Introduction:

Recognizing when and how to delegate are important roles of the professional nurse. In this case study, you will be asked to think critically about a nurse’s role in delegation.

Case Study:

Ms. W, a family nurse practitioner (FNP), has spent the last 30 minutes with Ms. R, a developmentally delayed, 30-week-pregnant, 19-year-old single Latina who lives with her boyfriend.

Ms. W is concerned about Ms. R because she has missed several appointments, and when she does keep an appointment she is late. She has missed important tests that needed to be done during the second trimester. Today she is at the clinic with a recurrent urinary tract infection.

Two months earlier Ms. R was prescribed an antibiotic for a urinary tract infection but failed to complete the full course of antibiotics. She claims the medication made her sick. She did not call the office to let Ms. W know she had stopped taking the medication even though Ms. W had given her specific verbal and written instructions to call if she had a problem taking the medication.

Ms. W is frustrated because she has worked hard to communicate with this client. When Ms. W talks to Ms. R, Ms. R appears to listen politely but generally does not respond. Ms. W always takes the time to write out the instructions and gives them to Ms. R. Ms. W has even given Ms. R her personal cell phone number.

Ms. W worries that Ms. R will not have support once the baby is born because her boyfriend works two jobs and she has no family close by. Ms. W has made some efforts to find community resources for Ms. R but is simply too busy to follow through. Ms. W considered transferring Ms. R to the high-risk clinic at the local hospital but was worried that Ms. R would not receive individualized care. Ms. W has not asked for assistance from any of the other staff.

You are the nursing supervisor for this clinic. You have on staff a nutritionist; a licensed vocational nurse (LVN) who has been trained to conduct client education on labor and delivery, routine prenatal care, parenting, and infant care; a Latina social worker who is fluent in Spanish and frequently translates for patients and staff; and a nurse who specializes in community health.

As the new nursing supervisor, you have observed Ms. W’s handling of this client. While you recognize that Ms. W is sincerely concerned about Ms. R, you notice that she has yet to seek support from within the clinic or follow through on attempts to contact outside resources.

Note: Case study adapted from “A Difficult Pregnancy: A Nurse Practitioner Looks for Answers” by Karol Rejman, MS, FNP. Copyright held by the National Center for Case Study Teaching in Science, State University of New York at Buffalo. Used with permission.

Task:

Write an essay (suggested length of 1–2 pages) in which you do the following:

A.  Explain steps you, as the new nurse supervisor, could take to promote interdisciplinary care in the clinic to improve quality and continuity of care for your clients.

B.  Explain how you, as the new nurse supervisor, could approach Ms. W about delegation and teamwork in a positive manner.

1.  Discuss Ms. W’s responsibility regarding delegation, supervision, and making referrals to optimize patient outcomes.

2.  Recommend a resource provided by a professional organization that Ms. W could access to learn more about delegation in nursing.

3.  Explain the delegation opportunities within the clinic given the needs of Ms. R.

C.  If you use sources, include all in-text citations and references in APA format.