Effective Communication and Delegation.
ANSWER
Chapter 6 & 7:
- Effective communication is crucial in personal relationships to build trust and understanding. In the therapeutic relationship, it’s essential for client-centered care and trust between the healthcare provider and the patient. In interprofessional healthcare teams, effective communication ensures coordinated and safe patient care.
- Similarities include the need for clarity, active listening, and empathy. Differences may arise in the nature of information shared and the level of formality.
- Congruence means that verbal and nonverbal communication align. It’s important because inconsistencies can lead to misunderstandings. For example, saying “I’m fine” with a frown sends mixed signals.
- Miscommunication can occur in electronic communication when tone and nonverbal cues are absent. For critical information, in-person or phone communication is often more effective.
- ISBAR (Introduction, Situation, Background, Assessment, Recommendation) is used for structured hand-off reports in clinical settings, ensuring essential patient information is conveyed accurately.
- A hand-off report should include patient name, diagnosis, allergies, medications, recent vital signs, and any pending test results. The effectiveness of the current system should be assessed through its ability to ensure accurate, timely, and safe communication between shifts.
- As a nurse, respond professionally, explain the situation, and provide a status update. Ensure Dr. Roberts is aware of the ongoing efforts to obtain the lab reports. Maintain open and respectful communication.
- Accountability in delegation means the nurse is responsible for the outcomes. Legal ramifications may include liability if the delegated task results in harm, so the nurse should delegate within their scope of practice and ensure competency in the person to whom they delegate.
- The responsibilities of RNs, NAPs/UAPs, and LPNs can vary by facility policies and state regulations. Effective delegation depends on individual competency and available resources. The Delegation Tree can guide decisions.
- Direct delegation involves the nurse giving specific instructions for a task. Indirect delegation involves assigning responsibility for a task without specifying how it should be done.
Clinical Experiences:
- When delegating patient care, the RN considers the task’s complexity, the competency of the delegate, the patient’s condition, and the legal and institutional policies.
- Prioritizing patient care depends on the patient’s condition and needs, with critical or unstable patients taking precedence.
a. Specific tasks for delegation depend on patient needs, but they might include taking vital signs, assisting with ADLs, or fetching supplies.
b. The effectiveness of nurse/preceptor in delegating tasks can vary, but good preceptors ensure clear communication, assess delegate competency, and provide feedback.
c. To ensure tasks are completed safely and appropriately, the nurse/preceptor should monitor the delegate, provide clear instructions, and follow up to ensure proper execution. Safety protocols and policies should be followed.
QUESTION
Description
Read Chapter 6 & 7
1. Discuss the importance of effective communication in the personal relationship, the therapeutic relationship, and the relationship within the interprofessional health-care team.
2. What similarities and differences can you identify among the above interactions?
3. Explain the concept of congruence between verbal and nonverbal communication.
4. There are many pitfalls to electronic communication. Identify a situation in which an electronic form of communication may result in a miscommunication. What other method of communication would have been more effective?
5. How have you seen ISBAR used during your clinical experiences?
6- Develop a hand-off report for yourself. Include items that you believe are pertinent for safe and effective nursing care. Refer to the information in the chapter for creating this report form. Using the information from the chapter, determine the effectiveness of the system currently in use on your unit for communicating shift-to-shift reports.
7-Dr. Roberts comes into the nurses’ station demanding, “Where are Mr. Adams’s lab reports? I ordered these stat, and they’re not here! Who’s responsible for this patient?” How would you, as the nurse, respond?
8-Explain the concept of accountability in delegation. What are the legal ramifications of accountability in delegation?
9. Dennie and Elias arrive in the unit for the 7:00 p.m. to 7:00 a.m. shift. Both nurses completed orientation 4 weeks ago. They find that they will be the only two RNs on the floor that night. There is a census of 48 clients. The remaining staff consists of two NAPs/UAPs and one LPN. What are the responsibilities of the RN, NAP/UAP, and LPN? Can Dennie and Elias effectively delegate client care tasks and care safely for all 48 clients? Use the Delegation Tree to make your decisions.
10. Discuss the differences between direct delegation and indirect delegation.
1. You have to observe delegation procedures in your assigned unit:
A-What considerations does the RN take into account when delegating patient care?
2-You have to look at the unit census and prioritize the patient care:
A- Give the rationale foryour choices.
3.Answer the following questions during your clinical experiences:
a. What specific tasks did your patients require that you might have been able to delegate?
b. How effective was your nurse/preceptor in delegating tasks to others?
c. How did your nurse/preceptor ensure that the tasks were completed safely and appropriately?
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