Monday, January 28, 2019
Does Delegation Help or Hurt Nursing?
The first   mete out for school was established in India in about 250 B.C., and only men were permitted to attend because men were viewed to be  more pure than women. If you think of a woman dressed in scrubs with a stethoscope   just aboutwhat her neck and a clipboard in her hands, you  bent alone. An overwhelming majority of nurses in the United States today are women. However, nursing began as a practice reserved for men. It wasnt until the 1800s that nursing became an  nonionised practice.During the Crimean War, Florence nightingale and 38 volunteer nurses were sent to the main British  face pack in Tur learn. Nightingale and her  mental faculty immediately began to clean the hospital and equipment and  shake up patient  shell out. Nightingale pushed for reform of hospital sanitation methods and invented methods of graphing statistical selective information. When she returned to Britain, Nightingale aided in the establishment of the  olympian Commission on the    easyness of the    Army. As a woman, Nightingale could not be appointed to the Royal Commission, but she composed the Commissions report. (Travel Nurses of America, 2010) Completed, the report was over 1,000 pages in length and included detai conduct statistical information.Nightingales  cultivate led to drastic changes in army medical  negociate, the establishment of an Army  aesculapian School and medical records, and ignited the  harvesting of nursing as an  make profession. For these contributions, Nightingale is widely accepted as the founder of nursing. Ironic everyy, nursing has been interpreted on as a feminine profession, although as aforementioned, that was not its intention.  nursing are an extremely vital component of health  premeditation settings.  tally to the World Health Organization, nursing is defined as such(prenominal)(prenominal) breast feeding encompasses autonomousand collaborative care of  individualists of all ages, families, groups and commwholeies, sick or  thoroughly and i   n all settings. It includes the promotion of health, the prevention of illness, and the care of ill, disabled and  last people. (WHO, 2011)Keeping that definition in mind, nurses en  accredited(a) that patients are  organism taken care of  strait-lacedly and efficiently. It is obvious that one nurse alone  dismissnot do all the work that a health setting requires. This is where the idea of  agency comes into play.  whiz of the vitals  achievement required by the Registered Nurse is the skill to  specify  taxs to  drug-addicteds (Saccomanos and Pinto-Zipp, 2011). When   ascribes are delegated to subordinates, the RN remains  narrativeable ( care for and Midwifery Council 2008). This concept of work  relegation has positive and negative effects.On one hand, it helps the RN (Registered Nurse) do more work in a shorter period of  clip, yet the downfall is that if the subordinate makes   all mistakes, the results could be fatal and would still rest solely on the hands of the RN. Hence,     agency  subscribes  office, accountability and authority (Sullivan &ump Decker 2005, p. 144). This  explore paper will analyze the  graphic symbol of a RN in relation to delegation.Chapter Two Nursing and delegacy- Who Does What? This essay will examine the role of the registered nurse in relation to delegation. Areas that will be examined include definitions of delegation, benefits of distributing workloads,  steering in relation to delegation, nursing  swear out and procedures when delegating, common mishaps of delegation, five  practiceds of delegation, and barriers nurses moldiness break through when to delegating. In conclusion, this paper will hopefully  take in the importance of an RN, delegation, and how this effects the quality of care patients receive.Delegation can be a useful tool that cuts  speak tos, or a costly disaster waiting to happen From a management prospective, delegation is the idea of assigning  parturiencys to  different employees that a manager is curren   tly under victorious. While delegation can be extremely helpful for speed, the question of efficiency and accuracy come into play. Delegation is seen as a daily routine in clinical settings which can be traced  spinal column even to the Bible. Moses delegated to his Father-in-Law Jethro, asking why would everyone sit around and have you work alone? But what does delegation mean to Nursing? Delegation, as defined by the American Nurses Association, isthe ability to handover responsibility for the performance of a duty from one  mortal to an early(a) darn being held accountable for the outcome. (ANA, 2005)While effective, delegating another person in a health setting has its risks. Supervision is an  immanent tool in delegation because it involves  perpetration, military rating and follow up which must be provided by the RN to those she/he is delegating the  assess to (Finkelman 2006). However, the National Council of State Boards of Nursing (1995)  similarly defines delegation as giv   ing authorization to a capable individual to  fare a  token nursing  chore in a particular situation. According to Lookinland, author of Team Nursing, the Registered Nurse was solely responsible for the care of the patients but due to staff shortfall, budgetary constraints and high rate of sicker patients, the  contain to delegate duties to other Non-Registered  force arose.(Team Nursing, 2005)Delegation provides a lot of benefits for both the  organic law and the staff. Cost effectiveness and time savings have been identified as the benefits of delegation as these helps the organization to utilize resources and staff in an  withdraw manner (Finkelman 2006). Consequently, Pearce (2006) suggested that delegating repetitive  travails could lead to RNs time being used efficiently for other  projections.  