Effective nursing requires strong communication, collaboration, and self-care. In this assignment, you’ll reflect on a realistic practice-based scenario that brings together key topics from Weeks 4–6: delegation, teamwork, patient rights, professional communication, and managing stress in clinical environments.
Scenario:
You are a student nurse working on a busy medical-surgical floor. The RN you’re shadowing asks you to assist with patient rounds, including reviewing vitals, helping with hygiene, and preparing one patient for discharge. You overhear a tense conversation between a nurse and a patient’s family member about discharge plans. Later, a nursing assistant expresses frustration about being asked to do something outside of their scope. By the end of the shift, you're feeling overwhelmed, unsure whether you handled everything correctly, and you’re reflecting on how to manage similar situations in the future.
Your Task:
Write a 750–1000 word reflection addressing the following prompts:
Part 1: Delegation, Collaboration, and Patient Rights
How would you determine what tasks can be delegated and to whom?
What strategies would you use to support collaboration with the RN and the nursing assistant?
How would you ensure patient rights are protected in this scenario (e.g., informed consent, privacy, respect)?
Part 2: Communication and Conflict
How would you respond to the communication breakdown between the nurse and family member?
What structured communication tools (e.g., SBAR, closed-loop) would help in this situation?
How would you apply active listening and professionalism in peer communication?
Part 3: Stress and Self-Care
What signs of stress or early burnout might you be experiencing in this scenario?
Which self-care or emotional regulation strategies would you use to reflect and recover after the shift?
How might you prepare for similar challenges in the future?
Sample Answer
Nursing Reflection: Delegation, Communication, and Self-Care
This scenario on a busy medical-surgical floor presents a realistic challenge that integrates key principles of effective nursing practice. Reflecting on this experience as a student nurse allows for a critical evaluation of decision-making, interpersonal skills, and self-awareness. My goal is to analyze the situation and formulate actionable strategies for handling similar complex scenarios in the future.
Part 1: Delegation, Collaboration, and Patient Rights 🤝
Determining Delegated Tasks and Personnel
The decision to delegate tasks must strictly adhere to the Five Rights of Delegation established by the National Council of State Boards of Nursing (NCSBN): Right Task, Right Circumstance, Right Person, Right Direction/Communication, and Right Supervision/Evaluation.
In this scenario, assisting with reviewing vitals and helping with hygiene are tasks typically appropriate for a student nurse or a Nursing Assistant (NA), provided the patient is stable and the tasks are routine. Preparing a patient for discharge involves a complex mix of education, paperwork, and coordination that remains the professional responsibility of the Registered Nurse (RN). As a student, I would assist under the RN's direct supervision but not take full responsibility for the discharge teaching.
To determine who to delegate to, I would consider the individual's scope of practice and competency. The NA can perform basic care (vitals, hygiene). However, the overheard frustration suggests the NA was asked to perform a task outside their scope (e.g., administering medication, performing sterile procedures, or complex patient education). My approach would be to:
Clarify: Directly ask the NA, "Can you tell me more about what you were asked to do?" to assess if the task was truly outside their defined responsibilities.
Consult: If the task was inappropriate, I'd bring it to the attention of the RN, advocating for the NA and ensuring appropriate delegation occurs moving forward. Delegation is a safety issue; respecting scope is paramount.
Supporting Collaboration
Effective teamwork is essential for patient safety. To support collaboration with the RN and the NA, I would employ the following strategies:
With the RN: I would use assertive, professional communication to clarify my role and the expectations for the shift, especially regarding the complex task of preparing for discharge. I'd ask, "What specific steps of the discharge preparation would you like me to focus on, and how will you supervise my involvement?" This ensures alignment and closed-loop communication. I’d also offer support where appropriate and check in regularly.
With the Nursing Assistant (NA): After clarifying the scope issue, I would acknowledge their frustration and value their contribution: "It sounds like you had a tough moment. Thank you for speaking up about your concerns regarding your scope of practice. Your work is really important to this team." I'd offer to help with basic tasks I can safely complete (like getting supplies) to ease their workload, building trust and respect within the team.
Ensuring Patient Rights
The patient's rights must be protected, especially amidst a tense conversation and a busy environment.
Privacy and Confidentiality: Given the overheard conversation, I'd immediately ensure the discussion between the nurse and family member is held in a private location (e.g., a consultation room or away from other patients/public areas) to protect the patient's confidential medical information.
Respect and Dignity: The tense nature of the conversation is a potential breach of the patient's right to respectful care. While I would not interrupt the conversation directly, I would document the observation and, if the tension escalated or became unprofessional, I would inform the charge nurse or my shadowing RN immediately. I'd remind myself and the team that all interactions, even when difficult, must treat the patient and family with respect.
Informed Consent: Discharge planning is a crucial part of informed consent for continued care. If the family member is disputing the plan, it suggests they may not feel fully informed or comfortable. I would encourage the RN to slow down, use plain language, and ensure the patient and family genuinely understand and agree to the post-discharge instructions (medications, follow-up, potential complications)