Assignment on Delegation of Duties to the Experienced Enrolled Nurse

Running head: ASSESSMENT 2
ASSESSMENT 2
Name of the Student:
Name of the University:
Author Note:

1ASSESSMENT 2
Part A: Delegation of Duties
This part of the assignment will be aiming for making proper decisions while delegating
the nursing practices to other healthcare practitioners of the team from a registered nurse’s
perspective.
Delegation of Duties to the Experienced Enrolled Nurse:
Firstly, the experienced enrolled nurse should be assigned to supervise the whole patient
care process during the night shift (Ahpra.gov.au, 2020). I will expect the nursing staff to attend
all the seven patients on an hourly basis and ensure that their requirements are being addressed. I
will also delegate him/her with the responsibility of other two members of the team and make
decisions in case of an emergency. I will also assign the experienced enrolled nurse to carry out
one of the 2 observational studies on the patients like Dorothy, Joshua, Isabel, Peter and Mary.
Those patients require 4 observations within 24 hours. During the night shift, there is only
requirement of making two observations, one of which will be expected to be performed by the
enrolled nurse, as per my delegation plan. As a registered nurse, I will assign the EN with the
responsibility of the patient Joe Black especially. The patient is 65 years old and have multiple
conditions such as bladder cancer, CA bowel and COPD. The patient is in requirement of a
palliative care. The EN must monitor him personally and attend to all of his needs at the earliest
opportunity in order to promote the practice of patient safety. The nursing staff will also be
expected to administer medications during emergencies.
The rationale behind choosing the EN as the supervisor of the night shift was that an EN
has a higher authority than the other members of the team, who were an assistant nurse and a
student registered nurse. The nursing staff was also experienced and thus he or she can be
expected to have proper knowledge to carry out these tasks. The reason behind assigning the EN
with the responsibility of Joe Black is that he can be considered as one of the most critical
patients. I assigned the best nursing professional with his responsibilities in order to provide him
the best care possible.
The role of an EN is to perform the duties like supervision, proper monitoring of the
patient conditions, handling various medication administration processes along with helping the

2ASSESSMENT 2
patients with their various physical and mental conditions (Dalton, Gee & Levett-Jones, 2015).
The EN has the responsibility of delivering the best patient care possible as a supervisor. He or
she is responsible for all the actions taken by the assistant nurse and the student registered nurse
during the night shift. The EN should also read all the files of the patients and stay updated about
the patient conditions, so she would be able to make quick decisions during an emergency. The
decisions must be error free in order to ensure the patient safety.
Delegation of Duties to the Experienced Assistant in Nursing:
I will delegate the duties related to the direct patient care to the experienced assistant
nurse. Those duties include the timely administration of medications to all the patients, helping
the patients with disabilities and mobility issues, carrying out the direct diagnostic assessments
along with monitoring the patients. As a registered nurse I will assign the assistant in nursing
(AIN) to help the EN to carry out the observational tasks. The patients such as Dorothy, Joshua,
Isabel, Peter and Mary are in need of two-time observations during the whole night shift. The
AIN will be assigned to carry out one of the observational duty as I have already assigned the EN
to carry out the second observation on those patients. I will also assign the AIN with the duty of
monitoring the other patients as well, such as Ruben and Joe. I will ask the AIN to help the
patients like Dorothy, Isobel, Ruben Joe and Marie with their mobility in case of need. Dorothy
and Joe require the assistance of about 2 people when attempting to move. The AIN must seek
the assistance of either the student registered nurse or the EN in order to help her in that task. I
will also assign the AIN with the responsibility of Esobel specifically, who is suffering from
anxiety, depression and hypertension. The patient is 68 years old and thus there is a possibility
that she will be rather restless during her sleep. I will expect the enrolled nurse to make an
effective communication with her and perform a mental counseling on her in order to make her
feel better. The AIN will also be responsible for various post-operative and pre-operative care
along with the wound care in the patients like Dorothy, Ruben, Peter and Mary. The nursing staff
will also be assigned with monitor the patients with catheters and cannula.
The rationale behind choosing the AIN for these duties are that the nursing staff is
experienced and she can be expected to have proper knowledge on the medication administration
process, monitoring the patient conditions along with being directly involved in the patient care.
The direct involvement in patient care includes the approaches like medication administration,

