Delegations and Supervisions by a Professional Nurse
A professional registered nurse is in charge of delegating and supervising nursing health care in a facility. These elements enable nurses to provide quality and direct attention to clients. The delegator, in this case, a professional nurse, assigns healthcare responsibilities to the delegatee, who is a member of an interdisciplinary team. One of the most important components of delegation is the nurse’s obligation to provide consistent patient care. Another component that focuses on the delegate’s ability to complete a given task within a specific role is authority. The other component of delegation is accountability, which refers to nursing professionals’ legal responsibility for their activities related to patient care. As a result, the professional registered nurse is always accountable for the outcomes of tasks delegated (Cherry et al., 2016)
A professional registered nurse has five delegation rights. They include the appropriate task, the appropriate person, the appropriate circumstance, the appropriate supervision, and the appropriate direction and communication (Gravlin et al., 2010). According to the right task and person rule, the nurse must balance the right task with the right personnel to handle it. Because the client is at the center of care, their needs must be balanced with the staff’s knowledge, skills, and abilities.
The appropriate situation is one in which the professional registered nurse ensures that the necessary equipment and resources are available and that the delegate has adequate supervision to complete the task. Every delegate requires supervision, and the registered nurse should ensure that the delegate provides feedback after completing the task. The delegate must assess the feedback and outcomes, as well as the overall patient outcome. The delegator must provide direct instructions to the delegate and communicate the expected performance directly. During my practice as a delegator, a fifty-two-year-old man with diabetes and hypertension was admitted. I delegated his care to a licensed practical nurse because he was stable and only required constant monitoring.
Furthermore, the delegator must ensure that the delegates are followed up on as they provide care. Monitoring the care, training the staff member providing the care, offering support and correcting these staff, and congratulating them on a job well done are all part of the supervision. In the previous example of the admitted patient with diabetes and hypertension, I supervised the practical nurse to whom I delegated care. I monitored the care provided by ensuring that every test related to the illnesses was performed and that the practice nurse provided consistent care. I also taught the nurse how to communicate with the patient and his or her family. Through this, I ensured that the patient received quality health care and the nurse established a positive relationship with the patient.
To practice nursing, a professional registered nurse must adhere to professional nursing standards. These standards are divided into two categories: standards of practice and standards of performance. The nursing standards include an assessment in which the registered nurse gathers vital information about the patient. The diagnosis standard is where the registered nurse analyzes the assessment data to determine the patient’s diagnosis. The outcome identification standard requires the registered nurse to identify the expected outcomes for the case in order to plan for the patients’ individualized healthcare. The registered nurse then develops a plan that includes the strategies to be used in order to achieve the desired results. Coordination of health care, health promotion, consultation, prescriptive authority and treatment, and evaluation are some of the other standards in this category (World Health Organization, 2009).
The performance standards include ethics, in which the registered nurse applies ethics while practicing nursing; education, in which the registered nurse obtains knowledge and skills related to current practice in order to provide quality nursing care, evidence-based practice, communication, leadership, collaboration, evaluation, resource utilization, and environmental health (Rassin, 2008). To achieve the expected outcomes, I evaluate a patient using the practicing standards and delegate the patient’s care to the appropriate staff. I also use performance standards to maintain professionalism and a positive working relationship with my colleagues.
References
Cherry, B., & Jacob, S. R. (2016). Contemporary nursing: Issues, trends, & management. Elsevier Health Sciences.
Gravlin, G., & Bittner, N. P. (2010). Nurses and nursing assistants’ reports of missed care and delegation. Journal of Nursing Administration, 40(7/8), 329-335.
World Health Organization. (2009). Global standards for the initial education of professional nurses and midwives (No. WHO/HRH/HPN/08.6). Geneva: World Health Organization.
Rassin, M. (2008). Nurses’ professional and personal values. Nursing ethics, 15(5), 614-630.
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Question 
Prioritization, Delegation & Supervision Discussion
Case Study to Promote Critical Reasoning
Julio works at a large teaching hospital in a major metropolitan area. This institution services the entire geographical region, including indigent clients and, because of its reputation, administers care to international clients and individuals who reside in other states. Similar to all healthcare institutions, this one has been attempting to cut costs by using more NAP. Nurses are often Aoated to other units. Lately, the number of indigent and foreign clients in Julio’s unit has increased. The acuity of these clients has been quite high, requiring a great deal of time from the nursing staff.
Delegations and Supervisions by a Professional Nurse
Julio arrived at work at 6:30 a.m., his usual time. He looked at the census board and discovered that the unit was filled, and Bed Control was calling all night to have clients discharged or transferred to make room for several clients who had been in the emergency department since the previous evening. He also discovered that the other RN assigned to his team called in sick His team consists of himself, two NAP, and an LPN who is shared by two teams. He has eight patients on his team:
•Two need to be readied for surgery, including preoperative and postoperative teaching, one of whom is a 35-year-old woman scheduled for a modified radical mastectomy for the treatment of breast cancer.
• Three are second-day postoperative clients, two of whom require extensive dressing changes, are receiving IV antibiotics, and need to be ambulated.
•One postoperative client is required to remain on total bedrest, has a nasogastric tube to suction as well as a chest tube, is on total parenteral nutrition and lipids, needs a central venous catheter line dressing change, has an IV, is taking multiple IV medications, and has a Foley catheter.
• One client is ready for discharge and needs discharge instructions.
• One client needs to be transferred to a subacute unit, and a report must be given to the RN of that unit.
Once the latter client is transferred and the other one is discharged, the emergency department will be sending two clients to the unit for admission.
1. How should Julio organize his day? Think about how you would set up an hourly schedule.
2. Make a priority list based on the ABC plus Maslow method.
3. What type of client management approach should Julio consider in assigning staff appropriately?
4. If you were Julio, which clients or tasks would you assign to your staff? List all of them.