215 role competence and delegation

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elevatedsound7
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215 role competence and delegation
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2013-04-24 14:28:58
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215 role competence delegation
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215 role competence and delegation
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  1. social roles are
    set of rights, duties, expectations, norms and behavior
  2. competence =
    ability to perform a specific task, action or function successfully
  3. Benner's stages of competence
    • novice
    • advanced beginner
    • competent
    • proficient
    • expert
  4. novice nurse =
    • no experience
    • taught rules to help them perform
    • rules tend to be universal/generic
    • limited and inflexible
    • "tell me what to do and I'll do it"
  5. Advanced Beginner Nurse =
    • Demonstrate marginally acceptable performance
    • recurring experience with real situations
    • begins to formulate principles to guide actions
  6. Competent nurse =
    • 2-3 years experience
    • begins to see actions in terms of long range goals or plans
    • based on conscious, abstract, analytic contemplation of the problem
    • planning on thi slevel helps achieve efficiency and organization
  7. proficient nurse =
    ability to see the whole versus the parts
  8. expert nurse
    does not rely on analytic principle to connect understanding to the situation to an appropriate action
  9. Roles of the professional nurse =
    • care provider
    • teacher
    • counselor
    • change agent
    • client advocate
    • researcher
    • manager
  10. functional nursing =
    nurses are assigned to specific tasks for a group of patients (assembly line nursing)
  11. team nursing =
    a nurse and other caregivers provide care to a certain group of patients. Focus on individual patient care
  12. total care nursing =
    a nurse provides total care to a certain group of patients for a designated shift. Expensive because nurse does all of the duties (bathing, feeding, assessments, meds etc)
  13. Primary nursing =
    nurse responsible for planning, evaluating and directing care. RN functions autonomously as the patients primary nurse throughout the hospital stay, 24 hours a day.
  14. patient-centered /patient-focused care
    cross-functional teams with groups of professionals from nursing and other departments working together to provide care to a given group of patients. Care is baed around the needs of the patient, not the department
  15. Cannot delegate what
    • activities of the nursing process
    • assessment, evaluation, nursing judgement functions
  16. five rights of delegation =
    • right task
    • right circumstances
    • right person
    • right direction/communication
    • right supervision
  17. RN only duties =
    • tasks that involve nursing judgement 
    • assess pt response to care
    • interventions that require independent, specialized nursing knowledge or skill
  18. DO NOT delegate to LPN
    • Hang/mix
    • IV medications *

    • IVPB
    • or IVP medications*

    • Plan
    • of Care


    • Unstable
    • patient

    • Transcribe
    • orders

    • Take
    • verbal orders from MDs

    Assessments


    Admissions

    Transfer

    • Return
    • from surgery

    • 1st
    • after a change in condition

    • Develop
    • or perform initial teaching - MAY
    • reinforce teaching

    • 1st
    • of anything

    • Check
    • advanced directives

    • Complete
    • discharge teaching plan
  19. DO NOT delegate to NA
    Charting

    • Treatment -  Except
    • soap suds enemas

    • Medications ÷  Except
    • OTC topicals

    • Assessments - Except
    • vital signs and blood glucoses (unless if patient is unstable)

    • MAY
    • delegate ADLs

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