Leadership in Nursing

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Case scenario 2.
It was a busy evening shift in your ward. Your medication round is behind time and you wanted to speed up the process. You place each patient’s pills in a cup and then, one at-a-time, handed the cup to a student in the medication room to take to the patient. Each of the patients for which she does this is able to swallow the pills and a little water.

Every organization exists to do work, from large hospitals and even to the wards. Work has to be coordinated and performed through the planning of individuals who have the responsibility to ensure the various tasks and different aspects of work are completed. In other words to say, managers have to assign work appropriately to the competency of their staff. “The organizational structure is a formal plan for arranging people in order to their Authority and Responsibility to achieve defined objectives.” (Grohar-Murray & DiCroce, 1992). Based on the scenario, the staff nurse did not assess the student’s ability and competence before delegating the task. There was also poor supervision and wrong direction of what should have been done. In the next few paragraphs I will resolve the problems and demonstrate how it shouldn’t have been a problem at all. Also, define what delegation is and point out how effective delegation applies to the case scenario.

Delegation is “transferring to a competent individual the authority to perform a selected nursing task in a selected situation.” (National Council of State Boards of Nursing, 1995).

First of all, serving of medications is a skill learnt in year 2. The staff nurse in the given scenario just handed out the medicines to the student without even assessing the level of knowledge, experience and competence the student has. “Delegation is sometimes done blindly without envisioning a clear match between a role description and the actual capabilities of the worker.” (Kleinman & Saccomano, 2006). This student could be a year 1 student on his/her first attachment and is ignorant to how the proper technique of serving medications is performed. The staff nurse might have given the wrong task to the wrong person, and the best option for the nurse was to check and ask for around if her fellow colleagues who are of the same seniority or higher are free to help. But based on this scenario, it was a busy evening and of course most of the other staff nurses are busy with their own medication rounds. A better alternative could be giving this task to a more experienced student nurse. At least a third year student has the relevant knowledge and maturity and is able to perform the skill of serving medications using the proper techniques and follow the 5 rights of serving medications. Yet, the staff nurse still has to guide the student or at least observe him/her, regardless of how much the student knows, or how busy the ward is. It is irresponsible for the student to misinterpret his/her abilities, or to carry on unsupervised with a task that he/she is not fully capable of doing well. It is unfair to the patient as there are unnecessary risks involved.

Therefore, delegating the right task to right person is important when it comes to effective delegation. Making sure the nature of the task fits the competency of each student nurse, and not just picking one out of convenience sake.

Secondly, there was poor or even no supervision over the student. The staff nurse actually permitted the student to perform a skill with the least supervision. Grohar-Murray and DiCroce (quoted in IOM, 2001) mentioned that “medical errors kill more people in the United States per year than AIDS, breast cancer, and more motor accidents combined, an approximate 200,000 per year.” The above statement without a doubt proves that medical errors are inevitable. Also, the occurrence rates are at such high numbers. Even trained professionals of much experience make mistakes every now and then; therefore it is very important that the staff nurse ensures...
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