COHORT A ONLY Scenario 1 Case details 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. R is 42 years of age and is a male patient who is legally blind. He is S/P (status post) lithotripsy for renal calculi. He is ambulatory with assistance. He needs to strain his urine when he voids, and he needs to drink 2 to 3 litres of non-caffeinated liquids during the shift. He also needs ice packs applied to his right flank. The next ice pack is due at 0730 hrs. Bed 2: Ms. M is 85 years of age and is a female patient diagnosed with new onset atrial fibrillation (AF) that is being monitored by remote telemetry. She is on an IV medication that requires titration. She also has Alzheimer’s disease and has a tendency to wander off. She needs constant direction during bathing and needs to be reminded to eat during meals. Bed 3: Ms. S is 65 years of age and is a female patient who is S/P abdominal hysterectomy who needs a blood transfusion. The blood bank called and stated that the first unit of packed red blood cells will be sent at 8 am. She has an initial dressing change that will need changed when the surgeon rounds at 8 am. She currently has an IV of NS at 125 ml per hour via an infusion pump. She has multiple IV medications ordered. She has a 20-gauge IVC site on her right forearm that is flushed and capped and available for the blood transfusion. She has just called to the nursing station that she is nauseated and in severe pain. Bed 4: Mr. J is 70 years of age and is a male patient who is S/P transurethral resection of the prostate (TURP), done yesterday. He is going to be discharged home at 1000 hrs. He needs discharge teaching. Bed 5: Mr. T is 72 years of age and is a male patient who is scheduled for a transurethral resection of the prostate at 1100 hrs. He needs preoperative teaching. Bed 6: Ms. A is 50 years of age and is a female patient who is scheduled to go to the hemodialysis unit at 0800 hrs. Someone from the health care team will need to take her via wheelchair. Bed 7: Ms. B is 55 years of age and is a female patient who is scheduled to go to the OR at 1400hrs for a vaginal hysterectomy. She should return from the post anaesthesia care unit at 1700 hrs. She has received patient teaching. Bed 8: Mr. H is 60 years of age and is a male patient who is going to be discharged home at 0800 hrs after a 23-hour hold for pain management related to renal calculi. He passed the two calculi seen on diagnostic testing. He has received his discharge instructions. Copyright © 2017 Wolters Kluwer 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.