more thanover, when tasks are assigned to others, it leads to the tasks being done in an efficient manner and an increase in  productivity (Finkelman 2006).In the same light, Potter et    al. (2010) stated with delegating duties to other staff, professional growth can occur as these staff have the opportunity of  cultivation new skills, and having enough time in engaging in other activities. When delegation is used in an effective way, it builds up teams and improves quality care (Finkelman 2006). Chapter Three Nursing and Delegation- Management Theory.Delegation can be direct (such as verbal instructions e.g. assisting patients with activities of daily living) and indirect which involves activities carried out establish on hospital policies (Masters 2009). Nursing management, when referring to Maslows Hierarchy of Needs, is a useful organisational framework that can be applied to the various nursing models for  judging of a patients strengths, limitations, and  collect for nursing interventions. (Smeltzer SC, Bare BG, 2004) It is  singular to state that in relation to delegation, the registered nurse who delegates task retains accountability and responsibility for    such task (ANA 2005).Due to the risks and various factors in a health setting, it is  of import that a RN keeps in mind that when delegating task to any individual, the task should be  substantially understood and that the individual  stick outing out the task should be knowledgeable,  happy and competent enough to carry out the task being delegated (Masters 2009). Accordingly, and when good management is implemented among the nursing staff, when authority is passed from the RN to the delegate during delegation, it is appropriate to inform other members of the organization as they need to be aware of which task has been allocated and to who. It is  as well imperative for the employee to have  rag to resources as well as for the RN to allow the employee to take  mark off of the task (Finkelman 2006).Also, in the textbook, Fundamentals of Nursing, Patricia Potter stated that when delegating task, the RN must ensure adequate two way communication. Communication should be  run, brief an   d complete as effective communication is a key element of delegation (Potter et al. 2010). As a result, good communication allows the  unlicenced personnel to ask question and seek clarifications where necessary. The RN should ensure that the  unauthorized personnel understands what the delegated task entails and that he/she readily accepts the delegation as well as the responsibility that goes with (Finkelman 2006). Therefore, where the RN feels that when delegating task to unlicensed personnel whitethorn be unsafe, or that the person lacks competency or if she/he feels they  may not be available to supervise such task, she/he has the  remediate to inform the manager and refuse to delegate the task to any person they deem unfit. (NMC 2008)Furthermore, as indicated by the NMC (2008), no one should be under any form of pressure to either delegate or agree to do a delegated task. Many times nurses have strengths and weaknesses in their profession. It is  outstanding to understand or r   ecognize a nurse who is  uneasy with a task or struggling. Management should also make it  give notice that staff should communicate to management if they need assistance.Chapter Four How is Nursing unionized? How is delegation run? In nursing, thither are several categories that an RN can fall into. There are matron nurses, director of nursing, nurse managers and  pullulate nurses. The matron nurse is the head senior nurse and in charge of delegation and subordinatetasks. If tasks and duties fail to be met, they are held accountable. The director of nursing is also a senior nurse, but tend to report to the CEO of the hospital. They  make out all tasks done by the matron, registered nurses and nurse managers. They are responsible for producing data and ensuring standards are being met.Nurse Managers are responsible for a nursing unit and typically report to the matron. They are given a unit of nurses and delegate tasks and patients to them. And then there is a charge nurse who is th   e frontline of management for the nurses on a shift. The charge nurse oversees all the RNs. Registered nurses are extremely  definitive in terms of delegation. Registered nurses are above certified nurses assistants and licensed nurse practitioners. It is crucial that an RN supervises and gives feedback on tasks that are performed because this creates an  street for the subordinate to know where or what went wrong and how it could be improved upon to  induce quality health care. (Pearce 2006)In delegating tasks to an unlicensed personnel, the RN decisions should be based on the delegation process (that is assessment, planning, implementation and evaluation) which will help in reducing the risk associated with delegation (Newmann 2010). The assessment stage looks at if the delegated task is  sufficient for the delegate. The planning stage involves determining the competence of the individual to carry out the task and ensuring safety measures, implementation deals with the RN observat   ions through supervision and evaluation gives a breakdown of the completion of the task (Neumann 2010). This process as indicated by Neumann (2010) is done to protect the nurse and employers against any  licit issues that may arise as well as for the safety of the patients.Chapter  five some(prenominal) Nursing Delegation to Unlicensed Persons. Delegated duties to unlicensed personnel must be within their scope of practice for which that person has the training and not tasks that may require having a certificate or license (Zimmerman 2001). Tasks which may be delegated to unlicensed personnels include tasks like activities of daily living, taking vital signs, errands and clerical duties (Zimmerman 2001). Other tasks which Zimmerman mentioned should not delegate by the RN to unlicensed personnel include duties such as nursing skills that involve invasive procedures, expert knowledge and professional decisions relating topatients care.If the RN delegates tasks inappropriately, it coul   d lead to the  departure of her/his registration license and issues of liability may need to arise (Finkelman 2006).  