Discuss What Tasks Could You Delegate To The UAPs?

Question

You are working the night shift on a medical unit and have been assigned charge nurse responsibilities. You are working with four RNs, one LPN, and two UAPs. A client becomes pulseless and is not breathing, and the nurse assigned to the client’s care calls a code. The nurse is occupied at this client’s bedside for 1.5 hours until the resuscitation effort is completed, and the client is transferred to the intensive care unit. This nurse also has four other assigned clients. In addition to the nurse assigned to care for the client requiring resuscitation, two of the other nurses working on your unit are assisting in the code.

Review the case study and write an essay (suggested length of 2–3 pages, excluding title page and reference page) in which you do the following:

Discuss what tasks could you delegate to the UAPs?
The LPN working on the unit is a new graduate and has been employed for only 4 weeks. How would you collaborate with this nurse when delegating tasks for completion?
Discuss how you will maintain the safety of the other clients on your unit while three nurses are occupied with the client requiring resuscitation?
Explain how might effective delegation to other team members contribute to care of the clients on the unit? (Remember, this is not a question about the patient that is coded, but how you will handle the unit while you are short staffed).

Solution

Delegation

While each patient deserves to receive necessary nursing care, circumstances may arise in which this becomes impossible. Therefore, it might be necessary to delegate some of the nursing tasks to other professionals in the practice environment. This paper thus considers a practice scenario and discusses the delegation of nursing tasks, patient safety, and effective delegation.

Tasks to Delegate to UAPs

Undoubtedly, nurses may find it necessary to delegate some of their nursing tasks to other personnel. As a nurse, one must know the nature of tasks that they can delegate to unlicensed assistive personnel (UAP). Tasks typically assigned to UAPs are those relating to assistance with basic comfort and hygiene as well as activities of daily living (National Council of State Boards of Nursing, 2016). Consequently, UAPs may assist with activities such as grooming and ambulation of patients, recording vital signs, observing changes in the patient’s condition, and providing nonpharmacological interventions for the patient’s comfort such as therapeutic back rubs (Yoder-Wise, 2018). A nurse may not delegate some tasks to UAPs such as assessments and nursing diagnosis because they require their professional knowledge and critical thinking (National Council of State Boards of Nursing, 2016). Therefore, a nurse may delegate basic hygiene and comfort activities to UAPs.

Collaboration When Delegating Tasks

When delegating tasks, nurses must collaborate with the delegates to ensure successful delegation. The nurse must remember the need to delegate to the right person as one of the five rights of delegation (Wagner, 2018). The LPN in this case has only been in employment for 4 weeks and may not have the requisite experience to carry on delegated tasks with the required competency. The nurse has to consider this and may choose to assign them a reduced scope of activities. Alternatively, the nurse may implement a higher level of supervision to ensure that the LPN carries out the delegated tasks properly (Wagner, 2018). It is important to note that the registered nurse remains in charge of the care of patients assigned to them and they must ensure that they do everything to guarantee the highest standards of care (National Council of State Boards of Nursing, 2016). Ultimately, there is a need for collaboration between the nurse and those to whom tasks are delegated.

Safety of Clients

Patient safety remains paramount in the provision of care. In the current scenario, three nurses are occupied with the resuscitation of a patient and there are four other patients who also require care. While the unit is understaffed under the circumstances, it is important to ensure the safety of all the patients. In this case, the UAPs can play the role of observing the patients who are stable and who do not require urgent care (Yoder-Wise, 2018). The LPN can then help administration of medication and updating on any notable changes in the patient’s conditions (Wagner, 2018). Overall, the nurse manager in charge of the unit must coordinate the provision of care in a way that promotes patient safety (Rochefort, Buckeridge and Abrahamowicz, 2015). Therefore, they need to ensure that the care provided to the patients is safe.

Effective Delegation

Effective delegation is important in the provision of care. It is especially significant considering the current practice environment realities such as nursing shortages and increased patient care complexity (Yoder-Wise, 2018). Proper delegation ensures the proper utilization of the resources available and that every patient receives attention. While three of the nurses attend to the coded patient, the other patients also receive care and are not abandoned. Effective delegation thus ensures a team effort that yields efficiency and results in provision of care for all patients (Rochefort et al., 2015). Ultimately, nurse managers must strive to ensure effective delegation.

References

National Council of State Boards of Nursing. (2016). National Guidelines for Nursing Delegation. Retrieved from https://www.ncsbn.org/NCSBN_Delegation_Guidelines.pdf

Rochefort, C., Buckeridge, D. and Abrahamowicz, M., 2015. Improving patient safety by optimizing the use of nursing human resources. Implementation Science, 10(1).

Wagner, E. (2018). Improving Patient Care Outcomes Through Better Delegation-Communication Between Nurses and Assistive Personnel. Journal of Nursing Care Quality, 33(2), 187-193. doi: 10.1097/ncq.0000000000000282

Yoder-Wise, P. (2018). Leading and Managing in Nursing. Amsterdam: Elsevier Health Sciences.