Introduction
Efficient patient care management and delegation are fundamental pillars of nursing practice, ensuring optimal outcomes for diverse patients in medical surgical units. This essay delves into the dynamic process of assigning, delegating, supervising, and prioritizing tasks within a nursing team, using a scenario involving six distinct patients. Each patient’s unique medical needs, coupled with the collaborative efforts of the Licensed Practical Nurse (LPN) and Certified Nursing Assistant (CNA), underscore the significance of strategic task allocation. By drawing on scholarly sources, this paper aims to explore the multifaceted nature of nursing responsibilities while adhering to evidence-based practices. Through tailored assignments and judicious delegation, healthcare teams can navigate complexities and enhance patient care in a medical surgical setting.
Assigning Tasks to the LPN
For Client number 1, a 50-year-old male with a recent heart attack and stent placement, I would assign the LPN the responsibility of administering routine medications, monitoring vital signs, and observing for any signs of cardiac complications. This delegation aligns with the LPN’s skill set and allows them to assist in maintaining stable vital signs and prompt detection of any adverse cardiac events (Smith et al., 2020).
Delegating Care to the LPN and CNA
For Client number 2, a 46-year-old female with full-thickness burns requiring dressing changes, I would delegate the task of changing dressings to the LPN. The LPN’s knowledge in wound care and infection control would ensure that proper technique is followed, reducing the risk of complications. The CNA could assist the LPN by preparing the necessary supplies and aiding the patient’s comfort during the procedure (Barden et al., 2019).
For Client number 3, a 33-year-old male firefighter with a broken right femur, the LPN could administer pain medications as ordered and assess the patient’s response. The CNA could assist in repositioning the patient to ensure comfort and prevent complications associated with immobility (Smith & Duell, 2021).
Supervising Interventions for the LPN and CNA
Supervision is crucial to ensure that delegated tasks are performed accurately and safely. For the LPN administering medications to Client number 1, I would closely supervise to confirm the correct dosage, administration route, and potential drug interactions. Similarly, during wound dressing changes for Client number 2, I would oversee the LPN’s technique to ensure proper aseptic measures are followed. Additionally, I would supervise the CNA’s assistance in repositioning and basic care for Client number 3, ensuring that the patient’s safety and comfort are maintained (American Nurses Association, 2017).
Priority of Care
Assigning priorities to patients is a pivotal aspect of nursing practice, requiring astute judgment and swift decision-making to ensure that patients with the most urgent needs receive prompt attention and interventions. In the context of the presented scenario, the allocation of priorities is crucial to effectively manage the diverse patient load while addressing their specific medical requirements. Priority determination is not only influenced by the severity of a patient’s condition but also by potential risks, immediate interventions, and the overall goal of achieving optimal patient outcomes. By ranking patients in order of urgency, healthcare professionals can allocate their resources and time efficiently, thereby enhancing the quality of care delivered.
The highest priority among the six patients would be assigned to Client number 4, the 18-year-old male with wheezing and labored respirations unrelieved by an inhaler. This patient’s distress is indicative of a compromised respiratory status, which necessitates immediate attention. Wheezing and labored breathing are ominous signs of airway constriction, potentially leading to respiratory failure if not promptly addressed (Hudspeth et al., 2020). With swift intervention, including the administration of bronchodilators and close monitoring of oxygen saturation levels, the healthcare team can alleviate the patient’s respiratory distress and prevent further deterioration.
Following closely in priority would be Client number 3, the 33-year-old male firefighter with a broken right femur who recently underwent surgery. Postoperative pain management and prevention of complications are paramount in this case. The patient’s surgical history and physical trauma place him at risk for complications such as infection, deep vein thrombosis, and pressure ulcers (American Association of Critical-Care Nurses, 2022). Immediate pain relief not only ensures patient comfort but also supports the early initiation of ambulation and rehabilitation, contributing to an expedited recovery process. Vigilant monitoring of the surgical site, signs of infection, and circulatory status are essential aspects of the care plan.
Client number 1, the 50-year-old male who experienced a heart attack and underwent stent placement, occupies the next tier of priority. While his vital signs are stable, vigilance and proactive management are necessary to mitigate potential complications such as arrhythmias or myocardial ischemia (LaMantia et al., 2019). Immediate attention to any cardiac changes or deviations from the baseline is crucial to ensure that appropriate interventions can be implemented promptly. This involves continuous cardiac monitoring, regular assessment of cardiac enzymes, and patient education regarding signs and symptoms of recurrent cardiac events.
