NRSG355: Clinical Integration Assignment Covering Modules 1, 2, and 3

This assignment response addresses key concepts from three modules of a nursing clinical integration course (NRSG355). Module 1 focuses on critical thinking, clinical decision-making, and professional development, including prioritization of patient care scenarios. Module 2 explores collaborative and therapeutic practice, emphasizing the roles within multidisciplinary healthcare teams and factors influencing team composition, along with a case study analysis of a patient with multiple health issues and the required team. Module 3 delves into delegation within nursing, outlining the delegation process, patient allocation models, and the application of a team-based model in a clinical setting with a focus on staff allocation and supervision. The assignment demonstrates understanding of scope of practice, delegation, and advocacy within the context of nursing practice, referencing relevant literature and applying theoretical knowledge to practical scenarios.

Running head: NURSING
NURSING
Name of Student
Name of University
Author note

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Response to Module 1
In terms of priority, the tasks I will take is –
vi. Firstly As you are taking this handover, an elderly female post-operative patient collapses
to the floor and is unconscious. She has had facial surgery – I should take up this task as last
The patient fell and collapsed right in front of me and it is my duty to care of the fallen
patient. I cannot send the enrolled nurses who is not yet competent or the clerk to care for
this medical emergency at any cost. This sudden fall or collapse of a person can distort the
surgical corrections of face. It is increasingly important to attend this patient immediately as
the damage is minimized and care is delivered as soon as people. Hence, collapse this
scenario is a medical emergency and have to be dealt by me.
i. Mrs. Chew’s intravenous (IV) infusion has tissued, her IV fluids are running
behind and she has missed her 14.00 hrs. IV antibiotic – I will take up with task
being a Registered nurse – it is my duty to check for any complications resulting
from missing of medication. The overall medication chart has to be rechecked by
me as to prevent any possible medication administration related complications.
The intravenous fluid levels needs to be checked and re-placement of the IV
fluids. The enrolled nurse who is undertaking an IV Canulation certificate can be
used as an important resource.
iv. Mr. Esposito is scheduled to leave the ward now for his cardiac catheterisation and he has
still not received his preoperative medication.
I have to intervene the situation as the enrolled nurses, the assistant nurses are
incompetent and the other Registered nurse is busy elsewhere. Administration of the right
drug or medicine in the perioperative situation should be ensured and for the effective

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culturally competent communication with patient – a registered nurse should take action
at first.
v. One of the surgical consultants (VMO) is waiting to discuss a medication error that
happened last week.
After all the important cases are met, I can then meet the waiting VMO. Since, this cases
poses the least risk but yet it has to sorted by the me – it is prioritized at the end.
Tasks, I will delegate to others:-
ii. Mr. Smith’s visitor has fainted
In a family nursing scenario – the assistant nurse and the enrolled nurse are right persons
to see the fainted guest.
iii. One of the staff toilets has blocked and is overflowing and waste is pouring out
rapidly.
The clerk can alone take care of these incidents.
Rationale –
The priority care must be based on the most acute and emergence case at first and then
followed by moderate to know risk cases. Attention to details, problem solving and decision
making are the tools to be effectively used in the clinical rationale of prioritization of patient
attending by the nurses (Drach‐Zahavy, Goldblatt & Maizel, 2015; Doran, & Hutchinson,
2017). Delegation is important when a nurse single handedly is unable to manage a lot of
emergency cases with care. Hence she must segregate the cases on basis of severity and acute
needs and then keep the most acute ones to herself and delegate the less important or urgent
cases to less skilled professional.

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Response to Module 2
2a. The factors that determine who are to be there in the multi-disciplinary team are nature of
disease, the clinical and allied health resources of the facility, the type of health service to
provided, the kinds of procedure to be developed, the stage of the disease, the overall
symptoms of the disease, the present signs and symptoms of the disease, multi system
disease, nature of disease (pathophysiology) (Sparks et al., 2017; Clarke & Forster, 2015).
Various socioeconomic factors also plan a vital role in formation of the multidisciplinary
such as patient’s degree of affordability to receive a particular type of disciplinary care, the
technologies to be used in the procedures and their expense to be bore by the hospital and the
patient (Cannon et al., 2016). The operational factors are also very critical such as
infrastructure, the procedural policies, the organizational disease specific policies, the kind of
health care model chosen by the hospital or the government working closely with the
framework of health care facilities. Other cardinal factors encompasses the change health
models, the evidence based practices and the collaborative practices.
The professional with most experience or the broadest spectrum of knowledge about
various disciplines should lead the team (Sims, Hewitt & Harris, 2015). The leader should in
any case – have strong leadership skills and motivational, problem solving approach as well.
More than other, the leader must have great interpersonal communication skills and apt level
of clinical reasoning.
The team coordinator also known as the team key worker is the most important
member of team as he links the different segments and functionalities of the team (Swanwick
and McKimm, 2017).
2b. Robert has multiple issues, as depicted and implied in the case study overall. The keys are
fall leading to injuries. He has suffered two fractures – one at the tibia/fibula and the other at

