RULES OF MANAGEMENT

   The Rules of Management

1.    Do not delegate assessment, teaching, or evaluation

2.    Delegate care for stable patients with expected outcomes

3.    Delegate tasks that involve standard, unchanging procedures

4.    Stable vs. unstable

   Right Task – can the task be delegated?

   Right person – who is the competent person for the selected task?

   Right communication – how do I get the person selected for the task to understand what I want?

   Right feedback – “How do I give feedback during my periodic inspection?”

Nurse’s aide, unlicensed assistive personnel (NA, UAP’s) does the following:

   Bed making, bathing, feeding, ambulating, general ADLs

   Unchanging, uncomplicated tasks

   Stable clients

Licensed Practical Nurse (LPN), Licensed Vocational Nurse (LVN’s)
Procedures requiring knowledge of sterile technique, medication administration (PO, SQ, IM but not IV)

   Examples: suctioning, catheterization, wound care

   Supplementary health teaching

Registered Nurses (RN’s)

   Decision making for all facets of client care

   Communicates with members of the health care team to relay changes in client’s condition

   Examples; administering chemotherapy, starting BT, caring for ventilator clients

   Most critically ill or sickest client

A 7-year old boy with a compound fracture of the left femur is being admitted to a pediatric unit.  Which of the following actions is best for the nurse to take?

1.  Ask the nursing assistant to obtain the child’s vital signs while the nurse obtains a history from the parents.

2.  Ask the LPN/LVN to assess the peripheral pulses of the child’s left leg while the nurse completes the admission forms.

3.  Ask the LPN/LVN to stay with the child and his parents while the nurse obtains phone orders from the physician.

4.  Ask the nursing assistant to obtain equipment for the child’s care while the nurse talks with the child and his parents.

Answer: 4