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What pitfalls or obstacles contributed to James’ lack of success?

March 28, 2022
Christopher R. Teeple

Case Scenario:
James has been a nurse for 4 years now. He works 3 p.m. to 11:30 p.m. on a very busy 32-bed medical-surgical unit. Census is 32, however, there were eight discharges during the day shift and eight new admissions have been steadily arriving to the floor mostly around the change of shift.
Staff moral and the sense of teamwork are low with coworkers upset with each other when the admission history, medication reconciliation, and plan of care are not completely done prior to leaving the shift.
Four patients have gone for procedures early in the evening and were stable but required frequent vital signs. James has asked the two UAP to take vital signs on the patients. He also asked a transporter to bring in a cup of medications for Mr. Smith, because he was on isolation and the transporter was already going into the room.
At the end of the shift, upon reviewing the vital signs to give report to the oncoming nurse, he noticed just one set of vitals were taken for each patient instead of the q1 hour as ordered. Upon final rounding for the evening, he also noticed that Mr. Smith’s cup of medications was on his bedside table and had not been taken.
In addition, these patients were nothing by mouth (NPO) prior to the diagnostic tests and both patients and families are upset because they never received dinner and now the kitchen is closed. James is upset.
Discuss the following questions in your discussion submission:
1. What pitfalls or obstacles contributed to James’ lack of success?
2. What delegation principles were broken?
3. What would you have done differently, if you were James?
Goncalves, S. (2019). Accountability and delegation. In A. M. Beauvais (Ed.). Leadership and
management competence in nursing practice (pp. 135-155). New York: Springer.
Post your initial response no later than 11:55pm of the date posted on the course calendar.
In your peer response, present a different view of what was taken by your peer. Be concise and specific in your response and ensure that your answers show analysis and synthesis of information as well as critical thinking that relates to this week’s discussion topic. Support your response in APA format with evidence from recent, scholarly, peer-reviewed journals (preferably nursing journals). “Recent” is within the last five years. While your textbook is an excellent source of information it is not a journal. Follow this link for more information: What is a peer-reviewed journal article? Your response may be typed directly into the discussion thread, or copied and pasted from your Word document, and include citation of sources (in text and reference list) in APA format. No files can be uploaded.

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