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the radius. This is a key physical injury that has to be managed on a priority basis. The other
issues that can be considered is the intellectual impairment of Robert that is existent and
persistent since his childhood. Cerebral palsy, the name of the condition resulting from a set
of non -progressive neuropsychological injury that affects the motor, sensory and the
cognitive part of the child development (Robinson, Prochaska & Yngve, 2017). This can
cause decreased motor coordination, perceptual and sensory problems as well. the most
marked issue as seen in some forms of cerebral palsy (Levitt & Addison, 2018) – is the
intellectual deficiency leading to intellectual or cognitive impairment which is the one of
cardinal issue with 52 year old Robert Hughes. The third key problem with Robert is
aggression and violent behavior resulting from his communication gap with health care
framework, present in his immediate environment.
The multi-disciplinary team or the MDT for Robert should include an orthopedic
specialist surgeon who would treat the fracture, a dietician who would provide him with the
right ‘healing’ diet, a neuropsychologist or a behavioral psychologist who would apply CBT
or cognitive behavioral techniques to re-educate his behavior, a mental health nurse who
would strengthen his psychosocial relations, a psychiatrist to treat him with medications that
makes him rest and sleep.
Response to Module 3
Delegation is an important component of nursing that includes prioritization, time
management and distributing the tasks based on criticality to other members in order to up
skill their performances. The task, the right person, right situation, right direction, right kind
of communication along with interpersonal skills along with the right supervision of the
junior nurses by the senior nurses – are the five vital steps of the nursing delegation process.
Various patient allocation models are in practice and they forms a day to day allocation
process within the framework of nursing manager, senior nurses, junior nurses, enrolled

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nurses and the nursing assistants (Purpora, Blegen & Stotts, 2015). There are 22 nurses in the
wards of whom 14 nurses went to the surgery in the day shift and the remaining 8 is about to,
in my shift. With me in the clinical scenario – there is one registered nurse that is me, one
other RN who is acting as the nursing manager in absence of the real manager who is on a
sick leave, there is one more Enrolled nurse and three assistant nurses. Of all the allocation
models – the total patient care models, the relationship based care models, task allocation and
the team nursing models are the most important ones. In the case scenario, the team based
model can be applied and the patient allocated can be decided. Based on team based model –
the hierarchy and connections of nursing in an organization is taken into consideration and
the work roles of each of them are taken into calculation (Banks et al., 2016). The nursing
manager, the registered nurses, enrolled nurses and the nursing assistants are important
components of the hierarchy and the team based system. The model strives to manage, teach
and communicate the nursing members by the peers and the seniors. In this case, the half of
the after hour patients that is 4 who has intravenous access and needs antibiotics before the
surgery should be allocated to RN and the other 4 patients who does not require the antibiotic
medications before the surgery can be allocated to the Enrolled nurse who can work with the
collaboration from the 3 nursing assistants. The Nursing manager needs to supervise,
manage, educate and communicate all the other 5 nursing professionals in the ward. The
registered nurses need to supervise, manage and communicate effective with the enrolled
nurses and the other three nursing assistants. According to the team based model which is
based on the social hierarchy of nursing applying their knowledge and practice of clinical
intergration to maintain the staff allocation system – and following the same hierarchical rule
of Team based model, the enrolled nurse must be educating and guiding the nursing assistants
accordingly. The collaboration of the clinical surgical nurses are very vital, especially in the

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after hours when the work force is decreased and hence, the stability and communication of
these nurses are highly tested.

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References
Banks, G. C., McCauley, K. D., Gardner, W. L., & Guler, C. E. (2016). A meta-analytic
review of authentic and transformational leadership: A test for redundancy. The
Leadership Quarterly, 27(4), 634-652.
Cannon, S., Lawry, K., Brudell, M., Rees, R., Wenke, R., & Bisset, L. (2016). Appetite for
change: A multidisciplinary team approach to behavioral modification for weight
management in a community health group setting. Eating and Weight Disorders-
Studies on Anorexia, Bulimia and Obesity, 21(4), 661-668.
Clarke, D. J., & Forster, A. (2015). Improving post-stroke recovery: the role of the
multidisciplinary health care team. Journal of multidisciplinary healthcare, 8, 433.
Doran, F., & Hutchinson, M. (2017). Student nurses’ knowledge and attitudes towards
domestic violence: results of survey highlight need for continued attention to
undergraduate curriculum. Journal of clinical nursing, 26(15-16), 2286-2296.
Drach‐Zahavy, A., Goldblatt, H., & Maizel, A. (2015). Between standardisation and
resilience: nurses' emergent risk management strategies during handovers. Journal of
Clinical Nursing, 24(3-4), 592-601.
Kuijpers, E., Luites, J. W., & Vriezekolk, J. E. (2016). OP0269-HPR Patient Participation in
Multidisciplinary Team Care: Views of Patients and Health Care Professionals.
Levitt, S., & Addison, A. (2018). Treatment of cerebral palsy and motor delay. Wiley-
Blackwell.
Purpora, C., Blegen, M. A., & Stotts, N. A. (2015). Hospital staff registered nurses'
perception of horizontal violence, peer relationships, and the quality and safety of
patient care. Work, 51(1), 29-37.

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Robinson, J. D., Prochaska, J. D., & Yngve, D. A. (2017). Pre-surgery evaluations by
telephone decrease travel and cost for families of children with cerebral palsy. SAGE
open medicine, 5, 2050312117720046.
Sims, S., Hewitt, G., & Harris, R. (2015). Evidence of a shared purpose, critical reflection,
innovation and leadership in interprofessional healthcare teams: a realist
synthesis. Journal of Interprofessional Care, 29(3), 209-215.
Sparks, J. L., Crouch, D. L., Sobba, K., Evans, D., Zhang, J., Johnson, J. E., ... & Carter, J.
(2017). Association of a surgical task during training with team skill acquisition
among surgical residents: the missing piece in multidisciplinary team training. JAMA
surgery, 152(9), 818-825.
Swanwick, T. and McKimm, J., 2017. ABC of clinical leadership. John Wiley & Sons.