The ever-changing working dynamics have led to the dire need to embrace delegation and supervision in different workplaces. According to Wagner (2018), delegation refers to the transfer of responsibilities from one person to another. In a nursing setting, it represents a clinical nurse directing another staff to perform nursing activities and tasks. Supervision and teamwork are essential instruments in promoting delegation in the healthcare sector. Effective leadership assists in identifying the suitable tasks for delegation as well as assigning responsibilities to the right clinical employee. However, inappropriate planning, monitoring, the scope of practice, and the lack of workers’ motivation result in delegation problems, which lead to increased workload and distress to the subordinates.
During my volunteer work in a healthcare facility in New York, I witnessed a clinical challenge, which emanated from improper delegation practices. One day, a registered nurse (RN) was busy with several office tasks, and thus, he requested a licensed practical nurse (LPN) to assess the abdominal pain of a patient who had complained to him. However, RN’s tight schedule made him forget that he had delegated a task to the LPN, thus failing to monitor the situation’s progress. Generally, LPNs do not undertake assessments because such roles are beyond their scope of practice, and they operate under the supervision of RN. Therefore, the LPN only executed preliminary evaluations on the source of the patient’s pain, leading to worsened health status that led to the necessity of critical care in a referral hospital. Upon examination by an RN, delays in earlier assessments caused the escalated complications. Since that day, I realized that mistakes in the delegation process could cause medication errors, which may risk patients’ health and increase their care costs.
Two relevant actions were essential in improving the delegation process and avoiding the healthcare facility’s negative effects. First, the RN should have considered the scope of practice of the LPN to make a rational decision on whether to delegate the role to her or choose another nursing practitioner. It was irrational to assign a complex task to a nurse who fulfills basic nursing and medical care duties. According to Young et al. (2016), the delegating authority needs to understand the skills required to complete a particular task to make a logical choice of an expert who can comfortably meet its demands. Besides, a nurse needs to have confidence in the assigned duty, thus avoiding confusion and anxiety concerning the possibility of negative outcomes. In the scenario, the most contributing factor to the delegation problem was selecting an LPN to execute obligations beyond his practice scope.
Additionally, supervision is a vital tool for overseeing the entire process of delegation and ensuring its success. The RN needed to understand that the LPN required guidance to assess the patient’s abdominal pain successfully. LPNs should work under the RN’s direction in the general medical practice (Wagner, 2018). Consequently, in the scenario, the RN should have ensured constant communication with the LPN to monitor the progress. In this way, the LPN could have consulted with the RN on challenging procedures during the abdominal pain examination. With no monitoring, the LPN assessed what she thought was right, thus ignoring critical tests, which led to worsening the patient’s condition. Undeniably, the RN failed to execute his supervisory role appropriately despite his tight schedule, thus threatening the patient’s health status. The RN should reexamine the healthcare facility’s delegation and monitoring processes to ensure correct choices of the healthcare experts, proper judgments, and effective supervision.
Delegation and supervision are two inseparable functions of the top management in different settings, including healthcare. The administration needs to maintain an excellent working rapport with their subordinates to ease the delegation process. Significantly, clinical leaders should consider their staff’s scope of practice when delegating roles to them. There should be also continuous monitoring to ensure nurses execute their obligations successfully based on the patients’ needs. The lack of effective supervision and unreasonable delegation to the wrong healthcare practitioners cause anxiety and confusion, which risk the patients’ lives, as witnessed in the illustrated scenario.
References
Wagner, E. A. (2018). Improving patient care outcomes through better delegation-communication between nurses and assistive personnel. Journal of Nursing Care Quality, 33(2), 187-193.
Young, H. M., Farnham, J., & Reinhard, S. C. (2016). Nurse delegation in home care: Research guiding policy change. Journal of Gerontological Nursing, 42(9), 7-15.