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When working as the clinical placement, an RN, where the delegation was used when working with the group of patients, in one instance, faced the problem of the co-ordination and the commitment from the other multidisciplinary team. Being an RN, my dut was to provide the best safe practice and care to the patient, however, due to the routine duties such as taking care of the patient current health, changing medication dosages and maintaining the records by the other nurses and to coordinate with the multi-disciplinary teams became an issue, during the routine shift handover (Baddar, 2016).
As per my opinion, when delegating my duties and tasks, during the time of the shift handover, it is important to be diligent, take a record of all the duties and the patient's response to it and while ending shift to hand it over to the next nurse on duty. It would also be a problematic concern if the nurses are not able t track and keep a record of all the information. I felt very bad, faced stressed and also understood the situation of the complex, as I have to delegate the care of the patient to the next nurse, whom I knew would not be able to keep a record of everything, such as the patient routine tasks, medication taken and also the routine care, due to which the patient often complains. I also felt while the nurse must coordinate with the multidisciplinary team, but due to the proactive and the delay in response from the multi-disciplinary team, also causes frustration and also lack of information. As the nurses, it is important to be swift in action, disciplined and while delegating the duties, to coordinate better and help the other peer nurse to work in the same manner.
I have often faced the communication issue and it has resulted in the lack of the coordination much as the nurses not taking the quick notes on the patients, not recording and keeping a track in the same manner, as I have done, leading to during the shift hand over and delegation of the duties, there is a lack of the responsibility and the accountability. By not taking records and while delegating the duties, I feel it is a challenge in the perceptions and the responsibility undertaken.Fr example, if the certain medication dosages have to be given to the patient at the 8 p.m. with the set dosages, the patient attendance chart and the medication records are not maintained. The same thing was when making the peer ask to call the multidisciplinary team, as the physicians on the duty are also equally busy and even attending many patients, keeping a record of every patient and then taking records would be difficult, it is important to check the doctor with the proper file and the handover notes so that any information is missed.
But some nurses in charge, do not record everything and keep a mental record, causing a conflict of the information and also leading to the careless mistakes. At every phase of the delegation of the duties, it is necessary to be proactive and even swift in actions, so that any mistakes or any careless attitudes can be rectified and corrected. Additionally, I have also experienced the problem of the nurse's attitudes, facing overconfidence, and even incapability to work in the same professional manner as the other nurses on duty follow it. As the nurse, all the nurses should work proficiently and proactively, rather than being directed with what to do and what to ignore.
As per the evaluation of the delegation challenges, while being on duty, the main problem has been faced are the peer nurses having a lack of knowledge and the inability to perform duties with the same capabilities of staff, further, the nurses are incompetent and also unskilled to perform at par (Gassas, 2017). The other problem faced is the lack of competency, skillset based issues, having a lack of experience, facing an adequate level of education, and also the incapability to handle the information in the same manner, as it has been detailed out. The other issue is the delegation while on the duty, as the peer nurses also not detailing entire information as they have the fear of being judged, or simply the problem of the coordination while delegating the duties in the same manner, causing a lack of low administrative support and facing over Confidence from the superiors. The other problems which can be seen are the lack of proper controls and undermined confidence while handling the specific tasks on duty (Kurt, 2018). It is important to check base with the peer skilled nurse tests, to understand how the nurses can coordinate and perform duties when they are delegated. Apart from the recruitment test, it is
important to have the skill-based tests, where a short test on the capability to cope up, handling pressure, and how to perform the routine duties professionally and diligently can be done. In the case of the nonperformance and the overconfidence problem, it can further cause the problems of conflicts and also the inability to handle the tasks in the same proficient manner. While delegating the duties it is also important to explain the reasons, understand the group of patient's main concerns and requirements, state the required outcomes, and further how to handle it effectively. It is also important to be supportive and be considerate when delegating the full and adequate steps and coordinating in the end (Khadim, 2018). The other obstacles while delegating are the fear of being disliked, facing an inability to give up control for the situation, to face the problem of the responsibility as to whom would be assigned and how it would be performed and in general a bad experience on the delegation.
