Chapter 5

1. Chapter 5 Working with Others: Teamwork, Supervision, and Delegation

2. The Health Care Team • Health team members communicate with each other to give coordinated and effective care. • Health team members share information about: • What was done for the client • What needs to be done for the client • The client’s response to treatment

3. The Health Care Team • Health care teams must have a holistic approach and promote all five dimensions of client’s life. • Physical, emotional, social, intellectual, and spiritual • Team members depend on each other to perform their roles and communicate effectively with each other. • Members of the health care team vary according to the setting and the client’s needs.

4. Benefits of Working on a Team • Opportunities for collaboration • Opportunities for communication • A wide array of abilities, skills, and perspectives • Better decision making and problem solving • Positive, trusting atmosphere

5. Challenges of Working on a Team • Recognizing role boundaries – never attempt any task you are not allowed to perform • Being flexible • Handling conflict – may mean apologizing or admitting mistakes • Expressing your needs and views – not being intimidated by physician and nurses

6. Teamwork • Most teams include a physician, nurses, social worker, support workers, therapist, the client, and the client’s family. • Family conference: • A meeting attended by the health care team and family members to discuss the client’s care. • A time to ask questions, express feelings, make decisions.

7. Teams • Facility support team • Director, supervisor, doctor, activities director, wound and skin care specialist, physiotherapist, RN, RPN, PSW • Community team • Supervisor or case manager, family, friends, other areas (nutritionist, cancer specialist, etc.)

8. Working Under Supervision • Support workers are responsible to the client and to co-workers. • Accountable to supervisor – RN/RPN/LPN • Other names of supervisors include team leader, charge nurse, case manager. • The client can also be your supervisor in a private contract.

9. Delegation • Task • A function, procedure, or activity that you assist the client with or perform for the client • Activities of daily living (ADLs) • Social and recreational activities • Household management • Basic nursing care tasks • Delegation is the transfer of function.

10. Delegation • Nurse practice acts give RNs and RPNs certain responsibilities and the authority to perform nursing tasks. • RNs can delegate to RPN and support workers. • The delegated nurse remains accountable for the delegated task. • Support workers are not allowed to delegate tasks.

11. Delegation (Cont’d) • When RNs delegate a task, they are required to: • Teach the task to the support worker. • Assess their performance. • Monitor the support worker to ensure they remain able to perform the task correctly and safely. • Your employer’s policies and guidelines, your job description, and provincial or territorial legislation determine what tasks can be delegated to you.

12. Five Rights of Delegation • The RN or supervisor must review the: • Right task • Right circumstances • Right person • Right directions and communication • Right supervision • Do not be offended or angry if you are not allowed to perform a task that you usually do.

13. Choices • Two choices: to accept a task or to refuse a task • You have the right to say no when: • Task is beyond the legal limits of your role. • Task is not in your job description. • You are not prepared to perform the task safely. • The task could harm the person. • The person’s condition has changed. • You do not know how to use supplies or equipment for performing the task.

14. Responsibilities • Use common sense. • Do not ignore an order or request. • You must communicate your concerns to the nurse. • You must have a sound reason for your refusal.