Max is a registered nurse (RN), working on a medical-surgical unit in a partnership model of primary nursing. He has been on vacation for 2 weeks and when he returned, Max learned that the CCA (an unregulated care provider or UCP) they typically worked with was not expected to be back at work for several months because of a health emergency. A new CCA, Isaac, who had worked in the hospital for only 2 weeks, has been brought to the unit as a replacement. Max was pleased to learn that Isaac had previous experience in another hospital as a CCA. However, as Max and Isaac began to work together, Max realized that Isaac does not understand the delegation criteria as established by the provincial College of Nursing. For example, Max entered a patient’s room to find that Isaac was removing an intravenous (IV) catheter from the patient’s arm because it had become infiltrated. Max took over the task, noting that the IV catheter was in fact infiltrated. After leaving the room, Max asked Isaac why he had begun to remove the IV catheter instead of notifying Max. He indicated that he had been told to do this at his last place of employment. Max indicated to Isaac that this task had not been delegated to him. He responded, “Why? I know how to do it.”
Using the Assignment and delegation: Guidelines for nurses (NSCN, 2019) (see link under Materials in Lesson 3.2), reflect on the points below as you analyze Max’s responsibilities and how they should respond.
a) Consider the NSCN guidelines on Assignment and Delegation (2019) and the difference between RN assignment and delegation. What is the key difference between the two?
b) With the example of IV catheter removal, compare and contrast the responsibilities of Max (RN) and Isaac (CCA).
c) In circumstances where a task has been delegated, what process do nurses have to follow? Describe and discuss.