NSB305 Leading and Learning: Building Professional Capacity - Free Sam

Choice of Issue and Justification:

The issue chosen for this study is delegation of tasks in registered nursing practice. In nursing profession, delegation is a practice, in which certain tasks of a registered nurse are delegated to another nurse (usually to an assistant, unlicensed, non professional or a beginner nurse). This practice provides the new nurses with hands on learning experiences through engagement in the task, and is usually supervised by an experienced registered nurse (Edwards et al., 2018). However, even though the responsibility of the task can be delegated to a different nurse, the accountability of the task is still on the person who is delegating the task, and thus the task delegator is responsible of the outcomes of the activity performed by nurse delegated with the task. Such situations can lead to confusions and conflict, especially when the task is not delegated properly or to the correct person or if the person taking up the responsibility of the nurse is not able to perform the task successfully, making the delegator of the task liable for any errors in the execution of the task (Roche et al., 2016). Therefore it is necessary, that conflicts arising from delegation of tasks be analyzed and strategies identified to prevent or mitigate such conflicts in order to maintain team cohesion (Kristiansen et al., 2016).

Explanation of impact if the issue is left unresolved:

If the conflicts (due to improper task delegation) are left unresolved, the performance of the team as well as individuals can get adversely affected due to the following reasons:

Stress and Anxiety:

Conflicts can increase the feelings of stress and anxiety among individuals. For the delegator, the source of stress and anxiety can be related to the ability of nurse delegated with the task to get the work done properly and the accountability of the delegator for any errors in the work. For the delegate, the source of stress and anxiety can be due to their lack of expertise or experience in the task. The stress and anxiety can also be caused to a sense of liability towards the effective execution of the task (Khamisa et al., 2015).

Clinical Errors:

Improper delegation of task can increase the risks of clinical errors, when the delegator has incorrectly chosen the delegate or when the delegate is unable to understand the responsibility of the task, resulting in a clinical error. The clinical errors can adversely affect the health of the patients and also the reputation of the organization (Oh & Gastmans, 2015).

Effect on Communication:

Conflicts caused due to improper delegation or execution of the task can reduce communication in the team as the delegator and delegate might stop communicating with each other, thereby leading to a communication breakdown within the team. The communication can also be adversely affected by a lack of trust within the team caused due to such errors (Yoo & Park, 2015).

Employee Satisfaction:

Due to increase in stress and anxiety and with a breakdown in communication in the team, the levels of job satisfaction of the nurses can be significantly affected, and can lead to reduced retention or increased attrition in the team. Furthermore, clinical errors can also affect the performance of the team and individual nurses further affecting their job satisfaction (AlAzzam et al., 2017).

Discussion of 3 realistic strategies:

Three important strategies that a beginner registered nurse can use to address conflicts caused due to task delegation includes:

Using Best Practice Policy:

Errors in delegation can be avoided though the application of the best practice in task delegation. Using the ‘Five Rights of Delegation’ can ensure that the right task is delegated to the right person, under right circumstances using right communication and with the right supervision. This can ensure that the delegator fully analyses the capacity of the delegate before delegating the task, as well ensuring that the circumstances are right for the delegate to pick that task. Using such practice therefore can minimize the chances of errors and therefore of conflicts in the team (Barrow & McMillan, 2018)

Helping in better communication strategies:

Better communication can be pivotal to support better team cohesion and mitigate or resolve conflicts at the soonest. Strategies such as feedbacks and team meeting can help to address problems faced by individuals or the team and identify or share knowledge that can be used to address the problems. Sharing of knowledge further supports team learning and team support, thereby improving the performance of the team. Through better communication, the challenges faced by the nurses while delegating or picking up a task from another nurse can be discussed to identify best solutions to the problems (Lee et al., 2014).

Identifying and managing the source of the conflict:

The conflicts are mostly caused due to errors while delegating or executing the task.  Identifying the error in such circumstances and resolving such errors can help to reduce the stress and anxiety faced by the delegator and delegate, and can therefore be strategic to resolve the conflict in the team. Effective strategies for monitoring and evaluation of the delegation and execution of the task can help to identify the error and thus find solution to fix those errors (Butler et al., 2015).

Conclusion:

Conflicts can reduce the performance of a team and reduce cohesiveness within the team.  Conflict management is thus an important strategy to maintain the team performance and productivity. In nursing practice, one of the most significant sources of conflict is due to delegation of task by an experienced nurse to an inexperienced nurse.  Errors in proper delegation or execution of the tasks can lead to stress and anxiety, clinical errors, communication breakdown and reduced employee satisfaction. It is important therefore that strategies are used to avoid such problems. Three strategies that can b used by nurses to address such conflicts are using the ‘Five Rights of Delegation’, effective communication strategies and identifying and fixing the error in delegation or execution of tasks.

References:

AlAzzam, M., AbuAlRub, R. F., & Nazzal, A. H. (2017, October). The relationship between work–family conflict and job satisfaction among hospital nurses. In Nursing forum (Vol. 52, No. 4, pp. 278-288).

Barrow, J. M., & McMillan, J. (2018). Nursing, Five Rights of Delegation. In StatPearls [Internet]. StatPearls Publishing.

Butler, J. R. A., Young, J. C., McMyn, I. A. G., Leyshon, B., Graham, I. M., Walker, I., ... & Warburton, C. (2015). Evaluating adaptive co-management as conservation conflict resolution: learning from seals and salmon. Journal of environmental management, 160, 212-225.

Edwards, S. T., Helfrich, C. D., Grembowski, D., Hulen, E., Clinton, W. L., Wood, G. B., ... & Stewart, G. (2018). Task Delegation and Burnout Trade-offs Among Primary Care Providers and Nurses in Veterans Affairs Patient Aligned Care Teams (VA PACTs). The Journal of the American Board of Family Medicine, 31(1), 83-93.

Khamisa, N., Oldenburg, B., Peltzer, K., & Ilic, D. (2015). Work related stress, burnout, job satisfaction and general health of nurses. International journal of environmental research and public health, 12(1), 652-666.

Kristiansen, M., Westeren, K. I., Obstfelder, A., & Lotherington, A. T. (2016). Coping with increased managerial tasks: tensions and dilemmas in nursing leadership. Journal of Research in Nursing, 21(7), 492-502.

Lee, T. L., Gelfand, M. J., & Kashima, Y. (2014). The serial reproduction of conflict: Third parties escalate conflict through communication biases. Journal of Experimental Social Psychology, 54, 68-72.

Oh, Y., & Gastmans, C. (2015). Moral distress experienced by nurses: a quantitative literature review. Nursing Ethics, 22(1), 15-31.

Roche, M. A., Duffield, C., Friedman, S., Dimitrelis, S., & Rowbotham, S. (2016). Regulated and unregulated nurses in the acute hospital setting: Tasks performed, delayed or not completed. Journal of clinical nursing, 25(1-2), 153-162.

Salas, E., Grossman, R., Hughes, A. M., & Coultas, C. W. (2015). Measuring team cohesion: Observations from the science. Human factors, 57(3), 365-374.

Yoo, M. S., & Park, H. R. (2015). Effects of case?based learning on communication skills, problem?solving ability, and learning motivation in nursing students. Nursing & health sciences, 17(2), 166-172.