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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. When delegating is important, remember the five rights, the right task, right circumstance, right person, right direction and communication for an effective patient outcome. Reference NCSBN, ana issue updated guidelines for nursing delegation. AONL. (n.d.). https://www.aonl.org/ncsbn-ana-issue-updated-guidelines-nursing-delegation Senario 2 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. Assigned to the UAP. This client is to be discharged; there are no acute/unstable/or critical issues with this patient’s care. This is an example of the right circumstance. As long as the UAP has the correct supervision and evaluation, this client can be safely delegated to the UAP (ANA & NCSBN, 2019). The one caveat regards any patient teaching that is needed at discharge. Neither the UAP nor the LPN can teach patients (Althoff et al., 2023b). I will coordinate with the UAP to enable an RN for the discharge teaching. This can also serve as a touchpoint for the evaluation/supervision of the UAP, which is important (ANA & NCSBN, 2019). Client 2: Room 423: A 70-year-old female was 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. Assigned to the LPN. This patient is afebrile with stable vital signs. This is the “right patient” for an LPN to be tasked with (ANA & NCSBN, 2019). However, the importance of direction/communication is key as there is always potential for decompensation, and careful direction with reporting/escalating parameters needs to be carefully outlined (Althoff et al., 2023b). Care must be taken to ensure that care for this patient is performed correctly and that there is proper monitoring and communication (Moradi et al., 2024). 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%. Assigned to RN. This COPD patient will require careful monitoring or breathing and may need their O2 titrated due to their decreased O2 SAT levels serving as their primary breathing drive (Althoff et al., 2023a). Patient teaching regarding pursed-lip breathing techniques is an RN’s responsibility (Althoff et al., 2023b). Careful monitoring of ABGs is also a responsibility of the RN (Althoff et al., 2023a).

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