Managers, Nurses and Delegation: Who Has Authority?

[SilverBells]

So wanted to brainstorm through a situation that came up recently.   At my facility, I am normally a nurse manager for a rehab unit.   Because of the COVID pandemic and fewer patients, I have been moved to assist on the LTC unit.  

The other day, when I went down there, one of the nurses listed off various things they were needing help with down on the unit: med pass, feeding people, vital signs, obtaining daily weights, etc.  I explained to her that I could help out with some things, but that I would still be attending to other duties, such as attending morning meetings and completing telehealth provider visits.  She seemed to understand at that time. 

However, about a day later, a patient had requested an enema in the afternoon. I passed this along to the nurse, who stated she would get to it if she had time.  About 5 minutes towards shift change, she mentioned to me that she had never gotten to it, and that the oncoming replacement was a TMA, who isn't supposed to be giving enemas.  In other words, I believe she was implying that I should be the one to do it.   

I gave her a couple of options: I could help finish up with some of her charting so she would have time, or she could pass it along to the evening supervisor.  I explained that I already had admission orders to review from the other unit.  I believe she ended up passing along the task to the evening supervisor.  From my knowledge, the enema was never  given because the patient ended up having a couple of large bowel movements.  

What I am wondering is who had authority in this situation.  The nurse seemed like she wanted to delegate certain tasks to me, but, as a manager, I would think it would be me that determines who completes which tasks, not her.  I guess I'm not sure what should have been done since we each had different opinions on who should do what.  The patient ended up being fine, but just wondering about future situations like this.  

Who does the delegation? The manager or the nurse?  

[Hoosier_RN, MSN]

10 hours ago, UrbanHealthRN said:

 

[Hoosier_RN, MSN]

I just rolled up to work. I found that a tech no call/no showed. I will work as a tech today, regardless of the 11am call I'm supposed to take, the 1pm meeting, and the 3pm interview. The charge nurse is off, so I can't have her do it. I won't throw it onto the floor nurses, they have a hard time remembering the flow. I can, so I will. It keeps me respectable, plus I can keep my finger on the pulse of my patients. It helps when other situations develop. I have a basic knowledge of the patients.

I did ask why they didn't call when tech didn't show. The others told me that they knew that I was already on my way, they had called the few off with no positive result. They didn't want me rushing to get there, risking vehicular safety. I'm going to hate leaving them in 2 weeks...

[TheMoonisMyLantern, ADN, LPN, RN]

22 minutes ago, Hoosier_RN said:

I just rolled up to work. I found that a tech no call/no showed. I will work as a tech today, regardless of the 11am call I'm supposed to take, the 1pm meeting, and the 3pm interview. The charge nurse is off, so I can't have her do it. I won't throw it onto the floor nurses, they have a hard time remembering the flow. I can, so I will. It keeps me respectable, plus I can keep my finger on the pulse of my patients. It helps when other situations develop. I have a basic knowledge of the patients.

I did ask why they didn't call when tech didn't show. The others told me that they knew that I was already on my way, they had called the few off with no positive result. They didn't want me rushing to get there, risking vehicular safety. I'm going to hate leaving them in 2 weeks...

This is an excellent example of a manager who was at the bedside as a nurse long enough, and is an expert in their specialty, to where they know what their staff requires for support during days when you get a surprise no call no show. While Hoozier is no doubt in for a busy day, it might actually be a breath of fresh air to step into a role they don't have to do everyday. 

[Wuzzie]

11 hours ago, SilverBells said:

And it probably stems from the fact that I was double checking an assessment/orders on an admission that someone else was taking care of.   Realistically I didn’t need to be assisting with any part of that admission.  Someone else was working on it and had not requested any help with it.  I was completing a Drug Regimen Review even though 2 other nurses had done one on the same patient 

This. Is. Not. Normal. 
 

OP, I think it would be good for you to talk to a professional about your issues before you tank your entire career. 

