assistant with answering calls and serve as a reference for the nursing assistant to ask questions or help with tasks if Sarah is not available. With regards to supervision, the LPN would need continuous supervision given that the working relationship is new. (Cherry and Jacob, 2014) Sarah should be available and willing to answer any questions or address any concerns the LPN
According to APTA,” PT should examine and evaluate the patient or client before delegating acts, tasks or functions be performed by an unlicensed individuals. In addition, PT should provide predetermined procedures and protocols for acts, tasks or function that have been delegated.”(7)
Without doubt, there are two variables that should be considered when evaluating the benefit of shared governance in long term/nursing home settings. First, obtaining consent from the nursing assistant to volunteer for the leadership role for the duration of one year, and the nursing assistant employment status at the time of consent. Second, the effectiveness of the shared governance project to reduce falls, weight loss, in-house acquired pressure injury, and nosocomial infection rates for the sake of the resident’s comorbidity.
Under the code of ethics for nurses this moral issue is also conflicting because you’re first and foremost obligation is to the patient. Now you also have your institution ethical code conduct that you also has to abide by. Provision 5. The nurse owes the same duties to self as to others, including the responsibility to preserve integrity and safety, to maintain competence, and to continue personal and professional growth (ANA, 2001, p.18). In this case the nurse owes it to herself in making the right moral decision to preserve integrity and safety of patient and
The nurse needs to recognize the limitations of each staff member and learn what assignments are within the scope of their practice and what are tasks that need delegation. Delegation is defined as a complex process that requires clinical judgment and final accountability for patients’ care (Weydt, 2010). An assignment is defined as “giving someone else a task within his/her own practice and is base on job descriptions and policies” (NCSBN, 2005, p. 1). The Board of Registered Nursing (BRN) and the Board of Vocational nursing & Psychiatric Technicians (BVNPT) website, lists what duties the RN and the LVN can legally do and is within their scope of practice, this is called the ‘nurse practice act’. A nurse assistant personnel (NAP) or Unlicensed Assistive personnel (UAP) may perform different tasks depending on the state that they reside in, but most include tasks that are considered activities of daily living (ambulating, hygiene, grooming)(NCSBN, 2005). The LVN can perform tasks that the nursing assistant can do, as well as other tasks which include: medication administration (oral, subcutaneous, intramuscular), simple dressing changes, wound care, suctioning, catheter insertion, drawing blood from a patient, and starting an IV and intravenous fluids. IV and blood draws are dependent on the LVNs certification, competence, and
Lorber, M., Treven, S., & Mumel, D. (2016). The Examination of Factors Relating to the Leadership Style of Nursing Leaders in Hospitals. Our Economy (Nase Gospodarstvo), 62(1), 27-36. doi:10.1515/ngoe-2016-0003
Having experience of the situation gives depth of knowledge to identify the different roles. Lead RN who holds BSN degree made better decision than ADN nurse. An elderly patient admitted for pneumonia who was getting IV fluids continuously, during night shift. She started wheezing and more shortness of breath. The respiratory therapy was called to provide breathing treatment so patient can feel better; however, it did not help at all. Although ADN nurse was reviewing patient H&P, medical history to collect data to analyze the problem to call the MD; however, she was not able to focus better intervention and outcomes. In meanwhile, Lead RN provided better intervention to make the patient more comfortable such keep head elevated, monitor I &O closely, assess every two hours and monitor patient more closely, then MD was notified and addressed the problems such as patient might me fluid overloaded. BSN nurse made better decision than ADN nurse because It might be due to working in nursing field since so many years; however, she had advance knowledge in depth to provide healthy and safe care to the patients. In fact, the nurses who holds BSN degree at work has stronger leadership skills and critical thinking than Associate
The modern nurse has much to be thankful for because of some of the early pioneers of nursing, such as Florence Nightingale and Jensey Snow. However, the scope and influence of professional nursing, as well as the individual nurse, has seen more exponential growth and change in North America since the establishment of the first professional organization for nursing, the Nurses Associated Alumnae of the United States and Canada, which in 1911 came to be known as the American Nurses Association.
