Nurse Practice Act Essay example

The first consideration a registered nurse should determine is if “The Right Task (Cherry 355-356)” is being delegated to the right staff member. Delegation to the right staff member must be in their scope of practice and have proven to competent to complete. An individuals’ scope of practice will be set forth by the facility in which they work. In addition to individual facility polices the nurse must adhere to the scope of delegation set forth in the Nurse Practice Act of Maryland. Per the Nurse Practice Act of Maryland the task to be delegated must be “within the area of responsibility of the nurse delegating the act (Code of Maryland Regulations 10.27.11.03).” An example of incorrect delegating would be having an unlicensed individual, CNA or LPN to

It is no secret that communication is key when providing direct patient care in a skilled nursing facility. However, there is a noticeable lapse in the communication between the care team when providing care to the individual or groups of individuals. Two main parts of any care team are the registered nurse and the certified nursing assistant, as these are the two people whom have the most direct and impactful roles with residents in a skilled facility. The Registered Nurse and the Certified Nursing Assistant play similar roles in providing patient care, but have different roles in its entirety. The role of the Registered Nurse (RN) is defined as having the competency and skill to provide direct and indirect health care to individuals, their families, and communities around them. Services are also provided designed to give out medications, to promote comfort or healing, promote healing, and to also provide the dignity of their patients and patient’s families (American College of Rheumatology, 2015).

The National Council of State Boards in Nursing defines delegation as “transferring to a competent individual the authority to perform a selected nursing task in a selected situation” (National Council of State Boards of Nursing, Resources section, 4). When delegating, the registered nurse (RN) assigns nursing tasks to unlicensed assistive personnel (UAP) while still remaining accountable for the patient and the task that was assigned. Delegating is a management strategy that is used to provide more efficient care to patients. Authorizing other individuals to take on nursing responsibilities allows the nurse to complete other tasks that need tended to. However, delegation is done at the nurses’

It is important to know that the task a nurse performs is within the scope of practice. So that a nurse can perform his/her task in a permitted way safely.

The General Duty of most Registered Nurses’ is to do whatever they can, in their power, to help every patient they come across on a daily basis in a comfortable, appropriate, manner. On the more specific end of a RNs’ duty, a Registered Nurse is expected to and responsible for: performing physical exams and health

Understanding”, 2008) However, this is complicated situation for a nurse that is not familiar with

Under the scope of practice of an RN from the New York State Education Department, an RN can diagnose and treat human responses to actual or potential health problems. To be able to perform those tasks a care plan must be made for each client. An RN manages the health care services such as observing and assessing the health status of clients and implementing/assessing nursing care. This all falls under the initial assessment of a client, which is within the scope of an RN. An RN uses information gathered as part of client assessment, they then have the capacity to assign client care to other members of the nursing team, RNs and LPNs, and assign tasks to other care providers such as nurse’s assistant. Even though there are parts of the nursing process that may be delegated to qualified personnel, the initial assessment is the RNs responsibility. The initial assessment is the basis for safe and appropriate client care, which makes it so vital and why not just anyone can perform it. RNs hold the overall responsibility in the nursing

Q by taking vitals right away and report immediately, since the night shift reported elevated blood pressure at the end of their shift. This would help in determining the next step in delegating and treating Ms. Q. If her blood pressure remained elevated, the RN would delegate the LPN/LVN to proceed with the next step. After getting vitals for Ms. Q., the RN would ask the UAP to assist with Mrs. A, because she is scheduled for a Doppler flow study this morning and can help by bringing the machine to the room and by assisting the patient with morning care and ambulation prior to the study being done. The RN could have delegated Ms. Q vitals to the nursing student as well, but since the vitals were extremely high, the RN chose to have an experienced UAP report the vitals within a specific time frame. The RN has delegated these tasks because they are within the UAP’s scope of practice. They are trained to perform certain duties and tasks such as documenting and reporting information, and assisting patients with their activities of daily living. If the RN were to delegate the administration of medication they could possibly give it to the wrong patient and cause adverse reaction. The fluidity of the communication between the UAP and the RN team leader greatly impacts identifying what is expected from the UAP to communicate to the RN. Siegel and Young (2010) explain that the UAP needs clear guidelines and procedures,

