Delegation In Nursing
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Delegation is an essential skill to the practice of nursing. You have had exposure to this concept from your entry into the nursing program. As you progress to your preceptorship it is important for you to understand and properly manage delegation decisions. Review information from the National Council of State Boards of Nursing (ncsbn.org) and the American Nursing Association (ANA) position paper on delegation in nursing in this link and its application to the scenario below. Link (Links to an external site.)
Melinda is a nurse on the medical- surgical unit of her hospital. She received a patient, Mrs. Pierce, as a direct admit from home. She has been calling her doctor yesterday complaining of headache, lightheadedness and blurred vision. She was treated for an inner ear infection two weeks ago with resolution of symptoms that have now returned. Because she has a history of heart problems and diabetes he decides to send her to the hospital for further workup. He has called in orders but will be in to see the patient later this afternoon.
As she engages Mrs. Pierce she says that the headache has decreased but she is still lightheaded and very hungry as she was worried about eating as she becomes nauseated when the lightheadedness is severe. Melinda informs her that her doctor has ordered an antiemetic for her and that she will administer it before breakfast. She asks that patient about any allergies and she reports that she has none. Melinda asks the charge nurse to place a heparin lock while she gets the medication, Zofran, for the patient. On return to the room she administers the medication and informs the patient that she will return to complete her assessment and will get someone to assist her with breakfast.
Melinda has asked Betsy, the nursing assistant, to feed Mrs. Pierce her breakfast because the patient was complaining of feeling very tired but hungry. Betsy notices that Mrs. Pierce is rather sleepy and has to be awakened several times during feeding. While Betsy is feeding Mrs. Pierce the meal, Mrs. Pierce chokes on her food. She remains dyspneic and develops cyanosis. The patient deteriorates and is transferred to ICU where she subsequently dies of complications associated with foreign body aspiration and aspiration pneumonia. The family brings a lawsuit against the hospital, Melinda, and Betsy.
Answer the following regarding the scenario and provide supporting references:
What issues are concerning regarding the actions/behaviors noted in this case?
Was this appropriate delegation? Provide support of why you felt it was or was not appropriate.
What is the responsibility of each of entity (hospital, Melinda and Betsy) as it relates to the five rights of delegation?
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Points will be deducted for not meeting above requirements. Information on what constitutes a substantive post can be found below. The grading rubric is attached.
What is a “substantive post”? A substantive post adds to the discussion and encourages a response from your fellow students. Here are some guidelines to help you earn credit for your discussion posts:
Explain why you agree or disagree, and add some examples to support your belief.
Relate your personal or work experiences to the topic at hand.
Ask additional questions of your classmates.
Make connections between the topics and the readings in the text.
Add ways you can apply lessons from the class to your work and educational life.
Write responses to your classmates that are at least 50 words.
Offer a two-word response like “I agree.”
Talk about something unrelated to the coursework, like a movie you saw recently.
Insult or mock classmates for their opinions. If you disagree, explain why you do — but in a constructive manner.
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