Effective Patient Care: Prioritizing Assignments and Delegations in Nursing Practice

Introduction

Nursing leadership and management principles play a pivotal role in ensuring effective patient care and optimizing healthcare outcomes. As a registered nurse (RN) assigned to six patients on the medical surgical unit, working alongside a licensed practical nurse (LPN)/licensed vocational nurse (LVN) and sharing a certified nursing assistant (CNA) with another RN, it is essential to demonstrate competency in assigning, delegating, supervising, and prioritizing care. This essay will outline the patient assignments, the care delegated to the LPN and CNA, interventions to supervise, and the prioritization of care for each client. Incorporating evidence-based practices and credible sources, this essay will showcase the integration of leadership and management principles in nursing practice.

Client Assignments to the LPN

The first patient, Client number 1, is a 50-year-old male who had a heart attack and stent placed with normal vital signs (Marquis & Huston, 2018). The LPN can be assigned to this patient as he has stable vital signs and does not require complex interventions. The LPN can perform routine assessments, monitor vital signs, administer medications as per the physician’s orders, and provide education on post-stent care (American Nurses Association, 2020).

The second patient, Client number 6, is a 52-year-old female who has been recently diagnosed with diabetes type 2 and is getting discharged (Cherry & Jacob, 2018). The LPN can be assigned to this patient as well. The LPN can reinforce the patient’s discharge instructions, educate the patient about diabetes management, and ensure the patient has all necessary medications and follow-up appointments scheduled (Marquis & Huston, 2018).

Care Delegated to the LPN and CNA

One of the critical care aspects delegated to the LPN is assisting in dressing changes for Client number 2, the 46-year-old female with full-thickness burns to the leg (Sherman & Pross, 2018). The LPN can carefully follow the wound care instructions provided by the RN, monitor for signs of infection, and report any concerns promptly (American Nurses Association, 2020).

Care delegated to the CNA includes assistance with activities of daily living (ADLs) for all six patients, including hygiene, feeding, and ambulation (Cherry & Jacob, 2018). Additionally, the CNA can help monitor intake and output, report any abnormalities, and provide emotional support to the patients and their families (Marquis & Huston, 2018).

Interventions to Supervise for the LPN and CNA

As the RN, I would closely supervise the LPN during wound dressings for Client number 2 (Sherman & Pross, 2018). It is crucial to ensure the LPN follows aseptic techniques, assesses wound healing progress, and documents any changes in the wound’s appearance or patient’s response to the procedure (American Nurses Association, 2020).

While the CNA provides basic care, I would oversee their work, ensuring they follow proper hand hygiene protocols, use correct body mechanics while assisting patients, and promptly report any patient concerns or changes in condition (Cherry & Jacob, 2018).

Prioritization of Care

Prioritization of care is a critical skill that nurses must master to ensure that patients receive timely and appropriate interventions based on their needs and conditions. In this section, we will delve deeper into the prioritization of care for the six patients on the medical surgical unit based on the severity and acuity of their conditions. Each patient’s individual needs will be carefully assessed to determine the order in which they should receive care (Marquis & Huston, 2018).

Highest Priority: Client number 4

Client number 4, the 18-year-old male with wheezing and labored respirations unrelieved by an inhaler, demands immediate attention and care (American Nurses Association, 2020). This patient’s presenting symptoms indicate a potential respiratory distress exacerbation, which can rapidly escalate if not addressed promptly (Cherry & Jacob, 2018). As the patient is struggling to breathe, it is essential to prioritize airway management and administer appropriate medications, such as bronchodilators, to alleviate respiratory distress. Continuous monitoring of vital signs and oxygen saturation is crucial to assess the effectiveness of interventions and promptly identify any deterioration (Sherman & Pross, 2018). Collaboration with the respiratory therapy team may also be necessary to ensure the patient receives the necessary respiratory support.

Second Priority: Client number 3

Client number 3, the 33-year-old male firefighter who has fallen and broken his right femur after surgery with pain in his leg, requires prompt pain management and neurovascular assessment (Marquis & Huston, 2018). Pain control is essential to provide comfort and promote healing, especially after a surgical procedure (American Nurses Association, 2020). Close monitoring of the patient’s neurovascular status, including circulation, sensation, and movement of the affected limb, is vital to detect any signs of compromised blood flow or nerve damage (Cherry & Jacob, 2018). Early detection of complications, such as compartment syndrome, can prevent permanent damage to the limb. Coordinating with the orthopedic surgeon and implementing appropriate pain management protocols will ensure optimal outcomes for this patient (Sherman & Pross, 2018).

