prioritization-delegation-and-assignment-practice-exercises-for-the-nclex-examination-4th-edition

leadership and direction would that nurse need from an experienced ICU RN?
Many hospitals delegate only tasks, a functional form of assignment, to
temporary personnel who are unfamiliar with the clinical area.
Right Direction and Communication
Now that the right staff member is being delegated the right task for each
particular situation and setting, team members must find out what they need to
do and how the tasks must be done. Relaying instructions about the plan for the
shift or even for a specific task is not as simple as it seems. Some RNs believe
that a written assignment board provides enough information to proceed
because “everyone knows his or her job,” but others spend copious amounts of
time giving overly detailed directions to bored staff. The “four Cs” of initial
direction will help clarify the salient points of this process (Hansten and
Jackson, 2009, pp. 287–288; 2012, pp. 299–300). Instructions and ongoing
direction must be clear, concise, correct, and complete.
Clear communication is information that is understood by the listener. An
ambiguous question such as: “Can you get the new patient?” is not helpful
when there are several new patients and returning surgical patients, and
“getting” could mean transporting, admitting, or taking full responsibility for
the care of the patient. Asking the delegatee to restate the instructions and work
plan can be helpful to determine whether the communication is clear.
Concise statements are those that give enough but not too much additional
information. The student nurse who merely wants to know how to turn on the
chemical strip analyzer machine does not need a full treatise on the transit of
potassium and glucose through the cell membrane. Too much or irrelevant
information confuses the listener and wastes precious time.
Correct communication is that which is accurate and is aligned to rules,
regulations, or job descriptions. Are the room number, patient name, and other
identifiers correct? Are there two patients with similar last names? Can this task
be delegated to this individual? Correct communication is not cloudy or
confusing (Hansten and Jackson, 2009, pp. 287–288; 2012, p. 299).
Complete communication leaves no room for doubt on the part of supervisor
or delegatees. Staff members often say, “I would do whatever the RNs want if
they would just tell me what they want me to do and how to do it.” Incomplete
communication wins the top prize for creating team strife and substandard
work. Assuming that staff “know” what to do and how to do it, along with
what information to report and when, creates havoc, rework, and frustration for
patients and staff alike. Each staff member should have in mind a clear map or
plan for the day, what to do and why, and what and when to report to the team
leader. Parameters for reporting and the results that should be expected are
often left in the team leader's brain rather than being discussed and spelled out
in sufficient detail. RNs are accountable for clear, concise, correct, and complete
initial and ongoing direction.
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