Q.3 Nurses as part of regulated health care practitioners are responsible and accountable to abide by the standards, codes and guidelines of nursing practice (NMBA, 2016). The nurse in the case study has breached the standard 1.4 of the Registered Nurse Standards for Practice. According to standard 1.4, the registered nurse should comply with "legislation, regulation, policies, guidelines and other standards or requirements relevant to the context of practice” when making decisions because this will be the foundation of the nurse in delivering high quality services (NMBA, 2016). The nurse in the scenario did not follow the hospital policy concerning “Between the Flags” or “red zone” and a doctor should be notified of this condition. Furthermore, the nurse failed to effectively respond to a deteriorating patient.
According to American Nurses Association (ANA), (2010) “the nurse promotes, advocates for and strives to protect the heath, safety and right of the patient” (p. 6). Nursing responsibilities should be acted at the highest standard and must be based on legal and ethical obligations.
Unprofessional Conduct according to the Arkansas State Board of Nursing is detailed in ASBN Rules and Regulations, Chapter 7, Section XV, #6. The section states the following conduct are considered unprofessional. Failing to assess, evaluate, and intervene, Incorrect documentation, Missappropriation of residents property, Medication and Treatment errors, Performing or attempting to perform procedures that the nurse is untrained to do, Violating confidentiality. Neglect/Abuse or failure to report these incidents, Failing to report violations or attempted violations to the ASBN, Inappropriate delegation of duties, Failing to supervise, Practicing when unfit.
The American Nurses Association Code of Ethics for Nurses has five elements that pertain to the Principle of Autonomy. Each individual element applies to “respect individual persons” (Baillie, McGeehan, Garrett T, M., Garrett R. M., 2013, p.33). In Chapter 2 of the Health Care ethics: Principles and problems text, it discusses thouroghly the consent of an individual to make their own decisions regarding their health and future requests of care. As a nurse or within all heath care professions, we must treat each individual patient with care, respect, and to remain mindful to the patient regarding any aspect of their lives. In the ANA Code of Ethics for Nurses, it explains ways of maintaining the empathy required in the health field. It further discusses that the respect for human dignity must be a priority, relationships to patients must remain neutral, the severity of the situation, the right to self-rule, and the professionalism that must be upheld by the nurse and their associates.
is the duty to do no harm. The nurse first needs to ask him or herself what
Delegation is assigning a task and its responsibility to another who is able to perform it, while with holding the accountability (Silvestri, 2013). To regulate delegation, each state Board of Nursing enforces their Nurse Practice Act. The Nurse Practice Act varies by state, but is a detailed guideline which recognizes the 5 Rights of Delegation to follow when delegating specific tasks. It also defines the nurses’ scope of practice, education/ license requirements, and sets the consequences for noncompliance with the Act, such as license suspension and reinstatement (Rosdahl, 2012). Improper delegation can be harmful, and without these guidelines malpractice/negligence can result. Negligence is the result of a person not acting reasonably. When healthcare professionals’ actions results in negligence it is considered malpractice or professional negligence (Rosdahl, 2012). Nurses are held liable for their actions for instance: not providing safe patient care by delegating untaught procedures to other nurses or failure to question physicians’ orders if they seem wrong and not reporting medication errors are just a few that may lead to
There are many themes that present in literature about delegation. American Nurses Association(ANA) defines delegation as the transfer of responsibility for the performance of a task from one person to another. The National Council of State Boards of Nursing(NCBSN) defines delegation as transferring to a competent individual the authority to perform a selected nursing task in a selected situation. I think delegation is a skill that needs to get proficient. Kleinman and Saccomano(2006) state that the nurse must be taught delegation skills, both in academic and clinical settings. The use of unlicensed assisted personnel(UAP) or licensed practical nurse(LPN) is essential in todays health care because of the increased acquity of patients and increased custom-service approach.