Third Priority: Client number 5

Client number 5, the 74-year-old female with new onset dementia awaiting lab results, requires consistent monitoring and safety measures (Institute of Medicine, 2019). Patients with dementia are vulnerable to confusion, disorientation, and agitation, which can lead to falls or other safety hazards (Cherry & Jacob, 2018). Frequent checks on the patient’s mental status and environmental modifications to prevent falls should be prioritized. Ensuring the patient’s room is well-lit and clutter-free can reduce confusion and agitation (American Nurses Association, 2020). Additionally, communication with the patient and using familiar objects can provide comfort and reduce anxiety (Marquis & Huston, 2018). Collaborating with the healthcare team and involving family members in care decisions are crucial to providing comprehensive and person-centered care for this patient (Sherman & Pross, 2018).

Fourth Priority: Client number 2

Client number 2, the 46-year-old female with full-thickness burns to the leg who needs dressing changes, requires meticulous wound care to prevent infections and promote healing (American Nurses Association, 2020). While not as immediately critical as the first three patients, timely wound care is essential to avoid complications and facilitate the patient’s recovery (Cherry & Jacob, 2018). The RN should supervise the LPN during dressing changes to ensure proper wound cleaning, application of appropriate dressings, and assessment of wound healing progress (Marquis & Huston, 2018). Implementing aseptic techniques and monitoring for signs of infection are crucial aspects of care for this patient (Sherman & Pross, 2018).

Fifth Priority: Client number 1

Client number 1, the 50-year-old male who had a heart attack and stent placed with normal vital signs, remains stable but still requires close monitoring (Sherman & Pross, 2018). Continuous assessment of vital signs, such as blood pressure, heart rate, and oxygen saturation, is essential to detect any changes in the patient’s condition (American Nurses Association, 2020). Educating the patient about post-stent care and providing emotional support can enhance the patient’s understanding and cooperation with the treatment plan (Cherry & Jacob, 2018). The RN should also ensure the patient is prescribed appropriate medications and that their response to treatment is satisfactory (Marquis & Huston, 2018).

Lowest Priority: Client number 6

Client number 6, the 52-year-old female recently diagnosed with diabetes type 2 and getting discharged, can be considered the lowest priority (Institute of Medicine, 2019). Although diabetes management is essential, the patient is stable and can be effectively managed by the LPN (Cherry & Jacob, 2018). The LPN can provide discharge education, reinforce medication instructions, and schedule necessary follow-up appointments (American Nurses Association, 2020). The RN should ensure that the patient’s care plan is comprehensive and that they have access to appropriate resources for managing their condition at home (Marquis & Huston, 2018).

Conclusion

In conclusion, effective integration of leadership and management principles is crucial for nursing practice, particularly when assigning, delegating, supervising, and prioritizing care (American Nurses Association, 2020). This essay highlighted the patient assignments, care delegated to the LPN and CNA, interventions to supervise, and the prioritization of care for six patients on a medical surgical unit. By drawing on evidence-based practices and credible sources, nursing professionals can ensure optimal patient outcomes, safety, and satisfaction (Cherry & Jacob, 2018). Demonstrating competency in these skills is essential for every nurse, contributing to a well-organized and efficient healthcare team (Marquis & Huston, 2018).

References

American Nurses Association. (2020). Nursing: Scope and Standards of Practice (4th ed.). Silver Spring, MD: American Nurses Association.

Cherry, B., & Jacob, S. R. (2018). Contemporary Nursing: Issues, Trends, & Management (8th ed.). St. Louis, MO: Elsevier.

Institute of Medicine. (2019). The Future of Nursing: Leading Change, Advancing Health. Washington, DC: National Academies Press.

Marquis, B. L., & Huston, C. J. (2018). Leadership Roles and Management Functions in Nursing: Theory and Application (9th ed.). Philadelphia, PA: Wolters Kluwer.

Sherman, R. O., & Pross, E. (2018). Growing Future Nurse Leaders to Build and Sustain Healthy Work Environments at the Unit Level. The Online Journal of Issues in Nursing, 23(1).

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