Australian General Practitioners: Desperately Seeking Satisfaction - Article Example

Introduction Responsibilities and roles are clearly defined in organizations ensuring that there is no conflict or misunderstanding between the involved parties. Organizations have clear guidelines on how tasks should be accomplished. In a hospital setting, doctors, nurses and other players are supposed to play within their roles ensuring optimum service to the patients. However, sometimes the tasks are many and thus the responsible people may decide to delegate the duties. The aim of this paper is to discuss delegation within a hospital settings bringing into consideration contents and factors associated to delegation within hospital settings. Nursing as a Profession Nursing is basically a profession that relates and blends the traditions of the past with the frequently changing reality in the health industry (Edwards, et al, 2002). The status of profession in nursing reflects the value of the society with respect to the nursing work, being professional refers to having knowledge in the subject, conscience in action, responsible to others and self. However, a true professional nurse should basically be an intellectual as opposed to physical, practical rather than theoretical, and be able to learn as a way of getting the knowledge. Delegation In nursing, there are various roles handled differently in the nursing profession, the primary roles of behaviour change include the need to manage and measure the outcome, the need to financially understand the organization’s situation (Chew & Williams, 2001). However, the management resorted to strategies that would improve the overall output in the healthcare through the transfer of nursing responsibilities and tasks to be performed by competent individuals, the process referred to as delegation. It is the mandate of the registered nurse (RN) to delegate nursing duties and tasks to the unlicensed healthcare workers though; the registered nurse is still overall accountable for delegated tasks and patient care (Conway & Kearin, 2007). Delegation is a management strategy used to enhance efficiency in the healthcare fraternity, the responsibilities and tasks delegation enables the registered nurse to attend to other tasks and situations that require urgent actions and professionalism. However, registered nurse must carefully make decisions considering the training and the skills of the unlicensed healthcare worker and the patient’s medical/ health conditions (Edwards, et al, 2002). There are factors to be considered before delegation is carried out. The registered nurse should state the expected outcome, completion time frame and any other concern to the Unlicensed healthcare worker before the delegation is carried out so that in case of anything that need clarification, the registered nurse should be able to reduce the cases of poor performance by the unlicensed healthcare worker for example: - situations where the unregistered healthcare worker fail to take the patients progress report which is of importance to the doctor in monitoring the patient’s conditions and response to medication. However, in performance, delegation enhances responsibility and accountability as the different role players would be answerable and responsible for the inactions and actions of others and self in the delegation context which is the nurse’s legal liability for her patients, actions and outcomes respectively (Chew & Williams, 2001). The failure of the unlicensed healthcare worker to take records and/ or monitor the patient’s situation is termed as unprofessional conduct. In Nursing, it is important to evaluate, assess and intervene, correctly document, proper medication and treatment, confidentiality and integrity through performing only the duties and roles that the healthcare personnel is trained and legally authorized to do (Kunzle, et al, 2001).     Reasons for delegation Doctors have difficult tasks of administering medication and treatment to patients, this workload can be reduced through delegation. However, this does not mean that the doctors will no longer have a duty, they delegate then make the overall cover-up and/ or attending to the more serious cases that arise (Kunzle, et al, 2001). Delegation would save both the doctors time and the patients’ waiting time hence reducing congestion in health institutions, hence patients’ confidence in the services obtained from the health institution (Conway & Kearin, 2007). There are cases in the health institutions which would cost more lives without delegation, stable patients should be assigned to registered nurses to monitor and write treatment reports that the doctors should use to monitor response to the administered drugs to recommend discharge or not to. Due to professionalism, the nurses will be able to handle complicated cases should the doctors approves the registered nurses’ capability (Conway & Kearin, 2007). The registered nurses may have been giving accurate patient reports, this would positively reflect the performance of the nurse leading to delegation of more tasks/ or duties. The clinical situation may impacts on the delegation of duties for example; when the doctor handles a serious case in the same clinic and/ or another clinic, the doctor may authorize the registered nurse to carry out the duties to save the life of the patient which is all that healthcare entails. Some duties/ tasks may not require the presence of the doctor e/g. the evaluation of patent’s progress and discharge planning. The doctor should delegate, giving instructions the required procedure to be followed in performing the duties, the doctor should countercheck later as the decision maker in this case. The availability of RNs in the clinic creates understanding between the patients and RN leading to delegation of nurses to patients takes reports and updates the doctor to confirm treatment and drug prescription respectively. Nurses can be delegated in any line of duty, for example; administrative delegations like admission of patients, discharge, and billing. Due to the shortage of nurses, the delegation within the nursing management is on the increase; however, this increases the workload on RNs, hence innovation, flexibility, job satisfaction, responsibility and change adaptation (Edwards, et al, 2002). Delegation and supervision of unlicensed health care workers The unlicensed workers in the healthcare are individuals who may have trained and certified to work but still not licensed to perform the duties of a registered nurse. For example but not limited to: -home health care aides, technicians in the patient care and certified nursing care assistants. However, in healthcare given to the elderly in adult homes and daycares, they prefer the services of the unlicensed healthcare workers comparatively to the traditional nursing care intuitions. The unlicensed healthcare workers should not be delegated duties of the registered nurses, instead be utilized as assistive support to RN. The supervision and leadership abilities of a RN is evidenced in the duties delegated to the UHCW taking into account the competency of the UHCW in the delegated duties and tasks, the number of direct care under the supervision of the registered nurse, the