In order of priority identify which tasks you yourself will undertake and which tasks you will delegate. 2: Document your rationales in detail.
Scenario: On returning from your tea break you are met by several staff members who relate the following information to you concerning your patients. i. Mrs Chews intravenous (IV) infusion has tissued her IV fluids are running behind and she has missed her 14.00 hrs IV antibiotic. ii. Mr Smiths visitor has fainted. iii. One of the staff toilets has blocked and is overflowing and waste is pouring out rapidly. iv. Mr Esposito is scheduled to leave the ward now for his cardiac catheterisation and he has still not received his preoperative medication. v. One of the surgical consultants (VMO) is waiting to discuss a medication error that happened last week. vi. As you are taking this handover an elderly female post-operative patient collapses to the floor and is unconscious. She has had facial surgery. The other RN is busy with NUM role. Staff currently available on the ward to assist you in addressing these issues include: the ward clerk an Enrolled Nurse who is currently undertaking her IV cannulation certificate but is not yet competent and an AIN.
References:
Elliott M. & Coventry A. (2012). Critical care: the eight vital signs of patient monitoring. British Journal of Nursing 21(10) 621-625. Retrieved from https://www.researchgate.net/publication/230638387Critical_care_The_eight_vital_signs_of_patient_monitoring
Casey A. & Wallis A. (2011). Effective communication: Principle of Nursing Practice E. Nursing Standard 25(32) 35-37. Retrieved from https://www.rcn.org.uk/data/assets/pdf_file/0005/380795/Nursing_Standard_Principle_E_April11563KB.pdf
TASK 2 (600 words for both A and B parts) 3 references per each part 2010-2015
PART A: Please read this fact sheet and answer the following questions:
The MND Australia Fact Sheet on Multidisciplinary Teams outlines professionalgroups who could make up a multidisciplinary health care team for a patient with motor neurone disease (MND). https://www.mndaust.asn.au/Get-informed/Information-resources/Living better for _longer/WEB-MND-Australia-Fact-Sheet-EB3-Multidisciplinary.aspx
1. What factors determine the professional groups on a health care team? 2. Who should lead the health care team? 3. Who is the most important member of the health care team?
PART B: Answer and discuss the questions related to the Case Study:
1. What are the key issues in this situation? 2. What strategies would you employ to address this situation?
Case Study
You are working in a health care team on a busy rehabilitation unit. Team meetings and patient reviews are conducted weekly. There has recently been a turnover of staff in the Physiotherapy department and a new representative from physiotherapy has joined the health care team. You notice although that this new member of the team members is often absent fails to provide patient updates and when challenged on these issues is exceptional confrontational. This behaviour is not only impacting on the effectiveness of the health care team but also on patient outcomes. You are the designated team leader and need to find a resolution.
References
Weller J. (2012). Shedding new light on tribalism in health care. Medical Education 46 132-142.
Kalishman S. Stoddard H. & OSullivan P. (2012). Dont manage the conflict: transform it through collaboration. Medical Education 46 926-934.
TASK 3 Handover (400) 3 references 2010-2015
You are working on the morning shift on the ward and receive a patient from ED. The ED nurse provides you with the following handover using the ISOBAR format.
Handover from ED nurse:
Mr John Block a 92 years old men coming to emergency department with abdominal pain and 3kg weight lost in the past week. He has a chesty cough with frothy sputum production and we suspect pneumonia He has been on early obs/vital signs downstairs He has a history of gastric ulcer CCF and CVA He is currently on 1.5 l oxygen via nasal prongs He has peripheral cannula in his left arm and he has IV antibiotics Cefazolin and Gentamicin which are given as per drug chart He is currently nil by mouth he has a good urine output going to the toilet twice today and has bowel opened yesterday You will need to start him on 50ml/h of IV Normal Saline He needs chest Xray at 1600 today sputum test and re-observation
Please answer the following:
1. What further questions will you need to ask the nurse?
2. List specifically what further assessments you would complete when the patient arrives onto the ward
References
Levett-Jones T. (2013) Clinical Reasoning: Learning to think like a nurse Frenchs Forests NSW: Pearson. https://www.utas.edu.au/data/assets/pdf_file/0003/263487/Clinical-Reasoning-Instructor-Resources.pdf
Felton M. (2012). Recognising signs and symptoms of patient deterioration. Emergency Nurse 20(8) 23-27.
TASK 4 (600) 4 references 2010-2015
You will need to discuss delegation and then make some decisions of your own using a case study. It would also be very useful to discuss the scope of practice of registered nurses
You are a Registered Nurse on the afternoon shift on a short-stay (24 hours) surgical ward. One other RN an EN and three AINs are also on duty. The NUM is off sick and the other RN is acting as NUM as well as taking a patient load. The ward is full: there are 18 patients 10 of whom went to surgery in the morning and 8 are going on your shift. Half of these a patients have intravenous access and antibiotics at some time during your shift.
ACTIVITY: Using your knowledge and experience of various patient allocation models (e.g. total patient care team nursing and task allocation) outline how you would allocate the staff to the patients. Include in your discussion your rationale for the model of allocation chosen and the scope of practice of the various staff.
References
Pearce C. (2006). Leadership resources. Ten steps to effective delegation. Nursing Management UK 13(8) 19.
https://www.rhc.ac.ir/Files/Download/pdf/nursingbooks/Contemporary%20Nursing% 20Issues%20Trends%20&%20Management-2014-CD.pdf

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