You are the recently graduated registered nurse working on a unit that practices patient-focused care. The particular unit practices a version of patient-focused care consisting of one registered nurse, one enrolled nurse, and one nursing assistant for a group of patients. 

You as the registered nurse, delegate tasks to the nursing assistant and assigns care that the enrolled nurse is permitted to do according to the registering bodies in Australia. The nurse completes report at 0730. The nurse has the following assignment for the 0700 to 1530 hrs shift:

Bed 1: Mr L is a 70-year-old male, diagnosis: urinary tract infection. Mr L is alert but is experiencing some confusion. Vital signs are ordered every four hours. He is experiencing urinary frequency. He is a falls risk, and needs to be reminded to use the urinal rather than getting out of bed on his own to use the bathroom.

Bed 2: Mr P is an 88 year-old male, diagnosis: pneumonia). It has been handed over from the Night Shift nurse that assisted Mr P with his hygiene requirements in the bathroom at 0630hrs, that whilst removing Mr P’s anti-embolitic stockings, the nurse noticed a pressure injury on his leg, which Mr P stated it is very painful, then night nurse has left the area uncovered for review this morning.

Bed 3: Ms. N is 78 years of age and is a female patient diagnosed with new onset sinus bradycardia that is being monitored by remote telemetry. She is on an IV medication that requires titration. She also has Dementia and tends to fall and wander. She needs supervision with all ADLs.

Bed 4: Ms S is a 30 year old lady who is normally ambulate and self-caring however due to pain and limited range of movement, due to L) knee arthroscopy yesterday) needs assistance in the shower and is then to prepare for an 0930hrs discharge. She needs discharge teaching.

Bed 5: Mr. T is 68 years of age and is a male patient who is scheduled for a laparoscopic cholecystectomy at 1100 hrs. He needs preoperative teaching.

Bed 6: Ms. A is 55 years of age and is a female patient who is scheduled to go to the day oncology unit at 0800 hrs. Someone from the health care team will need to take her via wheelchair.

Bed 7: Mr W a 43-year-old male, new admit, diagnosis: suspected Crohn’s disease. Mr W has been having abdominal pain and severe bouts of diarrhoea for the past several months. He was admitted this morning. He is NBM to rest his bowels and to prepare for an upper gastrointestinal diagnostic series. He has been hypotensive and has IV fluids running and prn pain medications.

Bed 8: Mrs C is a 60-year-old female, diagnosis: congestive heart failure. Mrs C was transferred onto the ward overnight. She was admitted four days ago with acute pulmonary oedema. She has history of CHF and takes diuretics, digoxin, and an ACE inhibitor at home. She is alert and oriented. She is short of breath, on 2L of O2 with oxygen saturation at 93%. She has an IDC in situ and is on strict fluid balance. Copyright © Department of Health 2020

Before leaving the handover room, what tasks would you consider delegating to the nursing assistant?

Which patients should the registered nurse care for during the shift and which patients should be assigned to the enrolled nurse and why?

Using the 5 principles of delegation identify what tasks you might delegate to each staff member and why.

Your rationale should be supported by evidence, particularly relevant in Australia

Please note: The list of a health assistant’s (nursing) duties may vary from individual to individual. This is because an individual’s scope of activities will be influenced by a range of factors including:

• the context in which they are working

• their own level of competence, qualifications and experience

• the policies, qualities and risk management frameworks and culture of the organisation in which they work. © Copyright, State of Victoria, Department of Health and Human Services 2015

Therefore, here is a position description of a Nurse Assistant role at Cabrini Hospital, Victoria, as a guideline for this assessment task.

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