NSB305: Leading and Learning: Building Professional Capacity Report

This report, designed for the NSB305 Leading and Learning module, critically examines the professional practice issue of care delegation and its associated leadership challenges faced by graduate registered nurses. It explores the difficulties of delegating care effectively and safely, including legal, ...Read More

Running head: CLINICAL CARE 1
Leading and Learning: Building Professional Capacity
Student’s Name
Institutional Affiliation

CLINICAL CARE 2
Leading and Learning: Building Professional Capacity
PART A: Delegating Care Effectively and Safely
Introduction
Graduate nurses face several challenges that directly affect them as individuals as well as
the patients they handle as care consumers. The working environment is sometimes chaotic or
fast-paced. Such a working setting is characterized by problems that could impact performance
and care experiences. The most affected practitioners are newly graduated professionals, which
explain why nurses should be aware of the origin and implication of workplace challenges. This
excerpt examines the difficulties posed by care delegation as a nursing practice challenge as well
as its implication on safe person-centered care.
Overview of the Challenge
Delegation of care in nursing is the process whereby nursing leaders direct other
practitioners to undertake specific activities and tasks in line with the scope of care management.
For delegation of duties to occur, there must be at least two parties or individuals where one
offers the direction while the other executes the given instructions (Joint Commission, 2015).
The delegator is often a leader or a person mandated with the responsibility of directing and
offering instruction. Graduate registered nurses are in most cases given the responsibility to
delegate a significant portion of care roles to another trained professional. Care delegation comes
with the responsibility of executing care tasks reliably and dependably. At the same time, the
process of delegation of care requires authority, which emanates from the training received and
the jurisdictions within the organizational policies, job description, and practice guidelines.
When a task is delegated, there is need for comprehensive accountability since, in care

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management, safety of patients and the effectiveness of interventions is mandatory. During
delegation, the care responsibility is transferred to another person; however, the graduate
registered nurse remains accountable to the entire outcomes associated with the assigned roles
(Hopkins et al., 2014). In this case, it remains a critical determinant of care outcomes and
consumer experiences, which implies that there is need for practitioners to understand the risks
involved and how to enhance outcomes associated with duty delegation n nursing.
Why the Challenge Pose Difficulties for GRN
There are several reasons why delegation of care poses a great challenge to graduate
registered nurses. Graduate registered nurses are expected to determine the tasks that require
delegation. Therefore, there is always a challenge to determining the legal and ethical scope that
defines each task before making any delegations. Organizational policies are to be considered for
a graduate registered nurse to effectively allocate or assign tasks to other people. Graduate
registered nurses require skills and experience to assess, plan, and evaluate each process to
identify the appropriate person to handle the tasks (Jenkins & Joyner, 2013). The challenge
comes when nurses are expected to delegate complex tasks to experienced practitioners while at
the same time giving roles to newly graduated nurses to improve their expertise. Such a conflict
is based on the need to enhance the safety of patients and treatment intervention outcomes.
After establishing the tasks to be handled, graduate registered nurses are supposed to
consider the impact of the underpinning circumstances associated with delegation of roles. For
example, it is one thing to assign roles to individuals but is another consideration to determine
whether the available resources are enough for task to be undertaken. Moreover, after delegation,
there is need for supervision. The impact of working environment also comes to the picture,
which influences the entire process of care delegation. In this context, it is clear that graduate

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registered nurses need to balance all these factors to guarantee outcomes in line with the nursing
standards of practice (Kaernested & Bragadottir, 2012). However, it is not always an as easy task
to align resources to available tasks, get the right supervision, and guarantee a favorable working
environment to other practitioners in a complex healthcare setting.
Furthermore, the other challenge associated with the care delegation that graduate
registered nurses have to deal with relates to finding the right person for the tasks. Owing to the
sensitive nature of healthcare delivery practices, one needs to have necessary training,
appropriate experience, capacity to work under minimal supervision, and the ability to manage
any emerging problems associated with the given tasks (McMullen et al., 2015). Graduate
registered nurses are required to identify individuals with a combination of these critical
elements before assigning any care management tasks. At the same time, they are required to
build a competent team through experience, in-practice learning, and job experience. In this case,
graduate registered nurses are expected to work with newly graduated nurses under tight
supervision to guarantee patient safety while building the skills of the young professional. Such a
scenario always results in significant challenges relating to care delegation.
Implication on Safe Person-Centered Care
It is important to note that the inability to meet care delegation efficiency could impact
the process of achieving safe person-centered care. Problems originating from inability of
graduate registered nurses to prioritize tasks based on legal, ethical, and guideline provision
defining care practice could lead to poor quality outcomes. Care management directly impacts
mortality rate, recovery period, patient satisfaction, and treatment efficiency (Mueller &
Vogelsmeier, 2013; Joint Commission, 2015). When practitioners are not assigned in line with
their qualifications and experience, they could jeopardize safety of patients against the nursing

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standards of practice. At the same time, inability to provide adequate resources, lack of balanced
allocation, and poor supervision of allocated tasks also affects the achievement of safe person-
centered care. Allocating tasks to right people improves the process of meeting the needs of
healthcare consumers; however, the contrary is equally true. There should be an effective
framework of communication; nevertheless, in the absence of such a system, delegation feedback
could delay, distorted, or disrupted to the extent of impacting the quality of care a patient could
receive. In a setting where there is inefficient delegation of duties, there is a high chance of
burnout among nurses, which exacerbates the ability of the practitioners to offer safe and
standard care (Mueller & Vogelsmeier, 2013; Joint Commission, 2015). At the same time, poor
delegation of roles affects the morale of healthcare workers, which eventually affect their
delivery and commitment.
Conclusion
In conclusion, the care delegation challenge affects the ability of nurses to meet the needs
of patients. The problem originates from the nature of leadership and supervision in a healthcare
facility, lack of motivation among practitioners, limited experience, and lack of enough
resources. When such a challenge occurs, it affects the process of achieving effective care
planning and implementation. In acute care, poor delegation could lead to high mortality rate and
in-hospital infections. It is equally not possible to achieve effective person-centered care when
the leadership is not able to foster comprehensive care delegation.
PART B: Speech: Realistic and Achievable Actions for GRN550
The challenges associated with delegation of care duties call for a strategic approach to
minimize the associated impacts. There is a need for graduate nurses to understand how to
overcome the problems emanating from the delegation of care duties. Graduate nurses are

