Chapter 20 Assignment

Your job is to delegate job tasks to each healthcare practitioner (Use the Staffing Table). Instructions:1. Fill in the Staffing Table or describe what tasks each person will perform during the day shift. o Use a Staffing Model (primary, team, or modular nursing) to help make your decision. 2. Your paper should be: o Typed according to APA style for margins, formatting and spacing standards o Typed into a Microsoft Word document or complete the Staffing Table, save the file, and then upload the file
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Chapter 20 – Assignment
Your job is to delegate job tasks to each healthcare practitioner (Use the
Staffing Table).
Instructions:
1. Fill in the Staffing Table or describe what tasks each person will
perform during the day shift.
o
Use a Staffing Model (primary, team, or modular nursing) to help
make your decision.
2. Your paper should be:
o Typed according to APA style for margins, formatting and
spacing standards
o
Typed into a Microsoft Word document or complete the Staffing
Table, save the file, and then upload the file
Chapter 20
Delegation
Delegation Definitions
• Getting work done through others
• Directing the performance of one or more people to
accomplish organizational goals
• Giving someone else the authority to complete a task or
action on your behalf
• Transfer or hand-off to a competent individual, the
authority to perform a task/activity in a specific
setting/situation
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Strategies for Successful Delegation
• Plan ahead.
• Identify necessary skill and education levels to complete
the delegated task.
• Select capable personnel.
• Communicate goals clearly.
• Empower the delegate.
• Set deadlines and monitor progress.
• Monitor the role and provide guidance.
• Evaluate performance.
• Reward accomplishment.
Copyright © 2018 Wolters Kluwer · All Rights Reserved
State NPA Essential Elements Regarding
Delegation
• State’s NPA definition of delegation
• Items that cannot be delegated
• Items that cannot be routinely delegated
• Guidelines for RNs about tasks that can be delegated
• Description of professional nursing practice
• Description of LVN/LPN nursing practice and unlicensed
nursing roles
Copyright © 2018 Wolters Kluwer · All Rights Reserved
State NPA Essential Elements Regarding
Delegation—(cont.)
• Degree of supervision required to complete a task
• The guidelines for lowering delegation risks
• Warnings about inappropriate delegation
• If there is a restricted use of the word “nurse” to licensed
staff
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Common Delegation Errors
• Underdelegating
• Overdelegating
• Improper delegating
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Causes of Underdelegating
• Fear that delegation may be interpreted as a lack of
ability to do the job completely or correctly
• A desire to complete the whole job himself or herself
• Fear that subordinates will resent delegated work
• Lack of experience in the job or with delegation, or
the need to control or be perfect
• Enjoyment of the work
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Causes of Overdelegating
• Poor management of time; spending too much time
trying to get organized
• Insecurity in the ability to perform a task
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Causes of Improperly Delegating
• Wrong time, to the wrong person, or for the wrong
reason
• Beyond the capability of the person, or something the
manager should do
• Decision making without providing adequate
information
Copyright © 2018 Wolters Kluwer · All Rights Reserved
• Please show Leadership Video Case: Staffing Shortage:
Who Can Handle CRRT? Available as part of Lippincott
CoursePoint for Marquis and Huston: Leadership Roles
and Management Functions in Nursing, 9th edition.
• For more info, visit thePoint.lww.com/CPMarquis9e.
Copyright © 2018 Wolters Kluwer · All Rights Reserved
The Five Rights of Delegation
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Rules of Delegation
• Always delegate to the right person, at the right
time, and for the right reason.
• Say no when you must.
• Reward subordinates for jobs well done.
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Question
Tell whether the statement is true or false:
It is always a bad idea to decline when one delegates a
task to you in a professional setting.
A. True
B. False
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Answer
B. False
Rationale: There are occasions when it is advisable to
say no to a delegated task (e.g., if taking on the task
would compromise your ability to perform other
necessary aspects of your job).
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Question
Tell whether the statement is true or false:
One drawback of delegation is that it diminishes one’s
power.
A. True
B. False
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Answer
B. False
Rationale: Delegating tasks actually increases
the supervisor’s power.
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Clear Communication and Delegation
• Define the task clearly.
• Delineate end results, time frame, and standards.
• Delegate the objective, not the procedure.
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Delegation as a Function of Professional
Nursing
• Organizations must have a clearly defined structure
where RNs are recognized as the leaders.
• Job descriptions must clearly define the roles and
responsibilities of all.
• Educational programs must be developed to help
personnel learn roles and responsibilities of each other’s
roles.
• Adequate programs must be developed to foster
leadership and delegation.
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Types of UAP and NAP
• Nurse extenders
• Care partners
• Nurse’s aides
• Orderlies
• Assistants
• Attendants
• HCAs
• Technicians
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Reminders
• In assigning tasks to NAP, the RN must be aware of the
job description, knowledge base, and demonstrated skills
of each person.
• The UAP has no license to lose for “exceeding scope of
practice” and nationally established standards to state
what the limits should be for UAP in terms of scope of
practice do not exist.
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Criteria for Delegation to a UAP
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Criteria for Delegation to a UAP—(cont.)
Copyright © 2018 Wolters Kluwer · All Rights Reserved
• Please show Leadership Video Case: Problems in
Delegation: A Busy Day on the Floor, available as part of
Lippincott CoursePoint for Marquis and Huston:
Leadership Roles and Management Functions in Nursing,
9th edition.
• For more info, visit thePoint.lww.com/CPMarquis9e.
Copyright © 2018 Wolters Kluwer · All Rights Reserved
“Satisficing” Versus Maximizing Mode
If the delegator requires a higher quality than
“satisficing,” this must be made clear at the time of the
delegation. Not everything that is delegated needs to
be handled in a maximizing mode.