number of patients available at that time, the institutional policies and procedures which varies with institutions, and is also a factor that determines the number of care givers supervised by a registered nurse at any time (Conway & Kearin, 2007). The medical condition of the patient is a factor to be considered before assigning unlicensed assisting personnel any task. Some patients may really have fragile medical conditions that require special attention and accuracy (medically fragile means that the patient who is neither stable nor having a chronic illness. The preferred duties to be performed by unlicensed healthcare workers are the routine tasks associated with the chronic diseases but not the acute tasks respectively. There are some tasks that the unlicensed healthcare workers may have done in the traditional delivery of patients for example: - basic hygiene and health tasks, ambulation, bathing, vital signs, feeding, weight assistance through elimination, maintenance of a safe healthy environment, simple changing of the dressing gauzes, just to mention but a few. The unlicensed health care workers are not allowed to delegate any task to other UHWs or even their seniors; it is the prerogative of the registered nurse to ultimately decide on the assignments and tasks appropriately. Each person registered or unlicensed must work in accordance with the laid nursing laws/ regulations and procedures involved in nursing practice (Conway & Kearin, 2007). The characteristic of effective delegation Effective delegation is the process of guiding and directing the outcome of a group/ individual task performance. However, it may refer to the oversight, guidance or direction, evaluation and making follow ups by RN for the accomplishment of the task delegated to the UHCW (Edwards, et al, 2002). Delegation and supervision meant for the management positions and the RN not in the management positions to supervise once they delegate the duties. For delegation of UHCWs, it is critical for the RN to monitor the conditions of the patient to be assigned, i.e. if the patient condition is stable, requires non complicated and technical experience then the patient would be delegated to UHCW. However, some patients’ conditions may be stable but complex. The RN should justify the condition to affirm the monitored conditions. However, not all the UHCWs are at par with the technology in the health institutions, some monitoring equipments may be delicate and prone to errors when wrongly handled, so the RN should consider the equipment stature before making a decision on UHCW delegation to patients (Kadushin & Harkness, 2002). However, some patient conditions may have adverse side effects that abruptly complicate their survival within very short time, patients with such conditions should be handled by the RN for proper monitoring to lower the emergency caused by poor diagnostic skills of the UHCW. With proper education, the RN will consider the UHCW with higher education to be the assistant to enhance understanding, quick learning and procedurally undertaking the duties assigned, with proper recording and analysis. However, UHW with better education simplifies the RN’s work hence accuracy and work efficiency. The amount and frequency of supervision is a factor in delegation process, the more frequent the RN visits the UHW the more confident UHCW will be and the better the work output. The ratio of RN to UHCW matters in the success of delegation (Edwards, et al, 2002). With only a few RN’s comparatively to the UHCWs’, the RNs will be overloaded than when they work independently. The quality and successes of delegation is inversely depended on the number of RN with respect to the UHCW, with good team work, task monitoring and practicable procedures results into success and stress free work done (Chew & Williams, 2001). Unlicensed health care workers These are individuals trained to handle assistive roles to the RN in the patience care activity provision as delegated by the RN; they have no option to the kind of task to be delegated regardless of the titles they hold. The RN is overall in-charge, the UHCW includes but not limited to the technicians, medication aides, and attendants (Edwards, et al, 2002). The supervision and delegation is done by the RN, which can either be through verbal or written communication. Before the RN delegates the duties, there are five professional and critical thinking rights that the RN must consider; if the tasks to be delegated are the right task for the UHCW or not, the prevailing circumstances are able to be handled by the UHCW as some circumstances may be complex and requires more critical thinking and professional experience. However, the UHCW may not be in possession of the person assisting should be accessed by the RN to confirm that the person will be able to handle the situation (Chew & Williams, 2001). The process of communication and directives from the RN should be well understood by the UHCW to make sure that the right procedures are followed as directed. It is the RN who delegates tasks related to care of the patients to the UHCWs but not the nursing process itself and any personal action if the assisting staff with be answerable to the RN. Taking into account the knowledge and skills of the UHCW, the RN will determine whether to delegate or not to delegate the elements of care. In most cases, the UHCW will liars with the RN to confirm the task allocated and if the work is done accordingly (Kunzle, et al, 2001). The overall decision on the work done will be made by the RN. After a series of delegations, the UHCW will then gained courage and hand on experience on the kind of jobs that are frequently delegated. Through the assessment of the completed tasks buy the RN, it would be easier to determine which jobs to delegate depending on the performance of the UHCW considering training, procedure, cultural competence, agency policies, experience and facility. The UHCW would cooperate to ensure the satisfaction of the RN (Kunzle, et al, 2001). Summary In conclusion, to being a nurse is dedication, it entails sensitive responsibilities, however, there are many lives that are dependent on the nurses and therefore it is a challenge to the nurses to handle nursing career with generosity and humbleness it deserves. Through organized, planned, healthcare delivery, quality assurance, preparedness, and ability to respond to patients needs, there would be remarkably low incidents of loss of life that occurs due to the nurses’ failure to execute their respective duties. References Chew, M. & Williams, A. 2001. Australian general practitioners: desperately seeking satisfaction. Med J Aust. 175(2), pp. 85-86 Conway, J. & Kearin, M. 2007. The contribution of the Patient Support Assistant to direct patient care: an exploration of nursing and PSA role perceptions. Contemp Nurse, 24(2), pp. 175-188. Edwards, N., Kornacki, M. & Silversin, J. 2002. Unhappy doctors: what are the causes and what can be done? BMJ, 324(7341), Kadushin, A. & Harkness, D. 2002. Supervision in social work, 4th Ed. Columbia: Columbia University Press. Kunzle, B., Kolbe, M. & Grote, G. 2001. Ensuring patient safety through effective leadership behaviour: A literature review. Safety Science, 48(1), pp. 1-17 Read More