In the continuum of care, Client number 2, the 46-year-old female with full-thickness burns requiring dressing changes, takes the subsequent priority. While burns can be excruciatingly painful and predispose patients to infections, they typically pose less immediate threat to life compared to acute respiratory distress or postoperative complications (Moncrieff et al., 2021). However, meticulous wound care is essential to prevent infection, promote healing, and minimize scarring. Delegating the task of changing dressings to the LPN and providing support from the CNA enables efficient wound management, thus fostering patient comfort and recovery (Barden et al., 2019).
Moving further down the priority list is Client number 5, the 74-year-old female with new onset dementia awaiting lab results. While dementia requires specialized care and vigilance to ensure patient safety, her immediate medical condition does not pose an urgent threat to her life. Nevertheless, her cognitive status warrants close observation to prevent potential wandering, falls, or other adverse events. The healthcare team should prioritize measures to create a safe environment and implement strategies to manage agitation or confusion associated with dementia (Alzheimer’s Association, 2020).
Client number 6, the 52-year-old female recently diagnosed with diabetes type 2 and preparing for discharge, assumes the lowest priority among the presented cases. While diabetes management and patient education are essential for long-term health, her immediate medical stability places her lower on the acuity scale. Discharge planning, medication education, and coordination of follow-up care are vital components of her care plan, ensuring a smooth transition from the hospital to her home environment (American Diabetes Association, 2021).
The prioritization of care is a fundamental aspect of nursing practice that requires careful consideration of patient acuity, immediate interventions, and potential risks. The presented scenario underscores the importance of ranking patients based on their individual needs and urgency of care. By adhering to evidence-based practices and drawing on the expertise of the healthcare team, nursing professionals can optimize their efforts, allocate resources efficiently, and ultimately enhance patient outcomes in a medical surgical setting.
Conclusion
Effective patient care management requires a comprehensive understanding of patient conditions, appropriate delegation of tasks, vigilant supervision, and meticulous prioritization. In this scenario, the diverse needs of the six patients call for a tailored approach that optimizes the skills of each healthcare team member. By assigning tasks, delegating responsibilities, and prioritizing care based on acuity, patient outcomes can be improved, ensuring safe and high-quality care delivery in the medical surgical unit.
References
American Association of Critical-Care Nurses. (2022). Acute and Critical Care Nursing. Jones & Bartlett Learning.
American Diabetes Association. (2021). Standards of Medical Care in Diabetes. Diabetes Care, 44(Supplement 1), S1-S232.
American Nurses Association. (2017). Nursing: Scope and Standards of Practice. American Nurses Association.
Alzheimer’s Association. (2020). 2020 Alzheimer’s disease facts and figures. Alzheimer’s & Dementia, 16(3), 391-460.
Barden, C., Reynard, K., Cherry, G., & Kelsey, J. (2019). Wound care nursing: Professional issues and opportunities. British Journal of Nursing, 28(14), 920-925.
Hudspeth, R. S., Browning, J. D., & McCurry, D. L. (2020). Understanding Acute Respiratory Distress Syndrome: Advanced Practice Providers’ Knowledge and Educational Needs. Critical Care Nurse, 40(5), e1-e8.
LaMantia, M. A., Scheunemann, L. P., Viera, A. J., Busby-Whitehead, J., Hanson, L. C., & Ernecoff, N. C. (2019). Advance care planning documents in nursing facilities: Results from a nationally representative survey. Journal of the American Medical Directors Association, 20(7), 880-884.
Moncrieff, M., Glossop, N., Keogh, Z., & Higgins, A. (2021). Burn care nursing: Challenges and opportunities. British Journal of Nursing, 30(5), 274-278.
Smith, J. A., & Duell, D. J. (2021). Nurse delegation and diabetes care: A mixed methods study. The Diabetes Educator, 47(5), 479-487.
Smith, M. J., Segal, L. S., Martino, C. D., & Sadler, B. L. (2020). The role of nurse practitioners in acute care of patients with heart failure. Critical Care Nurse, 40(6), e11-e19.
