Nursing: Delegation of Tasks, Multidisciplinary Teams, Patient Care, and Staff Allocation

This document discusses nursing responsibilities such as delegation of tasks, multidisciplinary teams, patient care, and staff allocation. It also covers factors that determine which healthcare professionals need to be there in a healthcare team, the most important member of a healthcare team, and the key issues in the dilemma. The document also includes a shift planner with an hourly plan for caring for each patient.

Running head: NURSING
Nursing
Name of the student:
Name of the University:
Author’s note

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Module 1:
As an RN, I have the responsibility to delegate relevant tasks to team members. Other
team members that can assist me in different task include the ward clerk, an EN who is
completing her IV cannulation certificate and note yet competent and an AIN.
The first priority is to attend to the needs of an elderly female post-operative patient
who has collapsed to the floor and has become unconscious. The EN must be delegated to
this patient and check her consciousness and possibility of fracture. Prioritizing this first is
important because if she is left unattended, there is risk to her life or chances of further
complications. Assessment is necessary to identify if patient need emergency treatment of
intervention (Torrance, Powell & Griffiths, 2015).
The second priority will be to attend to Mr. Esposito as he is scheduled to leave the
ward now for his cardiac catheterization. I will provide him preoperative medication as there
is no more time left and no others staffs can administer medication according to their scope of
practice
The third priority will be to resolve the toilet blockage issue as it may cause
inconvenience to other patient. The ward clerk may take on this responsibility. Meanwhile, I
can take over Mrs. Chew’s assessment of her intravenous infusion. This is important because
her IV fluids are running low and maintaining appropriate flow is responsible for patient
safety (Moritz & Ayus, 2015). As she has missed her medication, administering medication is
important too.
The fifth priority will be attend to Mr. Smith’s visitor. This responsibility can be
given to AIN who can provide emergency medical care and take the visitor to a safe place.

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The last priority will be to discuss with surgical consultants regarding medication
errors. I will handle this and the rationale for prioritizing this task at last is that the
medication error has happened last week and there are no immediate actions to be taken to
promote safety of patient.
Module 2 – Collaborative and Therapeutic Practice
Part a.
1. Factors that determine which health care professionals need to be there in a
health care team:
The involvement of different health care professionals in a multi disciplinary team
will depend on the type of disease condition for which patients need treatment. For example,
to create a multidisciplinary team for a patient with motor neurone disease, it will be
necessary to include members who have particular expertise in dealing with motor neurone
disorder such a neurologist and respiratory specialist. In addition, the health care team other
allied health professionals like nurse, dietician, social workers, physician and psychologist
(MND Australia, 2019). Secondly, the severity of a disease condition will determine the type
of health care professionals who need to collaborate with each other to deal with complex
symptoms of patient. For example, the study by Uriol Rivera et al. (2018).revealed that for
management of life threatening disease conditions like cancer, introducing multidisciplinary
team for cancer management is critical to make urgent clinical decisions and improve the
prognosis of serious disease.
2. Member who should lead the team:
Multidisciplinary team most focus on coordinated approach to care without having any
specific leader. However, in case of care delivered on a daily basis, the doctor or the general

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practitioners is the person who leads the team and coordinate activities of other team
members. Grol et al. (2018) supports that GPs take lead in building multidisciplinary health
care team. However, more recent research suggest the need for specialist nurse to take on
leading role in a multidisciplinary health care team because of their coordinating role during
the transition care process (Soukup et al., 2018).
3. Most important member of a health care team:
Patient is the most important member of a health care team as they are the biggest
stakeholder and the all the members of the health care team are involved in addressing the
needs of patient. All care priorities, interventions and delegation activities are centred around
the immediate health needs and clinical issues of patient (Frosch, 2015). Hence, unless
patient satisfaction is achieved, the goal of creating a multidisciplinary team is not fulfilled.
These reasons make patients the important part of a health care team.
Part b:
1. The key issues in the dilemma are the impact of hospitalization of mental state of
patient and the risk associated with care provided at home. It will be difficult to
decide whether mental health or physical health of patient needs to be prioritized.
According to the principle of beneficence, the best strategy should be to choose the
option that promotes patient safety as health care workers have the duty to minimize
harm and promote good towards patients (Haddad & Geiger, 2018).
2. The best outcome that will be good for Grant and his family will be allow him to
recuperate at home, where he will be surrounded by his family members and he will
not develop emotional distress because of prolonged hospitalization. Boland et al.
(2017) gives evidence regarding positive health impacts of home support
interventions of elderly patients.

