I absolutely love training new grad nurses. Their excitement and fresh look at the profession transports me back to fifteen-plus years ago when I first started. I work midnight’s so I have the pleasure of fine-tuning all the information that the day shift preceptors taught. Things I like to focus on are the importance of teamwork as well as the art of delegating as a new nurse.
As a night nurse in the hospital, I have fewer resources and there are fewer staff members. Many times, there will be one to two patient care assistants to 15-25 patients. We all rely on our aids, but it is important early on to not overuse them. I stress to my nurses if a call light goes off and you’re not busy, whether or not your it’s your patient, if you can assist, you should. This is a simple and general form of delegation for everyone to partake in. When finished, always report to the patient’s nurse what was needed and done to update and complete the delegation process.
How Delegation Can Prevent a Crisis
Making a patient wait 30 minutes to be assisted to the bathroom can be the difference between a patient attempting to go by himself and having a fall, which causes new issues for all the staff that could have been avoided, and meeting the patient’s needs and having a shift without a crisis. In this case the delegation helps prevent a problem.
If you’re really busy and cannot assist everyone who needs you, utilize simple forms of delegation and teamwork to assign tasks such as asking another nurse or aid to refresh the patient’s water or straightening up his bed. This can keep an already emotional patient from breaking down in tears while they are trying to keep it together. Providing an extra blanket may keep that patient from calling multiple times the rest of the night because they are warm and now can fall asleep.
These may seem like minuscule tasks, but to that patient, they could be the difference in them feeling cared for versus feeling a lack of control. You will hear patients say, “It was so quiet on the floor tonight I thought no one was around,” which could mean they were feeling scared and lonely and just needed reassurance the nurses were still there to care for them.
Start Your Shift by Defining the Ground Rules
Setting the precedent for teamwork and the generalized delegation process is best done at the beginning of the shift. After report, speak with the patient care aids and identify which patients are total care and will need frequent repositioning and changes. Making a plan early in the night and prioritizing patients will help with time management. It also helps to prevent incontinence dermatitis and pressure ulcers. This doesn’t mean we can’t change up the plan through the night if someone needs more frequent assistance or we have an emergency.
Re-prioritizing throughout the shift is a normal occurrence. Using teamwork in this manner will also help prevent staff injuries. Many times, we feel rushed and will try to assist a patient on our own. That may not always be the safest approach. Remember, it is always important to protect your back from the moment you begin. Asking for help will promote his.
When you aren’t overwhelmed with physician messages, new admits, or critical patients, I encourage you to take steps to work smarter, not harder:
- Take water when you make your rounds or do your med passes. This will help with patients who keep requesting water over the call light or with the odd middle-of-the-night oral medication, saving you and your aids steps.
- If you have a narcotic or blood pressure medication to pass grab the Dynamap as you’re walking towards the room instead of hunting down the aid to do it for you. This way when you really don’t have time to do these small tasks and you delegate, your aids won’t feel as if you abuse them.
- Anticipating patient’s needs can go a long way towards having an uneventful shift and fostering happy patients.
TEAMWORK Essentials
A good team player helps as much as they ask, and always says Thank You! You will hear from aids who get frustrated with nurses just sitting at the desk and won’t assist them in small tasks. They tend to not work 
as hard for those nurses and in the end, it is the patients whose care is affected. The aids know the difference when a nurse is working such as charting or waiting for a phone call or an admission to come up, or if they are just sitting there chatting up another employee. It is frustrating to have that nurse constantly tell them to see what that patient wants, take the patient to the bathroom or get them water. Answering call lights is just as much the nurse’s job as it is for the aid.
When the team works together, the quality of patient care is improved, and the job can be more fun and rewarding. All of us who work in the hospital have hard and exhausting jobs. If we can learn early on to work as a team, it will give us a better overall relationship with co-workers. Learning when and how to delegate is an important part of our job that is sometimes overlooked. Delegation is an art, and it takes practice.
Guest Post by Melissa Murphy RN
With over fifteen years of nursing experience ranging from post-partum to hospice one of the best parts of nursing is mentoring the new nurses and helping them build a solid foundation in their journey.
Thanks Melissa!
More resources:
The Art of Delegation in Nursing