Have you ever delegated something to a colleague only to have it not work out?
I have a recent example of this. Last Thursday, we collected a urine sample on a resident. I found out that afternoon that I would be off on Friday, so I asked six colleagues to please follow up on the results, knowing that the weekend was coming and provider coverage would be limited. I came back this morning to find out that an antibiotic had been ordered Friday evening, but it had never been entered. None of the 6 individuals I had asked had followed up on this. In the meantime, the resident had an unwitnessed fall over the weekend and had a quick ER visit. He returned with no injuries, but I can't help but wonder if his untreated UTI contributed to the fall. I feel guilty about having last Friday off, because I know the order would have been taken care of had I been there. I'm far from being perfect, but it's just not something I would have missed. I'm frustrated that I asked for help with ONE thing, an easy task, and I didn't get help from anyone.
Has anyone else ever experienced this? How did you address your concerns? Did it impact your ability or willingness to delegate in the future?
I have to say that the above instance is a prime example of why I do not delegate much. I try not to take too many days off because of things like this. I've always had trust issues, and things like this just make it worse.
Specializes in Psych (25 years), Medical (15 years).
Patterns, patterns, patterns.
If we always do the same things we've done in the past, we can expect the same results.
As far as behavioral reactions, we all operate within the template of our predisposed genetics. It is an empirically proven fact that the personality is more of a result of nature than nurture.
Therefore, if we act in a certain way, we can reasonably expect certain reactions due to identification of patterns and responses within that personality template.
This thread, like so very many others, is a really good example of response patterns, passive-aggressive being the norm.
I would say when something is everyone’s job it actually ends up being no one’s job. I would have delegated it to 1 person and made it their personal responsibility as opposed to asking 6 people who will all claim they assumed someone else would do it.
I would say when something is everyone’s job it actually ends up being no one’s job. I would have delegated it to 1 person and made it their personal responsibility as opposed to asking 6 people who will all claim they assumed someone else would do it.
I came back this morning to find out that an antibiotic had been ordered Friday evening, but it had never been entered.
Regardless of anything else in this story, who's responsibility was it to enter this order? There's your lapse and that breakdown in the system specifically needs to be addressed (not just for this time but for all future missed orders).
Have you ever delegated something to a colleague only to have it not work out?
I have a recent example of this. Last Thursday, we collected a urine sample on a resident. I found out that afternoon that I would be off on Friday, so I asked six colleagues to please follow up on the results, knowing that the weekend was coming and provider coverage would be limited. I came back this morning to find out that an antibiotic had been ordered Friday evening, but it had never been entered. None of the 6 individuals I had asked had followed up on this. In the meantime, the resident had an unwitnessed fall over the weekend and had a quick ER visit. He returned with no injuries, but I can't help but wonder if his untreated UTI contributed to the fall. I feel guilty about having last Friday off, because I know the order would have been taken care of had I been there. I'm far from being perfect, but it's just not something I would have missed. I'm frustrated that I asked for help with ONE thing, an easy task, and I didn't get help from anyone.
Has anyone else ever experienced this? How did you address your concerns? Did it impact your ability or willingness to delegate in the future?
I have to say that the above instance is a prime example of why I do not delegate much. I try not to take too many days off because of things like this. I've always had trust issues, and things like this just make it worse.
I'm having a hard time understanding why you would ask 6 people to follow up on the labs. Doesn't the patient have a nurse 24/7? The nurse that has the patient for the shift the labs come in is responsible for calling the provider about the labs. The nurse that has the patient when the antibiotic comes from the pharmacy is responsible for starting the medication. So, I'm not getting the issue?? Silverbells, I've never seen anyone with so many troubles. If I had that many issues where I worked, I'd quit.
You have to live your life and make work a part of it, not the center of it. You are entitled to your time off and you're NOT responsible for what happens when you're not there. Since you can't be there 24 hours, there must be a system in place for new orders to be entered, correct? If you're the only one with responsibility for this, there's a serious problem with how your place of business works.
It's very unfortunate that this happened, and I would agree that a fall may have occurred because it wasn't addressed in a timely fashion. Is it your fault? No. And as someone else pointed out, potentially asking so many people to follow up may have led them to believe that someone else was going to do it. Who gets the new orders? Did someone speak with a provider? If so, they should have followed up and entered the order. To me delegating is asking someone to do something when you're there but have to prioritize your own activities. Whoever was there when the results came in was supposed to DO THEIR JOB and start that order. You didn't have to delegate it because you weren't there so you weren't responsible. This is no way falls on you.
Exactly. I haven't worked in a lot of places but have worked in a few LTCs. Im thinking they all operate in about the same manner . you have licensed nurses assigned to each area and that nurse is responsible to check on delivery of med, to her assigned area, enter orders to the MAR, and start such medication . I guarantee, if I had neglected to do that task I would have been brought before the administrator to explain why not.
Have you ever delegated something to a colleague only to have it not work out?
I have a recent example of this. Last Thursday, we collected a urine sample on a resident. I found out that afternoon that I would be off on Friday, so I asked six colleagues to please follow up on the results, knowing that the weekend was coming and provider coverage would be limited. I came back this morning to find out that an antibiotic had been ordered Friday evening, but it had never been entered. None of the 6 individuals I had asked had followed up on this. ...
[...]
Actually, you are looking at this incorrectly. Obviously one of the group not only followed up on the lab result, but contacted the physician as well, as evidenced by the ordered antibiotic.
If you are trying to find where the system didn't work you need to evaluate how orders are taken from the physician, entered on the MAR, and subsequently ordered from your pharmacy.
Specializes in ER/School/Rural Nursing/Health Department.
On 3/23/2022 at 1:51 AM, kp2016 said:
I would say when something is everyone’s job it actually ends up being no one’s job. I would have delegated it to 1 person and made it their personal responsibility as opposed to asking 6 people who will all claim they assumed someone else would do it.
I agree. Its why in CPR class we teach that you POINT at one person and say "YOU call 911". By making it one person's responsibility there is a much better chance of the person doing said task.
However, in this case--delegation shouldn't be needed. Whoever was on duty when the order was made should have completed the order and started the antibiotic. The bigger concern is that NO shift of nurses between Friday and Monday looked at a physican order. What if that had been for something life threatening like insulin change or a cardiac med? That is a dangerous lack of responsibility by all the nurses that were involved and the facility needs to have a policy in writing on how orders will be handled in the future.
I would say when something is everyone’s job it actually ends up being no one’s job. I would have delegated it to 1 person and made it their personal responsibility as opposed to asking 6 people who will all claim they assumed someone else would do it.
First, to the OP, no reason to feel guilty about having a day off.
Exactly what I was thinking. Just looking at it from a process stand point--why was it delegated to 6 people? This is sounds like the classic "everyone thought someone else would do it, so no one did it." Also, it sounds like it is important to evaluate how information and "to do" tasks are passed on from shift to shift.
SmilingBluEyes
20,964 Posts
I agree with the others who say this does not fall into territory of delegation. They are not doing their jobs.
What are you prepared to do about that?