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Essay : Patient-focused care.

Scenario 3 Case details

You are the recently graduated registered nurse working on a unit that practices patient-focused care. The particular unit practices a version of patient-focused care consisting of one registered nurse, one enrolled nurse, and one nursing assistant for a group of patients.

You as the registered nurse, delegate tasks to the nursing assistant and assigns care that the enrolled nurse is permitted to do according to the registering bodies in Australia. The nurse completes report at 0730. The nurse has the following assignment for the 0700 to 1530 hrs shift:

Bed 1: Mr. K is a 42-year-old woman with moderate right upper quadrant pain who has vomited little amounts of yellow bile and whose symptoms have worsened over the past week and is awaiting an ultrasound and required IVF to be commenced whilst NBM.

Bed 2: Mrs is a 79 years old and has recently been admitted and treated for community acquired pneumonia (CAP) and Deep Vein Thrombosis (DVT). She states she is becoming increasingly SOB and is was unable to sleep much overnight.

Bed 3: Ms. T is 50 years of age and is a female patient who is day 1 post-operative bowel resection who needs a potassium infusion. The doctor has prescribed the infusion for 0800hrs. She also has an initial stoma bag change that will need changed when the surgeon rounds at 0800hrs. She has multiple IV medications ordered and IVF running at 12/24 currently. She has pressed the call bell, as she feels like her heart is fluttering and she feels “weird.”

Bed 4: Mrs N has just been brought up to the ward from emergency. She is 64 years old, and her local doctor recommended that she be admitted to the hospital to help stabilise her Type 2 diabetes. The doctor has ordered bloods to be taken via venipuncture and a BGL for 0730hrs and has asked she been kept NBM until the results are back from pathology. The dietician has phoned and has asked you to also order a Diabetic Diet from the kitchen.

Bed 5: Mr. W is 24 years of age and is a male patient who is scheduled for a R) shoulder arthroscopy at 0900 hrs. He needs preoperative teaching.

Bed 6: Ms. L is 60 years of age and is a female patient who is scheduled for an MRI in the Radiology Department at 0830 hrs. Someone from the health care team will need to take her via wheelchair.

Bed 7: Miss H is a 69-year-old female of Aboriginal Indigenous orientation. Edith presented to the Emergency department with exacerbation of COPD 5 days ago. She has completed a course of steroids and IVABS for an underlying chest infection and is for discharge today. She is confused and presses the call ball constantly asking when her daughter is coming. She required discharge education.

Bed 8: Mr Henry Benjamin is a 73-year-old gentleman who was admitted to hospital following a fall in his home in which he fractures his right neck of femur. He is booked for surgery at 1700hrs and has received pre-operative education.

Before leaving the handover room, what tasks would you consider delegating to the nursing assistant?
Which patients should the registered nurse care for during the shift and which patients should be assigned to the enrolled nurse and why?

Using the 5 principles of delegation identify what tasks you might delegate to each staff member and why.