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Original Question
What is the difference between scenario1 and 2 ,Do you agree with their assignments? Provide a rationale for your decision. What would you change about their assignment? Scenario 1 There are three patients admitted to the unit and I have to decide who on my team will be assigned to each patient. A Client 1: Room 422 A: A 49-year-old male client admitted two days ago with hypertension and peripheral vascular disease. The client underwent a stenting procedure to the left popliteal artery one day ago. The client is expected to be discharged home later today. I would assign the LPN to this client , the client is stable and expected to be discharged, the lpn can monitor VS, stent site and discharge instructions which are in the lpn’s scope of practice. However the RN would provide discharge education and the LPN can reinforce the instructions. Client 2: Room 423: A 70-year-old female admitted yesterday with a diagnosis of community acquired pneumonia. She is afebrile, with stable vital signs. She has a saline lock in place and is receiving IV antibiotics every 8 hours. She is on oxygen at 2L/minute; her oxygen saturations have been 93-95% on the previous shift. The RN would be assigned to this patient who requires Respiratory assessment, evaluation of antibiotic and oxygen therapy and management of the saline lock. The RN is qualified to perform these assessments and to create and adjust a plan of care for the client. The UAP would be assigned to Client 3: Room 424: A 67-year-old female admitted with an exacerbation of COPD three days ago. The client is receiving IV solumedrol every 8 hours and is on oxygen at 2L/minute nasal cannula with oxygen saturations of 89%. This client is stable so the UAP can monitor VS, assist with ADL’s , ambulate and report any changes in the clients status to the RN. It is in the UPA scope of practice to perform ADL,s, perform VS, ambulate patients who are stable and maintain comfort. scenario 2 Below are three patients that are admitted to your unit. For each patient, you must identify who on your team should be assigned to each patient and provide a rationale for why. There is 1 RN, 1 LPN, and 1 unlicensed assistive personnel (UAP) to whom you can delegate to. You may want to refer to the NCSBN Delegation Guidelines Download NCSBN Delegation Guidelinesfor assistance. Client 1: Room 422 A: A 49-year-old male client admitted two days ago with hypertension and peripheral vascular disease. The client underwent a stenting procedure to the left popliteal artery one day ago. The client is expected to be discharged home later today. Unlicensed assistive personal I would assign to this client. This client is stable and ready for discharge. The delegatee shares the responsibility to keep patients safe and this includes only performing activities, skills or procedures in which he or she is competent and comfortable doing (NCSBN, 2016). Client 2: Room 423: A 70-year-old female admitted yesterday with a diagnosis of community acquired pneumonia. She is afebrile, with stable vital signs. She has a saline lock in place and is receiving IV antibiotics every 8 hours. She is on oxygen at 2L/minute; her oxygen saturations have been 93-95% on the previous shift. Licensed Practical Nurse I would assign to this client. This client has stable vital signs and a saline lock in place that the LPN can monitor. This will allow the nurse leader responsible for delegation to develop a plan to address the situation (NCSBN, 2016). Client 3: Room 424: A 67-year-old female admitted with an exacerbation of COPD three days ago. The client is receiving IV solumedrol every 8 hours and is on oxygen at 2L/minute nasal cannula with oxygen saturations of 89%. Registered Nurse I would assign to this client. This client has exacerbation of COPD, receiving solumedrol IV, and has a unstable oxygen saturation of 89% via 2L oxygen nasal cannula. Delegation calls for nursing judgment throughout the process. The final decision to delegate rests in the hands of the licensed nurse as he or she has overall accountability for the patient (NCSBN, 2016).
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