What are the possible causes of the LVN/LPN’s failure to follow up on the delegated task?
Scenario 1 Dealing with Resistance to Delegation (Learning Exercise 20.3 in Marquis & Huston text) – page 458
You are the RN supervisor in a skilled nursing facility. Most of the direct patient care is provided by LVNs/LPNs and nurse’s aides. It is an extremely busy day, and there is a great deal of work to be done. Several times today, you have found one of the LVNs/LPNs taking long breaks in the lounge or chatting socially at the front desk despite the unmet needs of many patients. On those occasions, you have clearly delegated work tasks and time lines to her. Several hours later, you follow up on one of the delegated tasks and find that they were not completed. When you seek out the LVN/LPN, you find that she went to lunch without telling you or the aide. You are furious at her apparent disregard for your authority.
1. What are the possible causes of the LVN/LPN’s failure to follow up on the delegated task?
2. How will you deal with this LVN/LPN?
3. What goal serves as the basis for your actions? Justify your choice with rationale.
Scenario 2: Handling Staff-Patient Conflict (Learning Exercise 21.9 in Marquis & Huston text) – page 488
You are the supervisor of a rehabilitation unit. Two of your youngest female nursing assistants come to your office today to report that a young male paraplegic patient has been making lewd sexual comments and gestures when they provide basic care. When you question them about their response to the actions of the patient, they maintain that they normally simply look away and try to ignore him, although they are offended by his actions. They are reluctant to confront the patient directly. Because it is anticipated that this patient may remain on your unit for at least a month, the nursing assistants have asked you to intervene in the conflict by either talking to the patient or by assigning other nursing assistants responsibility for his care.
1. How will you handle this staff-patient conflict?
2. Is avoidance (assigning different staff to care for the patient) an appropriate conflict resolution strategy in this situation?
3. If you chose to encourage the nursing assistants to confront the patient directly, what coaching or role playing might you use with them?