In my opinion, cases of poor delegation and obstacles are due to face the problem of the mishandling and the low efforts by the nurses on duties and the incapability to handle the work (Khadim, 2018). The other problem faced is the lack of confidence and the problem of facing the fear failure along with facing the reactions from the team members. It is important to delegate and to be sensitive when assigning the other nurse on duties, with the help of effective communication, and to direct the nurses at every stage of the duties initially. The nurses on duty should also be checked for the specific knowledge, how they are accepting the duties assigned, and what would be the effective ways to handle it in a better manner (Gassas, 2017). Through the delegation of duties and with the better course of the action, delegation can happen in the successful way. The nurses have to be more cordial and be able to handle in the best priority manner and to understand the transparency during the hierarchy process. It is important that the nurses can think, relate, and also work in line with the best efforts (Barrow 2019). It has also been analyzed, the problem of how to handle one own task in an effective manner, developing a work based relationships with the other team members, having a piece of in-depth knowledge and also to inform fully another peer when delegating and to command in the same manner as the other professional nurse
was working. The other problems, when faced during the delegation, are the lack of knowledge, the incapability of the other practicing nurse to perform duties, lack of the skills, experience and also the low level of education and having an incompetent job description along with experiencing a fear of being judged and how to handle the delegated tasks. It is also important to acquire the active administrative support and to attain effective communication skills, to lead command, and also deliver the duties. When the nurses are on duties, it is important to be transparent, concise, keeps the records clear, and even when delegating the duties, to detail what is happening in the case and how it should be handled with the care professionally. Every step requires full command and control, that could allow effective ways to handle it diligently.
As a strategy to delegate duties and to coordinate better, it is important to be in the commanding position, to be a leader, to delegate the duties in a better scope of manner (Nancy, 218). The first step would be the right to take the adequate tasks, be in the command of the right to handle the circumstances, to have the right effective person and approach, along with handling with the right person and attaining the right set of directions and having the effective course of communication. The last stage to perform would be the rightfully handle the supervision and evaluation. Even though, at every stage, there is no clarity, overlapping of the responsibilities, not having enough time to perform the duties, not getting credit and also there can be lack of duties to be performed and can cause the low responsibility to manage the confidence and inability to suffer due to the fear of failure and facing the adverse reactions from the team members. (Kurt, 2018) At every stage of the leading and commanding, it is important to be an effective communicator, be clear as to what has to be handled, and what is the future outcome projected, to be on the same page. the other duties would be how to map and command the roles and the responsibilities in an effective manner and with better transparency. At every stges, in my opinion, no information should be hidden and told as the information has been projected with the same
perception and attitude. it is important to channelize the resources and then professionally handle them with the focus on safety practices and care (Khadim, 2018).
To conclude, often the conflicts when handling during the delegation stages can be due to the lack of accounting and the responsibility of the duties and there can be an issue of the nonperformance of the task and the set issues to be handled. the other problems which can be faced when handling the issue would be the leadership qualities, commanding and detailing every information with full attention, and the preciseness, to avoid any confusion. It is important to lead, command, and be in the position to avoid any overlapping issues and any complexities.
Baddar, F., Salem, O. A., & Hakami, A. A. (2016). Nurse Manager's attitudes and preparedness towards effective delegation in Saudi Hospitals. Health Science Journal, 10(2), 1.
Barrow, J. M., & Sharma, S. (2019). Nursing Five Rights of Delegation.
Gassas, R. S., Mahran, S. M., & Banjar, H. I. (2017). Nurse managers’ attitude and competency towards delegation in Jeddah City. American Journal of Nursing Science, 6(2), 72-79.
Khadim, H. A., Ali, A., Ijaz, M. S., & Rooman, N. (2018). Nurse manager’s attitudes and preparedness towards effective delegation in a tertiarycCare Public Hospital Lahore. Natl J Heal Sci, 3, 99-106.
Kurt, S., Kose, B. G., Balik, N. T., & Ozturk, H. (2018). Assessment of delegation level in nurse managers. New Trends and Issues Proceedings on Advances in Pure and Applied Sciences, (10), 69-77.
Nancy Panthofer, M. S. N. (2018). Appropriate delegation in ambulatory care nursing practice. AAACN Viewpoint, 40(1), 14-15.
Young, H. M., Farnham, J., & Reinhard, S. C. (2016). Nurse delegation in home care: research guiding policy change. Journal of gerontological nursing, 42(9), 7-15.
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