Chapter 5 Working with Others: Teamwork, Supervision, and Delegation
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
The Health Care Team z
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Health team members communicate with each other to give coordinated and effective care. Health team members share information about: ¾ What was done for the client ¾ What needs to be done for the client ¾ The client’s response to treatment
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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The Health Care Team z
Health care teams must have a holistic approach and promote all five dimensions of client’s life. ¾
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Physical, emotional, social, intellectual, and spiritual
Team members depend on each other to perform their roles and communicate effectively with each other. Members of the health care team vary according to the setting and the client’s needs. Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Benefits of Working on a Team z z z
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Opportunities for collaboration Opportunities for communication A wide array of abilities, skills, and perspectives Better decision making and problem solving Positive, trusting atmosphere
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Challenges of Working on a Team z
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Recognizing role boundaries – never attempt any task you are not allowed to perform Being flexible Handling conflict – may mean apologizing or admitting mistakes Expressing your needs and views – not being intimidated by physician and nurses
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Teamwork z
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Most teams include a physician, nurses, social worker, support workers, therapist, the client, and the client’s family. Family conference: ¾ ¾
A meeting attended by the health care team and family members to discuss the client’s care. A time to ask questions, express feelings, make decisions.
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Teams z
Facility support team ¾
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Director, supervisor, doctor, activities director, wound and skin care specialist, physiotherapist, RN, RPN, PSW
Community team ¾
Supervisor or case manager, family, friends, other areas (nutritionist, cancer specialist, etc.)
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Working Under Supervision z
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Support workers are responsible to the client and to co-workers. Accountable to supervisor – RN/RPN/LPN ¾ ¾
Other names of supervisors include team leader, charge nurse, case manager. The client can also be your supervisor in a private contract.
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Delegation z
Task ¾
A function, procedure, or activity that you assist the client with or perform for the client • • • •
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Activities of daily living (ADLs) Social and recreational activities Household management Basic nursing care tasks
Delegation is the transfer of function.
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Delegation z
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Nurse practice acts give RNs and RPNs certain responsibilities and the authority to perform nursing tasks. RNs can delegate to RPN and support workers. The delegated nurse remains accountable for the delegated task. Support workers are not allowed to delegate tasks. Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Delegation (Cont’d) z
When RNs delegate a task, they are required to: ¾ ¾ ¾
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Teach the task to the support worker. Assess their performance. Monitor the support worker to ensure they remain able to perform the task correctly and safely.
Your employer’s policies and guidelines, your job description, and provincial or territorial legislation determine what tasks can be delegated to you. Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Five Rights of Delegation z
The RN or supervisor must review the: ¾ ¾ ¾ ¾ ¾
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Right task Right circumstances Right person Right directions and communication Right supervision
Do not be offended or angry if you are not allowed to perform a task that you usually do.
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Choices z
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Two choices: to accept a task or to refuse a task You have the right to say no when: ¾ ¾ ¾ ¾ ¾ ¾
Task is beyond the legal limits of your role. Task is not in your job description. You are not prepared to perform the task safely. The task could harm the person. The person’s condition has changed. You do not know how to use supplies or equipment for performing the task.
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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Responsibilities z z z
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Use common sense. Do not ignore an order or request. You must communicate your concerns to the nurse. You must have a sound reason for your refusal.
Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
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