RULES FOR DELEGATION
You will be required to make delegation decisions on a regular basis throughout your nursing career. The following strategies for delegation are for NCLEX but they are effective tools for real world application.
Always know you have a team to support you.
Use stable vs. unstable patient, Maslow's Hierarchy of Needs, and CABs to help you decide whether you can let a nursing assistant or RN check on the patient.
Only delegate activities for your stable patients with predictable outcomes.
- Never delegate any functions having to do with assessment, evaluation, education and nursing judgment.
- Delegate activities that are involved in standard unchanging procedures, such as bathing, feeding, dressing, and transferring.
- Complex activities are not to be delegated.
- Always keep in mind what you are basing your decision on when you choose to delegate a task. Ask yourself who, what, where, and when to delegate effectively.
CAB: CIRCULATION, AIRWAY, AND BREATHING
We know that circulation is the highest priority. When a question contains CAB options for prioritization, choose circulation!
THE NURSING PROCESS
MASLOW'S HIERARCHY OF NEEDS
Use your knowledge of Maslow's Hierarchy of Needs to assist you in your practice of prioritization.
When the options include a higher-level need, such as belonging or self-esteem, over a lower-level choice, such as food, sleep or pain, choose the lowest level option available.
Words such as best , most , least , last , and first.
These terms are helpful in detecting the correct choice.
Pick out the priority words in the sentences below.
- Your patient says that she has lost control of her life. What would be the best action the nurse could take to support this client?
- What is the first action that the nurse should take if a client has become disconcerted and aggressive toward the healthcare team?
- You are working on the rehab unit and your patient, a 40 y.o. male, had a MVA (Motor Vehicle Accident) 6 months ago. He suffered a broken back, and, as a result, now has to spend the rest of his life confined to a wheelchair. He states "I don't have a quality of life, sometimes I wonder if I will ever have a purpose again." What would be your best therapeutic response?
NCLEX MEMORIAL HOSPITAL
Close your eyes and picture yourself here. The NCLEX is not based on the real world. You are just beginning your career at a new hospital. This hospital is always well-staffed and offers perfect working conditions. You always have time, equipment and all the supplies you need. There is a fully stocked pharmacy and pharmacist at your service.
At the NCLEX Memorial Hospital, there are many departments, including an attached Long Term Care facility, a rehabilitation wing, a psych floor and a top-notch obstetrics floor. There is a pediatrics unit, a NICU, an ICU and an emergency room capable of handling all types of accidents and illnesses and catastrophic events for the entire community and beyond.
Your only obligation is to care for the patient in the NCLEX question presented to you. And rest assured, your patient always reacts according to textbook outcomes so don't get distracted by adding your own experiences and information to the decision-making process.
TEST TAKING TIPS
Be prepared to slow down and carefully read each word of the question.
Although there is no time limit, it is important to keep a steady pace when testing.
First, remember to give yourself credit on everything you do know rather than on what you don't know. As a nurse, you will come across unique situations on a regular basis. Having these strategic tools will help in the decision-making process you will be faced with for the rest of your career.
Our minds automatically look for patterns in unfamiliar data in an attempt to make sense of the unknown. Be aware of this pitfall as this action may cause an incorrect interpretation of important information.
Try not to spend more than 2 minutes on each item. If you read the question too many times you run the risk of adding more information that is not a part of the question or may not apply to the given situation.
Don't answer questions too quickly, even if you feel you know the answer. This has a better chance of working against you than for you.
Consider all the options before you make your selection and move on to the next item.
Most importantly , take time to practice, practice practice!
It's time to pull newly gathered information and combine it with your nursing education. Transfer your textbook knowledge into real world application.
Learning to trust your intuition can be your most effective tool. Your intuition increases its capability to instinctively grow with your knowledge bank. Learning that you can count on your first instinct can be the best advice you follow as you will continually pull from these resources throughout the rest of your nursing career.
Believe in yourself!
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