The Nurse Practice Act defines the process of Delegation as Authorizing an unlicensed person to provide nursing services while retaining accountability for how the unlicensed person performs the task. It does not include situations in which an unlicensed person is directly assisting a RN by carrying out nursing tasks in the presence of a RN (Texas Board of Nursing). The nurse must consider patient safety as priority while assigning task to LPN/ Unlicensed Nursing Assistant. The five rights of delegation that is right task, the right person, the right circumstances, the right directions and communication by RN and right supervision by RN can help guide Registered Nurse in assigning patient care to LNP and UNP. The Registered Nurse must also
According to The Rule §224.8 Delegation of Task the rule states “(5) personal hygiene and elimination, including vaginal irrigations and cleansing enemas” this task can be assigned to the UAP. The nurse was administering morning medications to one of he patient, when the other assigned patient needed help ambulating to bed side commode for elimination. The nurse assigned the UNP to help the patient with bedside commode. Before assigning the task, the nurse communicated with the UAP about the patient surgical history, patient physical strength, and safety precaution while assisting the client. Once the task was completed by the UNP, the nurse assessed the patients and patient bed for safety and provided positive feedback to the
Nurses are always exposed to situations or often interact with others where their values or belief might contradict with others. Conflict can often lead to distress and increases stress in the workplace environment, however if handled appropriately it can promote growth and understanding amongst the staff.
One example of conflict observed at unit 18 tower at Chi St Luke’s Hospital is as follows. Staffing and scheduling is the number one conflict that the management has to address on the regular basis. One nurse on the unit was upset with her schedule for coming week. As per the nurse she requested off for that day, however she was still scheduled to work that particular day. She talked to the nurse manager about the situation, however the nurse manager responded that the time frame for requesting off was too short and the schedule was made prior to the request. However, the nurse said she did notify the manager about her unavailability for the particular day. The nurse manager explained the policy to the nurse and recommended the nurse to communicate with other nurses who must be willing to change schedule for the particular day. The nurse communicated with other nurses about her situation and requested for favor for work for the particular day. One of the nurse
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)
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
The comparisons of Licensed Vocational Nurses (LVN) and Registered Nurses (RN) are simply the bases for all nurses. LVNs and RNs protect the patient’s privacy, provide safe environments, and administer medications and treatments. The Texas Administration code (2007) says all nurses will, “accurately and completely report and document: the client’s status including signs and symptoms; nursing care rendered; physician, dentist or podiatrist orders; administration of medications and treatments; client response(s); and contacts with other health care team members concerning significant events regarding client’s status”(D). Nurses are to maintain a professional nurse-client relationship; it is their responsibility to know and recognize what that entails. Nurses are bound by law to provide nursing care without discrimination regardless of age, sex, sexual orientation, ethnicity, nationality, religion, health problems or socioeconomic status. Some other similarities include measures to prevent the spread of infectious pathogens, collaboration with other health care team members and patient, prevent patient harm.
As a nurse it is our primary job to protect and promote the well being of patients throughout the health care industry. Each nurse has the responsibility to practice faithfully and to uphold all ethical values. These values are outlined and regulated by two very important entities, The Nursing Practice Acts and the Texas Board of Nursing. Nursing Practice Acts, are specific laws in each state that define a nurse’s scope of practice. These acts were first established in 1909 with the purpose of protecting public health, safety, and welfare. Their purpose is to provide rules and regulations that will protect society from unsafe and unqualified nurses. Nursing professionalism is rooted in the ethics and ...
...iation. (2009). ANA Position Statement: Patient Safety: Rights of Registered Nurses When Considering a Patient Assignment. Washington, DC: Author.
delegate to other LPN and nursing assistants but can’t delegate higher to a registered nurse. The
There was inappropriate staffing in the Emergency Room which was a factor in the event. There was one registered nurse (RN) and one licensed practical nurse (LPN) on duty at the time of the incident. Additional staff was available and not called in. The Emergency Nurses Association holds the position there should be two registered nurses whose responsibility is to prov...
College of Nurses of Ontario,(2009).Practice Guidelines: Conflict prevention and management. Retrieved April 3, 2014 from http://www.cno.org/Global/docs/prac/47004_conflict_prev.pdf
Conflict has been an issue for man since the dawn of civilization. In today’s fast paced world conflict, especially in the workplace, is a frequent occurrence. When that workplace is a health care environment where lives are at stake, emotions run high and collaboration with many different disciplines is required conflict often becomes a prevalent part of everyday life. Conflicts in the workplace can lead to reduced morale, lowered productivity resulting in decreased patient care and can cause large scale confrontations (Whitworth 2008). In the field of nursing whether a conflict is with a peer, supervisor, physician, or a patient and their family, conflict management is a necessary skill.
In the hospital setting, being able to work well with other colleagues within the department is indispensable to efficacy and effectiveness in patient care. The situation of the night shift described by relations between two female CNAs with 20 years’ experience each and the new hire CNA within a mark positioning is conducive to conflict. Both CNAs attitudes changed toward to work and work environment gets more unpleasant since new arrival. The conflict may be characterizing the detection of transformations between a group of employee’s dues to difference in values, attitude, beliefs or goals (Sullivan, 2013). Sullivan (2013) described structural conflict as poor communication, competition, opposed interests, and lack of combining insights
Among the nursing staff, they claimed that it is hard to complete their task because of the poor communication resulting from the incivility. This had a great impact on patients’ safety because nursing is all about communication with other health care providers in order to deliver the best care to patients. If communication is not effective, chances are error will occurs. For example, nursing needs a good shift report from the nurse in the previous shift in order to understand the patient’s condition and provide for them the best care that shift, but if they do not receive a good report or a thoroughly report that causes them to miss something that the patient will need or have had, error will then
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.
Question one and twenty were similar in the type of remediation that was necessary in order to stop the conflict from occurring. The theme that the student noticed with the question was the nurse’s role of stopping the person from becoming upset, before solving the problem. She learned by answering these questions that remediation is the priority in this situation. Being able to calm the situation before addressing the problem and solving the bigger issue. Additionally, for question twenty, by process of elimination option three was wrong because it was not therapeutic communication and it did not solve the immediate problem, the doctor’s anger. Reporting the incident to the chief nursing officer was unnecessary, and would only heighten the issue (Towson University, 2017). Option one is not wrong, but it is not the first thing the nurse should do, this is the option the student wanted to pick in the beginning. However, the question required her to reread and identify the stem of the question, the doctors anger. Hargrove – Huttel & Cadenhead (2009), reinforced this rationale by providing a deeper rationale that the charge nurse’s first action is to diffuse the doctor’s anger especially since inappropriate behavior should not be at the nurse’s station (pp.