3ASSESSMENT 2
helping the patients with their movement, checking the catheter and the cannula in the patients.
The reason behind assigning the AIN with the responsibility of Isobel was that she was one of
the patients who might require the help of a nursing expert during night (Ho et al., 2015). As the
EN will be responsible for attending the most critical patients, the AIN will be directly assigned
with the patients with less critical condition but in need of constant care even during the night
time.
The roles of an AIN is to deliver a patient care by helping the patients with their basic
needs, such as in movement, bathing, eating along with changing the bandages in case of the
presence of any wound. The assistant nurse is responsible for providing various assistances to
other nursing staffs (Choi, Goh, Adam & Tan, 2016). The nurse has the responsibility of carrying
out all the duties assigned to him or her by his or her supervisor, which will be the EN here.
Delegation of Duties to the Student Registered Nurse:
I will assign the student nurse with the responsibility of observing all the patients mainly.
The student nurse will be responsible for helping both the EN and the AIN with all their
responsibilities. I will ask the student registered nurse (SRN) to follow all the instructions
provided by the EN or AIN strictly and take actions as per requirement. I will also delegate the
responsibility of studying all the patient histories in detail, so that he or she can stay updated on
the condition of the patients along with predicting the risk conditions associated with each and
every patients. The SRN will also be assigned with administering various medications to the
patients. The nursing staff will be expected to carry out this duty along with the AIN. He or she
will be assigned with the task of monitoring all the patients in case of the unavailability of EN or
AIN and attending the patients as per their requirements. Though he or she will be advised to
consult the EN or AIN before making a decision related to the patient care. The SRN will be
expected to observe all the actions taken by the EN or AIN to provide the care to the patients and
analyse those actions based on the theoretical knowledge. As a registered nurse I will also
delegate the responsibility of helping the patients with mobility issues to the SRN. The SRN will
be expected to help the patients like Dorothy and Joe Black, who require the assistance of
minimum two people to assist them with movement. I will assign the SRN to perform all the
nursing duties for the patients in case of unavailability of the EN or AIN.

4ASSESSMENT 2
I have decided to assign the student registered nurse with least direct responsibilities,
because the nurse does not have any practical experiences in the direct patient care activities. The
student nurse have the theoretical knowledge to make analysis of the patient conditions,
administration of medications and the proper nursing practices. Hence he or she can be expected
to know what decisions to make considering the patient conditions. The EN and the AIN are
already assigned with many responsibilities and there are possibilities that they will not be able
to monitor all the patients effectively. The SRN will observe the patients and inform her
superiors in case of any emergencies, which will lower the safety risks in the patients.
The roles of a student registered nurse is to learn and perform all the duties of a nursing
staff. The duties involve proper monitoring of the patients, making assessments on the patient’s
conditions along with determining the proper action plan for the best patient care (Billings &
Halstead, 2015). The responsibilities of a SRN involve being attentive to the instructions of his
or her supervisors and act according to their instructions strictly.
Part B: Assessment of Anaphylactic Reaction in Mr. Ruben
Introduction:
In the clinical setting, delegation is considered as the process when a nurse has the
authority to direct another person to perform nursing activities. On the other hand, negligence
during delegation resulted in compromised care of the patient. This section of the essay will
provide an in-depth analysis of delegation and negligence in the following paragraphs.
Discussion:
The case scenario highlighted that during the duty hours, enrolled nurse asks student
registered nurse to administer an IV flucloxacillin to Mr Ruben which resulted in anaphylactic
reactions. In order to provide best possible care to the patient, nursing professionals are required
to comply with 5 rights of delegation such as a right person, right task, right directions and
communication, right circumstance and right supervision and evaluation (Russell, Williamson &
Hobson, 2017). Since student nurse has no practical experience of working with the team
members, by instructing student nurse to administer the IV flucloxacillin enrolled nurse failed to
comply with the right person, right direction and communication and right supervision and

5ASSESSMENT 2
evaluation (Grant, 2017). Moreover, while handover of Ruben suggested that he is allergic to
penicillin, enrolled nurse instruct student nurse to administer IV flucioxacilline without
reviewing the handover indicating negligence of the nursing professionals (Cusack, 2019).
Consequently, enrolled nursing professionals failed to comply with standard 9 (Practices within
safety and quality improvement guidelines and standards) of NMBA which suggested that within
a multidisciplinary team, enrolled nurse must contribute, analyse and consult the risk patient
subjected to 9 (Nursingmidwiferyboard.gov.au 2019). The enrolled nurse also failed to comply
with standard 7 ( communicates and uses documents to inform and report care) which suggested
that enrolled nurse review and document the health status of the patient before allocating care
and uses various communication method to engage with other professionals (Cusack, 2019). The
lack of proper delegation and negligence subjected patient into risk such as anaphylactic
reaction.
Considering the practice of student registered nurse, since student nurse lack of the experience
of working in a multidisciplinary team, the student nurse failed to comply with the delegated care
process by neglecting handover and administrate the medication. Consequently, student nurse
failed to comply with the standard 1 of NMBA for registered nurse (thinks critically and analyse
the nursing practice) which suggested that nursing professionals must assess accurate
documentation and contribute in the care process.
Conclusion and Next step:
At this juncture, the enrolled nurse is responsible for the majority of the fault where
student nurse also failed to comply with the nursing standard. The next would be mandatory
reporting to the registered nurse regarding the negligence and lack of compliance with five rights
of a delegation under mandatory reporting legislation of Australia. The mandatory reporting
must be done to the Australian Health Practitioner Regulation Agency and it should be note done
to the incident report (Bismark et al., 2016). The family members of the patient are required to
inform regarding the incident and registered nurse must ensure that Mr. Ruben receives quality
care. Moreover, the enrolled nurse can be involved in the training and clinical supervision for
negligence.

6ASSESSMENT 2
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