Question

You have a preceptee assigned to work with you for 6 weeks. She has been a nurse for two years and has been working in an ICU. Her name is Elissa and she is approximately 25 years old. You work on a busy med-surg unit where several nursing assistants have been employed 15 years or more. After 3 weeks you notice she never delegates any tasks to the nursing assistants and she cannot complete all of her work by the end of the shift.

What are some possible reasons for Mindi’s behavior?

How should you as the preceptor guide Mindi in delegating to the nursing assistants?

Using the 5 rights of delegation, develop a plan of action with Mindi.

Your preceptee, Melody, is 40ish. She graduated from a local nursing program 3 months ago and she is now an RN. She has been working with your for 2 weeks. You began her patient load with one patient and she did a great job although she seemed to stay busy with this assignment. She is very thorough in everything she does. Her technical skills are excellent. You have been progressively moving up her patient assignments. This morning you assigned her three patients. She completed and charted her morning assessments. The charge nurse and the unit secretary are away from the floor. Now at 11:00 a.m. she was getting ready to go to lunch and the following things happen?

Mr. Price who was admitted yesterday with DVT complains of acute shortness of breath.

Mrs. Manning’s accucheck is due at 11:00, her IV is infiltrated, and she has a 12:00 antibiotic.

Dr. Lovell is standing at the desk demanding LOUDLY that an old chart be requested to the unit STAT for Mr. Clark who was admitted with pneumonia two days ago and is stable.

How is Melody as a novice or advanced beginner likely to feel in this situation?

What can you as the preceptor do to help?

How would you direct Melody in managing this situation?

Answer 1

Question :1

Ms Elissa has work experience in ICU and she might be dealt with one or two patients in her each shift,so she might be thorough with her each patient or cases in her specific ICU. when she joined in medical surgical unit, staff- patient ratio is different and she has to deal with different types of cases and might not have that much knowledge,skills and exposure or she may not be competent in each case, as she has only 2 years of experience. This can delay her work.It is stated that,several nursing assisstants have been employed for more than 15 years, so as a new joinee,she may hesitate to assign a work to the elder nursing assisstant or  she may not have a good interpersonal relationship to other co workers.

Provide Ms Elissa with job description and list down what all the duties can be assigned to a nursing assistant.Teach her that, nursing assistants are responsible to do the basic needs of the patient and they are there to do their job assigned by registered nurse and no need to hesitate to assign them.

The five right of delegation are, right task, right circostance,right person, right communication,and right supervision/evalution.So the plan of action could be,

- delegate the right task (tasks which comes under their job description) and make sure she had enogh training or experience to do their task.

- help the preceptee , if the patient condition is deteriorating to avoid dangers associated with situation.

- Assign the task, which can be handled by the delegatee or if she show confidence to do that .

- Provide clear and understandable instruction to avoid miscommunication.

- monitor implimentation of delegated task with time management , make corrections if needed and provide feedback.