[Davey Do]

@Hoosier_RN: Do you recall a statement that I  made recently where I said, "There are threads that are so predictable they make me want to stimulate my uvula with a rounded eating utensil"?

With all due respect to the OP and every other contributing member, this is such a thread. In no way do I wish to derail this thread and take the focus off of the premise of delegation and authority, but am requesting a pause for the cause of consideration.

I have merely briefed over the submissions, So I could be incorrect, and if so, please let me know and I will accordingly appropriately concede that my premise is erroneous.

Here's a typical progressing with such a thread as this: A premise is made in such a way that an immediate emotional response is negatively experienced, and attacks follow. The action of submission could be interpreted in a way that the opening premise is submitted with the desire to elicit negative responses and negative attacking responses subsequently follow.

Attacking a premise is an appropriate maneuver in any discussion or debate. However, in the process of attacking the premise, the person is simultaneously attacked. Why? Because it feels good, but for the sake of my premise, I will not go into that now.

The very first response to the OP contained the essence of an attack, not only on the premise, but the person as well. The person became the premise in the attack. There's where all followed suit. The OP fanned the flames with whatever ammunition they could muster which led to more emotions, and thereby, more attacks.

There's a reason I submit images other than for entertainment value and that is because there is a slight chance that the subtle, symbolic message behind the image will be considered.

For example, I posted an animation of my cartoon character slowly eating popcorn. This was my way of saying, "People, we're watching a drama".

A couple of more attacks were made on both the premise and the person. My cartoon character speeded up the popcorn eating which was meant to convey increasing drama.

I have to leave in a short time to TCB, but please allow me to end with this:

If we merely attack the premise and not the person, there will be no drama and an intelligent discussion, instead of a predictable, drawn out drama will take place.

However, people love drama, so, la sa la BON ton roulet!

 

[Hoosier_RN, MSN]

21 minutes ago, Davey Do said:

@Hoosier_RN: However, people love drama, so, la sa la BON ton roulet!

 

You are 100% correct my friend. Let it roll...but I don't need a spoon, and leave my uvula alone ?

This person and premise has been attacked due to the repeated posts, just reworded

I was going to call for nurse blaq on you popcorn eating. I'm surprised to have not seen them

[TheMoonisMyLantern, ADN, LPN, RN]

20 minutes ago, Davey Do said:

@Hoosier_RN: Do you recall a statement that I  made recently where I said, "There are threads that are so predictable they make me want to stimulate my uvula with a rounded eating utensil"?

With all due respect to the OP and every other contributing member, this is such a thread. In no way do I wish to derail this thread and take the focus off of the premise of delegation and authority, but am requesting a pause for the cause of consideration.

I have merely briefed over the submissions, So I could be incorrect, and if so, please let me know and I will accordingly appropriately concede that my premise is erroneous.

Here's a typical progressing with such a thread as this: A premise is made in such a way that an immediate emotional response is negatively experienced, and attacks follow. The action of submission could be interpreted in a way that the opening premise is submitted with the desire to elicit negative responses and negative attacking responses subsequently follow.

Attacking a premise is an appropriate maneuver in any discussion or debate. However, in the process of attacking the premise, the person is simultaneously attacked. Why? Because it feels good, but for the sake of my premise, I will not go into that now.

The very first response to the OP contained the essence of an attack, not only on the premise, but the person as well. The person became the premise in the attack. There's where all followed suit. The OP fanned the flames with whatever ammunition they could muster which led to more emotions, and thereby, more attacks.

There's a reason I submit images other than for entertainment value and that is because there is a slight chance that the subtle, symbolic message behind the image will be considred.

For example, I posted an animation of my cartoon character slowly eating popcorn. This aws my way of saying, "People, we're watching a drama".

A couple of more attacks were made on both the premise and the person. My cartoon character speeded up the popcorn eating which was meant to convey increasing drama.

