Delegation

[mimi1jb]

hello everyone,

im a second year student and i am having trouble with delegation and responisibility questions. im doing a case study where i am a charge nurse and when returing from dinner (3-11 shift) i am presented with the following informations. all the other rn's are busy but i have myself, a ward clerk and aiv certified lpn at hand.

i have 6 patients and here are their situations:

1. mr. murphy's iv has infiltrated. she is behind in her iv fluids and she has missed her 6 pm antibiotics. i know that the infusion should be stopped, iv discontinued and sterile dressing applied to the site after cafeul inspection to determine the extent of the infiltration. then i know that the iv should be started in a new site. now my question would be what do i do about the missed antibiotics and loss of time with the iv fluid? i know i would assigned the lpn for this task.

2. a visitor has fainted. i would assign the lpn to assist this patient. i would have him check the person's airway, breathing and circulation. if necessary, begin rescue breathing and cpr. loosen tight clothing around the neck, keep the person lying down for at least 10 - 15 minutes, preferably in a cool and quiet space, if vomiting has occurred, turn the person onto their side to prevent choking, raise the person's feet above the level of the heart (about 12 inches). the ward clerk should not be assessing somebody who is potentially in cardiac or respiratory arrest.

3. the public tiolet is overflowing and waste is pouring out rapidly. this is a biochemical hazard and immediately needs to be taken care of. i just do not know who i would assign this to. the warrd clerk?

4. three patients have not recieved their dinners trays and it is now 7pm. i believe the task would be assigned to the ward clerk.

5. the or has just called and they are on their way to take mr. smith for a cardiac catherization. his preoperative meds have not been givien. the charge nurse would take this task. we havent reached the cardiac lectures yet, and im not able to find anything similar to this in my text but i would imagine you have to tell the or to wait since you may need to oder the pre-op med. im not sure how this situation would ne handle. any help?

lastly, dr. russo is waiting to discuss a medication error that was made two weeks ago. the charge nurse would have to handle this task. why? because she oversees the nursing staff on the floor.

as for list each in order or priority..i believe it would be ..

fainting (#2), the or (#5), iv (#1), the toilet (#3), dinners (#4), and dr. russo (#6)

would that be correct??

thank you in advance,

mimi

[RN1989]

Priority sounds pretty good to me.

Ward clerk needs to be calling maintenance and housekeeping for the toilet and dietary for the trays. She can throw a blanket on the floor to keep the water from coming out of the bathroom.

I think that I would ask the LVN to check and make sure that the consent and meds were done for the OR patient while I worked on the fainting person. If have too, tell OR you have an emergency on the floor and they have to wait. Have ward clerk call for house super or response team to assist with victim and take to ER for check (that is usually most hospital's policy to cover themselves).

Ok for LVN to do IV after OR taken care of. Give missed antbx ASAP and retime doses. Nothing you can do about not getting fluids - this happens a lot. If pt missed large amt of fluids, leave note for doc or consider a call and see if he wants a bolus w/ or w/o lasix, or just continue and watch.

Dr. should be discussing med error with manager not charge nurse.

I sure hope I'm not a pt in your classes "hospital" setting. They are really trying to set you up on this one. :)

[hikernurse]

Priority sounds pretty good to me.

Ward clerk needs to be calling maintenance and housekeeping for the toilet and dietary for the trays. She can throw a blanket on the floor to keep the water from coming out of the bathroom.

I think that I would ask the LVN to check and make sure that the consent and meds were done for the OR patient while I worked on the fainting person. If have too, tell OR you have an emergency on the floor and they have to wait. Have ward clerk call for house super or response team to assist with victim and take to ER for check (that is usually most hospital's policy to cover themselves).

Ok for LVN to do IV after OR taken care of. Give missed antbx ASAP and retime doses. Nothing you can do about not getting fluids - this happens a lot. If pt missed large amt of fluids, leave note for doc or consider a call and see if he wants a bolus w/ or w/o lasix, or just continue and watch.

Dr. should be discussing med error with manager not charge nurse.

I sure hope I'm not a pt in your classes "hospital" setting. They are really trying to set you up on this one. :)

I dunno; kind of sounds like a typical day to me . . .

These priority choices are the same ones I'd have chosen.

I always liked these assignments in school, kind of like putting a puzzle together. And much funner than figuring out acid-bases imbalances, LOL.