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required to adhere to practices that enhance safety and quality outcomes (Joint Commission,
2015). Through emotional intelligence leadership, collaboration, self-evaluation, and reflection,
GRNs could overcome the challenges characterizing care duty delegation in nursing as I am
going to highlight in the next few minutes (Erkutlu & Chafra, 2012).
Nursing practice is associated with constant duty delegation based on schedules and
shifts. However, through emotional intelligence, graduate nurses could be in a position to
determine the best approach to emerging challenges during duty allocation (Cleary et al., 2018;
Erkutlu & Chafra, 2012). In some cases, it is possible for nurses to encounter burnout because of
workload; however, emotional awareness is central to understanding how to balance work and
life issues to enhance performance. Improper allocation of duties could affect patient outcomes
both on a short-term and long-term basis (Mueller & Vogelsmeier, 2013). In this case, graduate
nurses should be able to determine the difference between what works best for an individual and
when duty calls regardless of the time. During critical emergencies where several patients are in
need of care beyond the existing capacity of a specific schedule, other practitioners could be
called for support. Graduate nurses require a high level of emotional awareness and self-
regulation to understand that the safety of patients should be given a priority (Cleary et al., 2018;
Erkutlu & Chafra, 2012).
Challenges associated with the delegation of nursing care could also be solved through
teamwork (Damgaard & Young, 2014). Graduate nurses are supposed to understand that
teamwork and collaboration play a significant role in improving patient safety and experiences.
A healthcare facility with limited teamwork spirit is associated with poor patient outcomes and
interpersonal conflicts that negatively impact the allocation of schedules and care tasks.
However, graduate nurses could embrace teamwork and collaboration to reduce problems caused

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by improper delegation of nursing care. At the same time, collaboration outcomes could equally
be used to inform care delegation decisions to enhance the outcome of consumers both in general
and critical care.
Moreover, one way of improving care management is through self-reflection and self-
evaluation. Nurses could equally use self-reflection to improve the process of care delegation and
management. Through self-reflection and evaluation, practitioners focus on their experiences and
how they could improve their skills to enhance the safety of patients as well as care outcomes.
Graduate nurses could mitigate the complexities that dominate care delegation in nursing by
regularly reflecting on their experiences to get insights on how to improve the process of care
delivery in subsequent encounters. Each experience is unique and in most cases requires
partnership across different professional units to achieve the desired outcomes (Corazzini et al.,
2013). In this case, graduate nurses should consider the need to improve their skills in practice
with the objective of enhancing the safety of consumers.
In conclusion, care delegation challenges affect the satisfaction of consumers and the
safety of care interventions. Therefore, graduate nurses should consider the best ways to mitigate
these problems and improve care practice. Through collaboration and teamwork, practitioners
under transition to practice could influence care outcomes and delegation decisions to optimize
the experience of patients. At the same time, emotional awareness and self-regulation could
assist graduate nurses to improve how they handle any situation related to delegation of care.
Moreover, self-reflection and evaluation will provide essential practice insights that could be
used to inform delegation decisions.

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References
Cleary, M., Visentin, D., West, S., Lopez, V., & Kornhaber, R. (2018). Promoting emotional
intelligence and resilience in undergraduate nursing students: An integrative review,
Nurse Educ Today, 68; 112-120.
Corazzini, K. N., Anderson, R. A., Mueller, C., Thorpe, J. M., & McConnell, E. S. (2013).
Licensed practical nurse scope of practice and quality of nursing home care. Nursing
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Coutt, B. (2014). The complex decision making needed in significant event analysis, Primary
Health Care, 24(2); 26-30.
Damgaard, G., & Young, L. (2014). Virtual nursing care for school children with diabetes.
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Erkutlu, H. & Chafra, J. (2012). The impact of team empowerment on proactivity: the
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Hopkins, U., Itty, A. S., Nazario, H., Pinon, M., Slyer, J., & Singleton, J. (2012). The
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assistive personnel and their impact on the quality of care, patient satisfaction, and RN
staff satisfaction: a systematic review. JBI Libr Syst Rev. 10(15): 895-934.
Jenkins, B., & Joyner, J. (2013). Preparation, roles, and perceived effectiveness of unlicensed
assistive personnel. Journal of Nursing Regulation, 4(3), 33–39.
Kaernested, B. & Bragadottir, H. (2012). Delegation of registered nurses revisited: attitudes
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McMullen, T. L., Resnick, B., Chin-Hansen. J., Geiger-Brown, J. M., Miller, N., & Rubenstein,
R. (2015). Certified Nurse Aide Scope of practice: state-by-state differences in allowable
delegated activities. J Am Med Dir Assoc., 16(1): 20-24.
Mueller, C. & Vogelsmeier, A. (2013). Effective delegation: understanding responsibility,
authority, and accountability. Journal of Nursing Regulation, 4: 20-24.
Joint Commission. (2015). National Patient Safety Goals. The Joint Commission. Available at:
http://www.jointcommission.org/standards_information/npsgs.aspx