I have to leave in a short time to TCB, but please allow me to end with this:

If we merely attack the premise and not the person, there will be no drama and an intelligent discussion, instead of a predictable, drawn out drama will take place.

However, people love drama, so, la sa la BON ton roulet!

 

This is very true, and to credit the OP not only in this thread but others they have been receptive to criticism despite receiving multiple pot shots that's a rare find these days.

[Wuzzie]

13 minutes ago, TheMoonisMyLantern said:

This is very true, and to credit the OP not only in this thread but others they have been receptive to criticism despite receiving multiple pot shots 

I used to think this too but now I’m not so sure. 

[LovingLife123]

On 2/3/2021 at 9:33 AM, Davey Do said:

@Hoosier_RN

The very first response to the OP contained the essence of an attack, not only on the premise, but the person as well. The person became the premise in the attack. There's where all followed suit. The OP fanned the flames with whatever ammunition they could muster which led to more emotions, and thereby, more attacks.

I disagree with you that my response was an attack on the OP. The OP titled this as who has authority.  I read the post and saw that the OP wanted to kind of help the LTC nurse.  She felt the LTC nurse was out of line asking her, a manager, to do specific tasks. The OP asked the nurse what she needed.  The nurse told her.  I would have done the exact same thing in the LTC nurses shoes.  

I’m not understanding why you are considering that an attack. There was no name calling, I did not belittle or degrade the OP.   I told her she was wrong.  Disagreeing with how somebody handles a situation is not an attack.   

[Davey Do]

21 minutes ago, LovingLife123 said:

4 hours ago, Davey Do said:

I’m not understanding why you are considering that an attack.  There was no name calling, I did not belittle or degrade the OP.   I told her she was wrong.  Disagreeing with how somebody handles a situation is not an attack.   

 

If I truly believed that a learning experience is that which was sought, I would be most happy to critique the entire post and make this an illuminating situation, LovingLife.

However, sensing there are other insidious needs wishing to be fulfilled, thus I will say this:

Let's agree to disagree.

 

[SilverBells, BSN]

4 hours ago, LovingLife123 said:

9 hours ago, Davey Do said:

@Hoosier_RN

The very first response to the OP contained the essence of an attack, not only on the premise, but the person as well. The person became the premise in the attack. There's where all followed suit. The OP fanned the flames with whatever ammunition they could muster which led to more emotions, and thereby, more attacks.

 

I disagree with you that my response was an attack on the OP.  The OP titled this as who has authority.  I read the post and saw that the OP wanted to kind of help the LTC nurse.  She felt the LTC nurse was out of line asking her, a manager, to do specific tasks.  The OP asked the nurse what she needed.  The nurse told her.  I would have done the exact same thing in the LTC nurses shoes.  
 

I’m not understanding why you are considering that an attack.  There was no name calling, I did not belittle or degrade the OP.   I told her she was wrong.  Disagreeing with how somebody handles a situation is not an attack.   

 

LovingLife123: 

I would agree that your post was not an attack.  It was very straightforward and to the point, but you didn't say anything that wasn't true.   It was clear that you didn't care for how the situation was handled, and that is fine.  When you create threads online, you open yourself up to feedback, positive or negative.   Sometimes the feedback is not what you want to hear, but need to hear.  Other times, there will simply be a difference of opinion and that's okay.   I think in this situation it was important for me to realize that I was in the wrong, especially since my colleague's request was not unreasonable. 

[SilverBells, BSN]

Update: 

There was some improvement in my performance today.  I was more involved with active nursing tasks, such as obtaining vitals, answering call lights and offering to help with transfers. 

Also, there was an admission over on the other unit and I stayed out of it.  I did not assist with any of the assessments because I was not asked to, and I did not stay late after work to "double check" my colleagues' work.   I have no idea if orders were entered correctly or if there are things that should be followed up on.   And, in this case, that is okay.  This is not my patient and I was not asked for help with her.  Therefore, no need to look through and correct her records.