Delegating: A Crucial, Sometimes Tricky Nursing Skill

Knowing where you fit in with the team.

Ralph Hogaboom / Flickr

As a new nurse I was entranced with my role. Throughout my schooling, I had worked closely with nurses and nursing instructors I admired, but out in the real world I was only beginning to understand how I fit in with the rest of the team. From those early years, I vividly remember two separate run-ins I had with nurse aides. I was so frustrated that they didn’t simply follow my instructions! Looking back, I think these disagreements were mostly about experienced workers “testing” me and our working relationship.

Delegation is not simple.

In “Delegating as a New Nurse” (free until January 10) in this month’s AJN, Amanda Anderson offers a wealth of practical information to help new and not-so-new nurses learn the art of delegation. I could have used her guidance back then. As she notes, delegation is not a “simple” task:

“It requires an appreciation of nuance and insight, both of which new graduates may lack. Delegation often requires skills that aren’t taught in nursing school and are difficult for preceptors to teach in the clinical setting.”

[…]

2018-12-26T10:34:48-05:00December 26th, 2018|nursing career, nursing roles|1 Comment
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A Few Notable Nurse Voices of 2018

A wealth of nursing voices.

I’m always amazed at the number of powerful, wise, courageous, funny nurse voices we have a chance to publish on this blog. Looking back over the past year, here are the links to a few posts by working nurses that stood out as worth another look.

Honoring the Moral Concerns of Caregivers Afraid of Giving Morphine

“‘I told her I’d take care of her,’ he whispers. ‘She took care of me. Now it’s my turn. I made her a promise. I don’t want to do the wrong thing.’”

A Day in the Emergency Room for a Nurse Who Loves Her Job

“I put my shoes on in the car like always. The shoes never go inside, as they bear remnants of the day before. I walk in to meet my tribe. We laugh off the previous day’s challenges as we start over.”

Comforting Our Patients: The Importance of Well-Chosen Words

“There’s seldom an opportunity to edit or revise on the floor of a nursing unit. Words cannot be unsaid.”

The School Nurse

“They march into my heart like little soldiers. There are lads and lassies, rich and poor, sporting bling and brawn.”

Reexamining Resilience

“I find that I have been so transformed by […]

2018-12-20T11:51:44-05:00December 20th, 2018|Nursing, nursing stories|2 Comments
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Breaking onto Boards: Tips for Nurses

Photo by Steve Debenport / Istock.com.

A 2014 survey by the American Hospital Association found that nurses—the largest group of health care professionals—held just 5% of hospital board seats (by comparison, physicians held 20%). It goes without saying that health care organizations stand to gain valuable insight and leadership by including more nurses in the boardroom. But as discussed by Blima Marcus in this month’s Professional Development column, nurses face many barriers to getting a seat at the table. These include:

  • the perception of nurses as “background” care providers rather than leaders
  • the tendency of board members and executives to nominate candidates who they are already familiar with and who work in a similar field
  • lacking the knowledge and skills needed to serve on a board (i.e., leadership and organizational skills)
  • not being a part of the socioeconomic class often associated with board membership—often, members are asked to make donations to their organizations

Overcoming the barriers

While these barriers may seem daunting, Marcus notes that there are practical actions nurses can take to put themselves […]

2018-12-18T10:03:55-05:00December 18th, 2018|Nursing, nursing career|0 Comments
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How Can Nurses Identify and Assist Human Trafficking Victims?

Wikimedia Commons/ AlvaroGzP

What do sex workers have in common with nannies, housekeepers, farmworkers, janitorial and restaurant staff, and factory and construction workers? They all work in settings where victims of human trafficking are commonly found.

Human trafficking is big business in the United States.

Our country is reported to be the second-largest market globally for women and children trafficked into sex work. Sex trafficking is the main form of trafficking among U.S. citizens, while forced labor trafficking is more common among foreign nationals living here.

Globally, human trafficking is second only to drug trafficking among criminal industries. Because nurses are “everywhere,” we are very likely to come into contact with human trafficking victims at some point. Would you know how to recognize one?

Possible indicators of human trafficking.

In a 2011 AJN article, Donna Sabella shares several possible indicators of human trafficking that warrant further investigation, including:

2018-12-13T08:10:08-05:00December 13th, 2018|Nursing, Public health|0 Comments
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Who Is Doing Advance Care Planning in Nursing Homes?

When I was an ED nurse in a city hospital years ago, we often received patient transfers from area nursing homes. Usually these patients were very elderly, appeared cachectic, and were largely unresponsive (as I recall, many were post-stroke or had dementia). Diagnoses were usually very similar: dehydration, hypotension, UTI, pneumonia; many had contractures. The usual care was rehydration with IV fluids, an NG tube, antibiotics, and often a Foley catheter. Sometimes they were septic and then they were intubated, placed on ventilators, and sent to the ICU, where just about everyone died after a short stay.

What’s the point of this care?

I often wondered, as did many of my colleagues, what was the point of this. It seemed futile, and injurious to the patient. Sometimes, if we could reach family members before nasogastric or endotracheal tubes were placed, we were able to secure an order to dispense with all but comfort measures. Otherwise, all measures were initiated and then things became complicated—legal issues arose about discontinuing futile care and families often couldn’t bring themselves to discontinue life support measures.

Today, a greater focus on advance care planning.

Advance care planning (ACP) was hit or miss in those days—mostly miss—and our patients suffered because of this. It’s only recently that emphasis has been placed on making […]

2018-12-10T11:07:41-05:00December 10th, 2018|Nursing|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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