Nurses are responsible for maintaining core values and standards of practice. This involves a vast array of professional responsibilities such as caring for a diverse population, maintaining the integrity of patients and promoting

On the other hand, the nurse who is delegating must avoid these assignments for new, float or traveling nurses and for LVN/LPNs: New onset/sudden/acute, new admission, transfer, newly diagnosed, discharge, require education/teaching or unstable patients, such as: high risk of sudden respiratory failure, or requires frequent assessments and changes in therapy, like electrolyte imbalances (NCSBN, 1995). In other words, the Nursing activities that may not be delegated include:

furthermore, the nurse is required to delegate based on the condition of the client while taking into consideration the AP skills, training, experience and the hospital/facility policy and procedure. The effectiveness of a delegation depends primarily on the nurse following the rights of delegation prior to the delegation and the supervision of the task delegated. Prior to delegating, Plawecki and Amrhein (2010) from the Journal Of Gerontological Nursing suggests that “An accurate assessment of the task to be completed is vital to the determination of whether the transfer of responsibility and accountability is possible” (3). The nurse should ensure that the right task is delegated for the simple reason that the task cannot be part of the nursing process of assessing, diagnosing, implement an intervention, planning care, evaluate the client outcome and teaching.

Clinical nurse specialists wear many hats in their day-to-day work setting. The five major components of the CNS role comprise of: expert clinical practice, educator, researcher, consultant, and leadership/management (Fulton, Lyon & Goudreau, 2014). Working as part of a multi-disciplinary team, CNSs can effect change by improving patient care, mentoring junior staff and colleagues, and refine organizational processes through improved standards of care. In addition to fulfilling the five major role components, the CNS integrates care across three spheres of influence: patients/families, nursing staff, and the organization/system of care.

A professional nurse is one who puts the needs and importance of patient care above all others. While striving for professionalism, nurses need compassion, patience, empathy, strong moral and ethics, accountability and the commitment to always act in the best interest of their patients. Nurses are held accountable for providing quality, safe, and effective nursing care (Hood, 2014). A professional nurse has the responsibility to continually improve and implement nursing standards while maintaining integrity by involving themselves in various tasks. Regular involvement in reading professional literature and sharing of evidence- based research with other healthcare personal helps increase knowledge and skills. This nursing ability can be used to encourage the actions of others in the healthcare team resulting in improved patient care. Nurses should encourage each other to become involved in hospital committees, provide an environment to encourage the discussions of ethical dilemmas, promote professional growth of nurses to voice their concerns and share viewpoints to address issues. “A professional nurse should expect to commit to a life of continuous learning growth and development”. (Hood, 2014, pp. 29). Nurses choose this profession to help others. As professional nurses we must maintain our ethics, values, characteristics, and commitment to drive our profession forward (CCN, 2015). Nurses must be autonomous, accountable, and be able to delegate to unlicensed assistive personnel. Being autonomous as a nurse means having control over their practice (Hood, 2014). It allows a nurse to take risks while being held accountable for ones’ actions (Hood, 2014).

When delegating tasks, the nurse should first know what the nurse practice acts and laws of the state, in which he/she resides, says about delegation. Once this information has been acquired, then the nurse needs to take into consideration a few other elements, such as: the patients’ needs, the situation at hand, and the facility’s policies and procedures. When using the decision-making framework, the nurse goes through all of the above elements and asks himself/herself questions. If the nurse is ever meet with a no for an answer, then the task may not be delegated. The first question that should be asked before delegating is what do the laws and rules of the state say about delegating this situation. Second, is it in the scope of practice

RNs are typically the first to notice changes in their patient due to their frequency of contact. RNs develop a day-to-day patient care plan. The RN is the primary person responsible for discharge planning and follow up care.