Supervising, Managing & Delegating Client Care

Remember that when you delegate that you give the appropriate task to the appropriate person. The best thing for you to do would be to get a hold of your state's scope of practice for CNA, LPN, and RN and that would give you a good starting point on who can be delegated to do what. Also, don't forget that individual hospitals can further limit scope of practice (i.e. BON says RN's may do arterial sticks, but the hospital has a policy saying only MD/NP/PA/RT may do arterial sticks). Good luck!

just as said above give the right task to the right person. i had alot of pt's on iv fluids and the tech wanted me to teach her how to program the pumps so that she could do kvo to give me a little extra time to grab the fluids i needed. well that is way out of her scope of practice and i told her that. so that is an example of delegating/supervising. as far as time management. i usually have 6-8 pts a night. i start with assessing the acuity level of my pts and deciding which one it is most important for me to see first. i.e. i will go see a fresh c-section before i see a 2 day vag delivery post partum. and i make lists, lots of lists. i also start off my shift by seeing who has meds due when. i make sure i give all my antibiotics on time but i dont worry as much about what time i give colace. if a pt has an 8p & a 9p med, depending on what they are i will usually give them at the same time so i am not running around when i have 7 other pts to deal with. hope this helps.

I want to thank both of you for helping me out. I wanted to get some real life delegation. Not what the book exactly says but how a RN really handles the situations.

Thank you again. I plan on using your responses for our presentaiton.

I recently commented on similar assignment to another student. I think it's kinda sillty to ask an RN student who has never worked as an RN to present on the topic of Supervising, Managing, & Delegating Client Care - something he/she has never done themselves... huh?!?! I've heard of some schools organizing students into 'charge nurse', nurse and assistant roles. That makes more sense to me, though it's still so manufactured and protected in most settings that it can only go so far.

This is one of my pet peeves with the trends in current basic nursing education. I mean, wouldn't it be more effective to have the school teach the students about delegation? Why should students pay to teach themselves? Do the schools explicity teach the legal scopes of practice & common roles locally for CNAs and LVNs? I know it's important for students to learn how to find information on their own, but you could assign the students to find and print up one's states' professional regulations and require the students to interview or shadow a working nurse with a focus on delegation and still provide the students with standard info.

Having students put together a presentation on delegation isn't likely to be applicable to the real world. After all, they likely don't have real world nursing experience to base it on. If the point is to practice presentation skills, have the students present on nursing skills that they have already been practicing.

Not that I have faith that most nursing schools would do a very good job of teaching delegation. There's just not enough time in the curriculum and so it end up tagged on and given lip service instead of an in depth look at the issues nurses must deal with in regard to delegating, supervising and managing

I would try some scenarios using different patient situations and healthcare personnel. For instance, my nurse practice act says the RN will assess, plan care, plan teaching. So if the patient is new asthmatic then the RN needs to asses, plan and teach. If the patient has sterile wound to be dressed then an LVN/LPN can do that. If the patient has blood sugar to be done q ac/hs then the CNA can do that. Then you detail WHY the RN makes appropriate decisions for each scenario. That is how I teach it and the students tell me it makes "sense" that way.

As todays nursing students we are learning to think for ourselves. We do not need to be spoonfed information but are taught to research & actively learn. It has been proven that students who actively learn, retain the information 50-80%. Whereas students that just sit & listen to a lecturer only retain 10%. Wouldn't you rather have a new RN with a retained education or a spoonfed education?

As todays nursing students we are learning to think for ourselves. We do not need to be spoonfed information but are taught to research & actively learn. It has been proven that students who actively learn, retain the information 50-80%. Whereas students that just sit & listen to a lecturer only retain 10%. Wouldn't you rather have a new RN with a retained education or a spoonfed education?

There's a difference between "spoonfeeding" and good teaching. I agree that students need to think for themselves and be active participants in their learning experience. Still, there is some role for instruction. Supervising, managing and delegating are central components of being a nurse in many settings and the instructors are asking the students to teach each other how to do it? Would you ask students to teach each other how to ski or play the piano or do long division? It's reasonable to ask students to teach each other something they already know, and to ask them to do research into some certain aspect of their studies. But to ask students to research and present on the practice of interpersonal skills in professional situations that they haven't experienced doesn't seem the best way to provide instruction.

I get a lot of interaction when I present the scenario then ask the class to give rationales why this assignment/delegation is or is not appropriate. Sometimes it helps to hear how your peers are thinking. This way we can learn from one another and be prepared for similar experiences.