T6.1: Discussion Board: Case Scenario
Case Scenario:
Maxine Overland is an RN, working on a medical-surgical unit in a partnership model of primary nursing. She has been on vacation for 2 weeks, and when she returns, she finds that the unlicensed assistive personnel she typically worked with is not expected to be back at work for several months because of a family emergency. A new nursing assistant, John Maxwell, who has worked in the hospital for only 2 weeks, is assigned as her partner.

Maxine is pleased to learn that John has previous experience in another hospital and is a certified nurse’s aide. However, as she begins to work with him, she realizes that he does not understand the delegation rules established by the state board of nursing. For example, she enters a patient’s room to find John removing an intravenous (IV) line from the patient’s arm because it has infiltrated. Maxine takes over the task, noting that the IV line is in fact infiltrated. After leaving the room, she asks John why he started to remove the IV line instead of calling her. He indicates that he was taught how to do this at his last place of employment. She tells him that this is not a delegated task in this hospital. He responds, “Why? I know how to do it.”

Later in the morning, Maxine reviews the vital signs of the patients to whom she and John are assigned. The values for all blood pressures, pulses, and respirations are numerically very close even though the patients previously had widely different vital signs results.

If you were Maxine, what would you do?