Question

Case Study: Inappropriate Delegation A Nurse Manager hires a nurse to work part-time evenings and every other weekend on a 42 bed medical/surgical unit. The Nurse has been out of school for two years and this is her first job as a staff nurse in a hospital setting, prior to this she worked in a physician's office. Shortly after completing orientation the nurse was assigned as the "charge nurse" for the next several weekends. After the nurse's first weekend as "charge nurse", the Nurse Manager receives the following complaints: From other licensed staff: "It seems like she just picked out rooms to make the assignments. She didn't listen to the report first or check the charge nurse report sheet. She didn't state any concerns at that time and seemed more concerned about her own patients and getting her medications out on time." From the Unlicensed Staff: "She asked me to do things I have never done before! When she told me to hang the tube feeding, I said I can't do that and she said JUST DO AS YOU ARE TOLD." From the Nurse: "I don't understand what the concern is? The tube feeding is just putting fluid into a bag. In the doctor's office, the assistants do all kinds of stuff, and besides I had my own patients…what is the big deal?" Questions for Discussion: 1. List 3 principles of delegation and supervision that were violated in this situation? 2. How could have the unlicensed staff person advocated for herself? 3. If you were working with this charge nurse what would you have done?

Answer 1

1.

• The nurse has violated the principle of absolute responsibility while making out the assignments by not checking the charge sheet,assigning the desired staff for getting the results
• The principle of parity of authority and responsibility has been violated by defaming the work of licensed nurse by a unlicensed nurse
• The principle of control is lost and violated by the nurse by coming out with her own clinical experience which is irrelevant to the situation

2.The unlicensed staff could have advocated for herself by

• Having a knowledge between what is right and not
• Getting support from others
• Explaining calmly about her situation

3.The orders of charge nurse has to be carried out but at the same time it should not go out of the scope of ones practice.In those cases things could have to be said to that charge nurse regarding it ,doing so can avoid consequences in the future.