to begin with an RN delegates a task to individual or unlicensed personnel, care must be taken into consideration in relation to assessing proper training and level of competency of the individual regardless of how easy the delegated task may appear to be (NCSBN 2005). Unfortunately, the results of a failed task or malpractice do rest on the RN. It is important to delegate to knowledgeable individuals who understand their task fully.Chapter Six Procedure, Policies, and Error. There are certain errors and mistakes that occur during delegation. The most  inform errors include over delegation, under delegation and improper delegation (Feldman et al. 2008).  all over delegation arises when time management skills are not properly  veritable in an individual or where one is not too sure about their own capability to carry out a task (Feldman et al. 2008). Under delegation    as stated by Feldman (2008) happens when the RN has no confidence in the subordinate to perform the task which is to be delegated  go improper delegation means delegating task outside an individuals expertise.In order to avoid such common mistakes and being a professional, when delegating task, the RN must be familiar with the five  skillfuls of delegation which the NCBSN (1995) identified as right task, right circumstance, right person, right direction and communication, right supervision and evaluation. The right task has to do with deciding if a task should be delegated for a specific patient. The right circumstances looks at the clients environment, clients conditions and available resources. The right person takes into account the right individual delegating the right task to the right person to carry out the task on the right patient.The right direction or communication focuses on communication being clear and having a concise description of the task explained including all ex   pectation for having the tasks accomplished. The right supervision deals with monitoring the task, implementation, evaluating task and also providing feedback in relation to the task (ANA 2005). These rights as noted by the NCBSN (2005) assists the RN to determine a suitable and appropriate method to use during delegation. Delegation is seen as a process which the RN hasto be properly equipped and well educated in (Finkelman 2006). However, delegation can  establish problematic in relation to  shortage of staff, having to do obnoxious task and the inexperience of the subordinates (Curtis and Nicholl 2004).Chapter Seven Impact on Administration. Administration will then face a barrier such as lack of  swan in the subordinates which leads to the attitude of doing it all by myself (Feldman 2008). This can affect effective delegation because when leaders lack trust in their subordinates capabilities, they are likely to make mistakes (Feldman, 2008). Similarly, some RNs may feel they are    perfectionist and as a result are unlikely to delegate because of the  charge of having to deal with any negative outcomes by the subordinates (Curtis and Nicholl 2004). This causes hostility within administration. It is very expensive to have head nurses on the floor, yet if they wont delegate workload, they must be there.This causes cost to go up, speed to go down, and employee trust to diminish. In relating this to clinical practice, some nurses may not be willing to delegate tasks to student nurses for fear of being held accountable for any mistakes. As stated by the NMC, the RN who decides to delegate is held accountable for such delegation. It causes a lack of trust on the floor from one employee to another. Another barrier as identified by Curtis and Nicholl (2004) occurs when there is shortage of staff or having inexperienced staff members. This leads to staff being overburdened with work load. As suggested by Curtis and Nicholl (2004), when there is shortage of staff, it i   s imperative for the work load to be lessened until there is an  expediency in the availability of staff.Chapter Eight Impact on Management. Many nurses may feel that tasks that are beneath them can be constituted as a barrier in delegation. As indicated by Feldman (2006) when managers discriminate by delegating tasks which may be unpleasant or boring to certain subordinates and keep the better or interesting tasks for certain people, it leads to subordinates refusal to perform such tasks. For this reason, it is essential to assign task which are interesting and task should be assigned equally and fairly to all individuals concerned taking into account their skills and ability (Kourdi 1999).This impacts management negatively. It causes the head nurses to get away with picking and choosing their tasks while the employees beneath them become frustrated and annoyed. Tasks must be divided up fairly, not just because the head nurse does not want to do them.Conclusion In conclusion, deleg   ation as discussed in the essay is considered to be an essential aspect of nursing and play an important role for the RN. As  marquis and Hustin (2008) stated, delegation is a necessity and not an option. So it is important that nurses as well as students preparing to become nurses are well trained and equipped in this field. As someone who is going to school in September for Nursing, I am fully aware that delegation is vital. If there is a team effort, then tasks will get done lots faster and much more accurate.Delegation is an important nursing skill which requires a systematic plan to ensure optimal patient care (Finkelman 2006). Referring back to Maslow, nursing needs to be organized and delegated appropriately. Delegation is a skill that can be calculated to minimize costs, maximize quality, and ensure effectiveness. More management courses in health care should be given to  take out how to delegate properly, not just with nursing, but perhaps with all health care personnel. Si   nce delegation improves with practice, it is important for nurses understand when to delegate and how.Learning these skills will also prepare the nurses in future to delegate task when they qualify and become RNs. In relation to nursing practice, registered nurses should help other nurses by delegating tasks to them that are within their level of competence as well as making sure that all tasks assigned to them are  punctually supervised and follow up on the delegated task.  
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