The extent to which a patient cooperates in a nurse-patient relationship is significant because it determines the success which in this case refers to the recovery of the patient from his or her illness. The case under consideration presents one of those difficult patients whose input in the relationship is significantly poor; a phenomenon that makes it hard for the nurse to get a solution to her problem. At such times, the nurse handling the difficult patient such Ms. W, the family nurse practitioner, is better off asking for additional help if Ms. R is to be assisted (Gaskin2008,pp.11-12).
As part of my supervisory duty, I will professionally approach the family nurse practitioner, Ms. W, and make it clear that given the complicated nature of Ms. R’s case, we are bound by the principles of the American Nursing Association (ANA) and the National Council of State Boards of Nursing (NCSBN) to look for the appropriate source of help for the patient. I will try to make her see that the professional expertise and attention that Ms. R’s problem requires is not within our reach, and therefore the best thing to do is to seek further help. The fourth provision of the nursing ethics code clearly outlines circumstances under which delegation is necessary (American Nurses Association 2010, pp.1-2). I will be therefore operate within the code by making this proposal to Ms. W; the family nurse practitioner. On the same note, I will make use of the guidelines on delegation given by National Council of State Boards of Nursing in part (V) sections A and B that require me to fully understand the delegation process. I have to access useful client information, look at the urgency of the case and consider other parties who may be involved in making the decision on delegation (National Council of State Boards of Nursing 2005,pp.8-10)
A staffing plan that is ideal for Ms.R is what it will take to have her medical issues dealt with. This plan will be crafted in consideration of the available professionals. The obstetrician will be given the first opportunity to talk to Ms.R.The reason for this is that Ms.R’s urine has ketones and this may be a sign of a deeper medical issue that may put the life of the unborn baby as well as that of the mother on the line. The obstetrician will therefore take the chance to carefully examine the patient and suggest the best way forward as far as treating Mr.R is concerned. After the obstetrician, a licensed vocational nurse (LVN) will come next. This nurse will talk to Ms.R on the best way to behave so as to keep her and her unborn baby safe and healthy. The next professional to attend to Ms.R will be the community health specialist. The role of this specialist will be to give Ms.R a comprehensive lecture on what to do and what not to do during and after her pregnancy. The focus will be to ensure that Ms.R is equipped with the principles of good parenting in general and responsible motherhood in particular. This will be followed by a social worker who will address social behavior that is beneficial to both the society and the individual with a special focus on Ms.R.The nutritionist will follow the social worker. Her or his role will be a thorough education of Ms. R on the best foods to eat during and after her pregnancy so as to ensure that she enhances both her health and that of her unborn baby.
With due reference to the case of Ms.R, the message I will give to Ms.W, the family nurse practitioner is that our low level staffing is not what the patient needs at the moment. I will try to make her see that Ms. R is in need of advanced care or attention and this is only possible if she is taken to a better clinic such as the high risk facility where the number of professionals is sufficient. These professionals will be in a position to attend to Ms.R according to the staffing plan outlined elsewhere in this paper and therefore she will stand a better chance of recovering well. The second reason I will give the family nurse practitioner is that a follow up can be made so that Ms.R does not get lost in the process. This will be a better way of allaying her fears of losing Ms.R,and it will make more sense if this promise is followed with a clear plan of keeping track of Ms.R. Delegating the responsibility of keeping track of Ms.R to Ms W will make more sense due to the nurse’s attachment to the patient.
The supervisory responsibility vested in me makes me the professional who is supposed to deal with delegation matters given that the supervisor has the powers to handle issues of this nature. Also, other issues that involve engagements with external parties are in my hands as the supervisor. Therefore, the delegation in the case of Ms.R is better handled from my office. However, involving the nurse who is directly linked or concerned with the patient will help due to the fact that this is the staff member who understands all the details of the case. This is why involving Ms.W is vital. Lastly, delegation skills are important in cases such as the one at hand, and any professional in the field of nursing is required to have a clear understanding of these skills. It is even more important for those in positions of administration such as supervisors.
American Nurses Association. (2010).Code of Ethics for Nurses with Interpretive Statements. Web.
Gaskin, I., 12008. Ina May’s Guide to Childbirth. (1st ed.).New York: Bantam Books.
National Council of State Boards of Nursing (2005).Delegation Decision-Making Process. Web.