Delegation and Conflict Management
Delegation can be a good thing because it helps reduce the workload on nurses. It can also be a bad thing because if delegation is not done properly or delegated to unqualified personnel. The nurse is responsible for understanding delegation and proper delegates. Delegation when done properly can benefit both the staff and the patients. For this assignment, I will discuss the assigned critical thinking and answer questions regarding the critical thinking.
Delegation is defined as the process for a nurse to direct another person to complete nursing tasks and activities (Huber, 2014). James is a recently hired registered nurse who is working with the charge nurse, Sherry, and the NAP, Julie. James is responsible for preparing a nonverbal patient for a mastectomy. He is not familiar with this procedure and what needs to be done prior to it. He informs Sherry he is unsure how to prepare this patient for a mastectomy since he never has done it before. Sherry instructs him that all the forms are the same as those for any other surgery.
There are key issues to consider about when to delegate and assign care to this patient. It is crucial for the nurse to understand who they can delegate what tasks to. When the nurse delegates a task to someone else they are transferring responsibility (Huber, 2014). A nurse assistive personnel (NAP) or an unlicensed assistive personnel (UAP) are people trained to function under the supervision of a nurse. One issue is when the nurse feels it is okay to delegate tasks that are only in the nurse?s scope of practice. Perhaps because the UAP has worked with the nurse and they have a trusting relationship or misunderstandings of what is able to be delegated to a UAP. Either way this can lead to harm to the patient. The UAP is also responsible for understanding what tasks they can and cannot perform. The tasks UAP are qualified to perform varies from state to state. A professional nurse who lacks the knowledge, comprehension, and competence to delegate care appropriately not only puts the patient at risk for injury, but also puts his or her own license to practice in jeopardy (Ruff, 2011).
The dimensions of power in this situation is coercive power and legitimate power. Coercive power because James is new and is worried about not performing assigned tasks on time. Legitimate power because James oversees or supervises Julie the NAP and delegates a task he should not have. The conflict is both organizational structure due to low staffing and interpersonal factors due to poor communication. James in uncomfortable with his assignment and is not given much help the charge nurse. James delegates a nursing task to Julie the NAP. The problems presented in this case is shortage of staff, communication errors, James does not feel comfortable and adequately trained to prepare a patient for a mastectomy, James is also a newer hired nurse and is still learning, the charge nurse is not helpful enough, and the patient is nonverbal which increases the chance of errors.
There are solutions to these problems. There should be more nurses working to help with the nine patients needing pre-op care. James should be able to observe a more experienced nurse pre-op the nonverbal patient for a mastectomy. The charge nurse should be more open to listening and supportive to James?s concerns about never performing the assigned tasks before. Nurse leaders and managers play a crucial role in the management of information and communication for the purpose of effective care coordination and the avoidance of unsafe and error-prone care situations (Huber, 2014). James could have communicated clearer to the charge nurse about being overwhelmed with the assignments. The charge nurse could have stepped in and helped James.
To facilitate the patient?s progression to surgery delegation is needed. James could ask Julie to call the patient?s POA to see if she can come in and sign the forms needed. James can then administer the medications needed for surgery and do his assessments with the charge nurse?s help to ensure proper procedures were performed. Work environments under which the members do not feel comfortable to voice their opinions or raise work-related issues could cause conflict between members, compromise work quality and subsequently negatively impact the entire organization (Kim & Oh, 2016). Building better relationships can lead to better patient outcomes. James could have felt more comfortable communicating his concerns with Sherry. Collaboration is a conflict resolution strategy that could have been used in this situation. Accommodating is another strategy that could have allowed better patient outcomes.
If staff refuses to accept delegated tasks the charge nurse has options. One option is to try to understand the reasoning behind declining a delegated task. Understanding why the nurse refuses is a good way to find a resolution. If the nurse is uncomfortable performing a delegated task the charge nurse should figure out if the reason is acceptable.
Delegation can help decrease the workload for nurses. It can be challenging for a nurse to delegate appropriate tasks. It is important for the nurse to feel comfortable delegating tasks. The nurse is expected to practice within the scope of practice. In the above, I discussed the assigned critical thinking and answered questions regarding the critical thinking.
Delegation and Conflict Management
The purpose of this post is to discuss the critical thinking exercise on page 158 of the textbook Leadership and Nursing Care Management (Huber, 2014). I will describe key issues regarding delegating and assigning care to the patient mentioned, dimensions of power and conflict; problems presented, possible solutions, to whom certain tasks should be delegated, and the charge nurse?s options if staff refuse to accept the delegated tasks.
When delegating care to the patient in the critical thinking exercise, the key issues to consider are that there are a charge nurse, a newly hired nurse, and a nursing assistant personnel or NAP (Huber, 2014). The patient is scheduled for a procedure this morning and newly hired nurse states that he is unfamiliar with the preparation for this particular procedure.
The dimension of power at play in this scenario is the dependency aspect of power. All staff members are dependent on each other to care for the patients correctly, the charge nurse depends on the new nurse to care for the patient, and the new nurse depends on the charge nurse to instruct him (Huber, 2014). The problem presented is that the new nurse does not know how to prepare the patient for her mastectomy properly because he has never performed that duty before. There are only two nurses present on the unit, the charge nurse, and this newly hired nurse, and one NAP who is in nursing school. There is only an hour and a half to prepare the patient for the procedure, and there are eight other patients on the unit for whom to care.
There are a couple of different solutions to providing proper care for the patient receiving surgery. One possible solution is that the newly hired nurse assumes care for the patient and the charge nurse explains the proper steps to prepare the patient for the procedure, this could be done using assertive dialogue (Huber, 2014). Another solution would be that the charge nurse uses reassuring communication with the newly hired nurse and assumes care for the patient and gives the newly hired nurse patients that he feels comfortable with providing care. By assuming care of the patient, the charge nurse is resolving the conflict by working around the issue (Huber, 2014).
Another option would be both the charge nurse and the newly hired nurse to compromise, and both prepare the patient for the procedure together which would provide an educational and evaluative situation for the newly hired nurse. The charge nurse should know that proper delegation requires knowledge of which tasks can be delegated safely and understand the limits of the staff to whom they delegate (Kaernested & Bragadottir, 2012).
If staff members refuse to accept the delegated tasks presented to them, then the charge nurse has several options. One option is to use conflict resolution skills such as accommodating and negotiating. If staff members still refuse to perform the tasks, then the charge nurse can move up the chain of command while ensuring that patients still receive care based on their acuity. In conclusion, it is a nurse?s responsibility to delegate care appropriately and safely to other members of the team. A nurse must understand the implications of delegation and know how to handle conflict when it arises to ensure that proper patient care is received.