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Monitoring Delegated Tasks
• Managers should ask the individuals to whom they are
delegating if they are capable of completing the
delegated task but should also validate this perception
by direct observation.
• Monitoring delegated tasks keeps the delegated task
before the subordinate and the manager so that both
share accountability for its completion.
Copyright © 2018 Wolters Kluwer · All Rights Reserved
• Please show Leadership Video Case: Problems in
Delegation: Blood Transfusion, available as part of
Lippincott CoursePoint for Marquis and Huston:
Leadership Roles and Management Functions in Nursing,
9th edition.
• For more info, visit thePoint.lww.com/CPMarquis9e.
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Question
Tell whether the statement is true or false:
The one prerequisite for delegating is to ask someone if
he or she is capable of performing a given task.
A. True
B. False
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Answer
B. False
Rationale: In addition to asking the employee, the
employee’s ability should be validated by observation
on the part of the supervisor.
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Resistance to Delegation
• Resistance is a common response by subordinates to
delegation.
• One of the most common causes of subordinate
resistance to, or refusal of, delegated tasks is the
failure of the delegator to see the subordinate’s
perspective.
• Resistance to delegation may also occur when tasks
are overdelegated in terms of specificity.
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Question
What are some common causes for resistance
to delegation? (Select all that apply.)
A. Failure of the supervisor to sympathize with the
employee
B. Delegated tasks are laid out in too much detail
C. Fear of doing the task poorly
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Answer
A. Failure of the supervisor to sympathize
with employee
AND
B. Delegated tasks are laid out in too much detail
Rationale: Resistance to delegation is most common
when a worker feels that the supervisor does not
understand his or her point of view, or when tasks are
overdelegated in terms of specificity.
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Delegating to Unlicensed Assistive
Personnel (UAP)
Potential Costs
• Liability for negligence
• Issues for task delegation
– Job description
– Knowledge base
– Demonstrated skills
• Responsibility for patient outcomes
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Elements Affecting Delegation to a
Transcultural Work Team
• Communication
• Space
• Social organization
• Time
• Environmental control
• Biologic variations
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Question
Which is not one of the cultural phenomena to be
considered with a culturally diverse staff?
A. Time
B. Space
C. Biologic variations
D. Religion
E. Social organization
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Answer
D. Religion
Rationale: Although religion may influence other factors, it
is not one of the six phenomena that Davidhizar and
Giger name.
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Chapter 20 – Nursing Management – Staffing
Staffing Table
Your job is to fill in the following chart or at least describe what assignments each person will have during the day shift today. This is normally
Mary’s job, but you are helping her out since she will probably be pretty busy today. The charge nurse usually only takes one or two patients
along with the rest of their duties, but since she will be with a new grad and an LPN, you are anticipating that she will be busy. Is her being busy
sound like a reasonable projection? It will be your choice what type of staffing model you utilize such as primary, team or modular nursing.
Mary, RN
(Charge Nurse)
John, RN
(New grad)
Sarah, LPN
(LPN)
Mary has been an
RN for 7 years
and has worked in
several different
units throughout
the hospital.
John has been a
nurse for only one
month.
Sarah has been an
LPN for the past 3
years and has not
done her IV
certification
course.
Amy, CNA
(CNA)
Amy has been an
assistant for the
past 5 years.
Patient #1: A 47-year-old woman admitted from the
recovery room at 2:15am after an emergency open
cholecystectomy. Vital signs are stable; she is
experiencing postoperative nausea and vomiting. She is
receiving intravenous morphine on a PCA pump and
antibiotics IV every 6 hours. She is also on a
maintenance IV drip. The T-tube is draining a moderate
amount.
Patient #2: A 20-year-old woman admitted two days
ago with abdominal pain, fever and nausea. She had a
endoscopic cholecystectomy last night and is due for her
first bandage change this afternoon.
NUR 4827 | Leadership and Management Theory
Mary, RN
John, RN
Sarah, LPN
Amy, CNA
Patient #3: A 76-year-old man in respiratory isolation
to rule out tuberculosis. Third morning sputum for AFB
is needed. Vitals are stable; and he is independent of his
iADL’s but has some physical limitations that he is
appreciative of help.
Patient #4: An 60-year-old man with congestive heart
failure (CHF). This patient is a DNR. Family is present
with the client. Respirations are shallow; blood pressure
is beginning to decline at the end of the last shift.
Patient #5: A 60-year-old woman admitted 3 days ago
with left lower lobe pneumonia. She is receiving
intravenous antibiotics, oxygen at 3 Liters N/C. She
spiked a fever to 39.5 C. overnight; acetaminophen was
administered. She receives piggyback antibiotic every 6
hours.
Patient #6: An 82-year-old man admitted 10 days ago
with a urinary tract infection. The infection resolved. He
is now waiting for long-term care placement. He
requires assistance with ADL’s and ambulates with
assistance also.
NUR 4827 | Leadership and Management Theory
Mary, RN
John, RN
Sarah, LPN
Amy, CNA
Patient #7: A 36-year-old woman scheduled for a
bowel resection at 10:00am She is NPO and has an
intravenous maintenance infusion running. Bowel
preparation is complete and preoperative teaching is
done. The consent needs to be signed and the operating
room checklist must be completed. Her pre-medications
must also be administered when called by the OR.
Patient #8: A 55-year-old man in the cardiac
interventional lab having an angiography done. He will
be prescribed bed rest on return and will have a sandbag
on his groin to prevent bleeding while his heparin level
is monitored during the day. His vital signs and groin
site will be checked frequently when he returns.
NUR 4827 | Leadership and Management Theory

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