Clinical Judgment

Clinical Judgment is the process of integrating evidence-based practice, critical-thought, the Nursing Process, knowledge, skills, and attitudes, as well as application of theory to practice in order to promote safe, quality care to clients in all settings.

Keeping that in mind, answer the following scenario:

You are the Charge Nurse in a large Urban Emergency Department (ED). You nursing staff include:

RN with 12 years of Trauma ED experience
New RN with 6 months ED experience
RN from the Medical Surgical floor with 8 years of experience
The following patients are in the ED, which patient will you give to each of the nurses and why?

A 76-year-old client who was involved in a motor vehicle accident and has hematuria.
A 38-year-old client with kidney stones complaining of severe pain.
A 24-year-old diabetic client with an acute urinary tract infection who will require discharge teaching.
An 80-year-old client that has not had a bowel movement for 4 days.
Please respond to at least two other student’s posts with substantial details that demonstrate an understanding of the concepts, and critical thinking. Remember that your posts must exhibit appropriate writing mechanics including using proper language, cordiality, and proper grammar and punctuation. If you refer to any outside sources or reference materials be sure to provide proper attribution and/or citation.
Two (2) Responses to your peers’ posts are due on Saturday of the week they are assigned

Each Response post should be a minimum of 1 paragraph with 5 sentences

Each Discussion post responses should have a minimum of 1 citation and reference
1st response-One of the rules of delegating tasks is to delegate the right task to the right nurse. Keeping this in mind, I would first look over each nurse’s experience levels and match them to a patient near their level of expertise. If the nurse has a background in the area of the diagnosis, it will increase the odds of a successful patient outcome.

The first patient I will assign is the patient in a motor vehicle accident. This patient will go to the trauma nurse. She will know what to do for this patient with minimal guidance. The next patient will be the patient with kidney stones. This patient will go to the med Surg nurse. This nurse will understand the diagnosis and expected signs and symptoms with the management of care. The patient that has not had a bowel movement in 4 days will also go to the Med Surg nurse. The last patient with a UTI will go to the new nurse. This nurse has the least amount of nursing experience and should be giving tasks that she has done before.

2nd responseWhen it comes to delegation, there’s several things that the delegator needs to take into account for before handing off an assignment. As the charge nurse, you should be well versed in how to delegate. Under the five rights of delegation, there exists: right task, right person, right circumstance, right supervision, and right direction and communication (Barrow, 2020).

Due to both legal and ethical constraints of delegation, the decision must not be taken lightly. The National Council of State Boards of Nursing describes delegation as ‘the transfer of authority by a qualified nurse to a competent individual for the purpose of completing selected tasks or activities’ (Porth, 2018).

The assignment should be based on the assessment of the patient’s needs and the scope and experience of skill of the nurse to whom care is assigned.

Under this particular scenario, I would delegate to the new RN the patient that’s requiring discharge teaching. This patient is considered stable if they are being discharged home. Teaching is something the new RN can provide. For the more experienced nurse with 8 years of experience on a medical surgical floor, I would assign the 80 year old patient that is constipated. Without further information I can’t say if the patient is stable, but this may be normal for the patient considering the differences in defecation patterns in different people. For the trauma nurse with 12 years of experience, I would delegate the patient experiencing hematuria and the patient with the kidney stones. They may require a greater level of care, especially the patient with hematuria after having been in the MVA. Due to the potential of high acuity, I would assign these two patients to the more experienced nurse. Any patients that I would consider to be unstable, I would assign to a nurse with more experience rather than a new grad that may have not seen this type of patient before and would require assistance.