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3. To guide the group to achieve the best outcome for Grant at home, it will be necessary
to ensure that all rehabilitation needs and care is appropriately available to him at
home too. Furthermore, one nursing staff needs to be there for Grant regularly at
home so that he gets assistance in activities of daily living and supporting his family
who may experience burden in caring for him (Doyle et al., 2017). In addition,
physiotherapy and occupational therapy sessions can be arranged for Grant at home
too.
Module 3:
1. As the handover received for the patient suspected with pneumonia does not gives any
information regarding his last vital signs, I can ask nurse regarding data for last vital
signs assessment done on the ward. This will help to find whether his symptom pain
and respiratory distress has resolved or not. Since the patient was suffering from
abdominal pain, I need to inquire nurse about the time since the last antibiotics and its
effect on pain. This data will help to further prioritize effective care plan for patients.
van der Maaden et al. (2016) gives the evidence that observation and assessment
related to patient discomfort, pain and dyspnoea in patients with pneumonia is
important to assess improvement in symptoms following treatment.
2. Further assessment necessary for patient after arriving at the ward will include:
Pain assessment: Pain assessment using PQRST format will be necessary to detect
changes in severity of pain and determine whether further antibiotics treatment is
necessary or not (Stephens, 2019).
Review of sputum: Review of sputum test result will be essential to evaluate if
interventions given are effective for patient or not

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Respiratory assessment: Complete respiratory assessment will be important to detect
respiratory discomfort for patient. This will help to determine whether patient will require
suctioning or interventions like repositioning will provide relief to patient (van der
Maaden et al., 2015).
Activity 3:
1. Based on the handover received for the patient at 13:00, the following tasks needs to
be done for each patient
Bed 1: She is on 3 doses of prophylactic cephazolin 8 hourly, and she has received a dose
in ED at 1200 hrs. Hence, she needs to be provided cephazolin again at 2000 hrs. In
addition, as her urine appears cloudy, further assessment is necessary for infection
surveillance
Bed 2: Bed 2 patient is in severe pain and fasting as he is due to have emergency surgery
in the evening. After checking with the handover nurse, oral paracetmaol and oxycodone
needs to be provided to patient for pain relief.
Bed 3: The patient is due be discharged at 1700 hrs, it will be necessary to review
discharge plan and give instructions to patient regarding care at home and further follow
up. Written order from doctor needs to be taken for discharged and patient should be
shifted to a new room. All belongings should be handover to the patient and his family
too
Bed 4: As a new patient is about to come from ED in 1 hour, it is necessary to clean the
bed and place new bed sheets and pillows.
2. The shift planner with an hourly plan for caring for each patients are as follows:

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Shift hours Order of priority Nursing activities
1300-1400 hrs A (Bed 2 patients needs to be
taken care of first because he is
suffering from severe pain and
needs urgent attention)
Bed 2 patient needs to be
immediately provided PRN oral
paracetamol and oxycodone
after follow up with doctors.
1300-1400 hrs B (Bed 4 activity needs to be
prioritized as a new patient will
come 1400 hrs)
The bedsheets and pillow cover
need to be changed and all
belongings and medications of
last patient needs to be removed
1400-1500 hrs C (Bed 1 patient needs to be
checked as her IDC urine
appears cloudy)
Assessment needs to be done
for chance of infection and her
IDC needs to be inspected to
identify whether it should be
changed or not. Diets and fluid
need to be provided as tolerated
1500-1600 hrs D (Bed 3 patients needs to be
made ready for discharge as his
parents will be coming by 1700
hrs)
All instructions related to
discharge must be provided.
Patient must be asked to change
and shift to a new room. All
belongings need to be given.
1600-1700 hrs E (Bed 2 patient) Bed 2 patient must be made
ready for emergency theatre
1700-2000 hrs F (Bed 1 patient needs to be
revisited)
Cephazolin needs to be
administered to patient again at
2000 hrs.

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Module 4:
I am a registered nurse (RN) on a short-stay surgical ward. Other nursing staffs
working with me includes one RN, an EN (Enrolled nurse) and three AINs (Assistance in
Nursing). In addition, as the NUM (Nurse Unit Manager) is on sick leave, other RNs are
acting as NUM. As there are 8 patients who are schedule to go for surgery, I would allocate
the staffs to patients based on their scope of practice and clinical skills they process. This
approach is relevant with the team nursing model of nursing where group of health care
professionals utilize team approach to provide care to patients in acute care setting. In such
team, the team leader or a charge nurse assigns task to team members based on their expertise
and the staffs assigned to different patient works within their scope of practice to provide
appropriate care. The significance of team nursing model is that it utilizes strength of all team
members and each patient receives individualized care (Isobel & Edwards, 2017).. The team
allocation model has been chosen for the scenario because the team consists of different types
of nursing staffs and as the patient flow is high, each members need to take up task so that
patient care and safety is maintained.
The staffs will be allocated using the team nursing model based on their scope of
practice. The team consists of RN, EN and AINs. According to the scope of practice for AIN
in Australia, they have the responsibility to provide support to RNs during patient care. The
key activities that they can complete includes providing assistance with activities of daily
living, providing technical support function (such as cleaning equipments, bed making and
biometric data collection), verbal and written communication and contributing to safe
environment for patients (Department of Health, 2019). Hence, three AINs on duty can be
given the responsibility to check intravenous access of half the patients and identify any
infection control related issue.

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As many patients at the ward must be given antibiotics, one RN and another RN
acting as NUM can be given the responsibility to check handover report of each patient and
administer medication as per timing. This responsibility is within the scope of practice of
RNs as according to the registered nurse scope of practice, they can compound, dispense and
administer medications to patient. There is one EN in the team and the EN can be given the
responsibility to administer medication as they can provide direct and indirect care to patient
(Nursing and Midwifery Board of Australia, 2016). The EN can conduct assessment of the
patient and prepare patients for surgery too. Therefore, two RNs and one EN can take on the
responsibility of medication administration and three AINs can take on the role of assessing
intravenous access of patient.

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