Delegation Dilemmas
Tasks a nurse can delegate to a CNA
Assisting with ADLs such as bathing, ambulating, and feeding stable patients
What should be considered first when assigning float staff?
The float nurse's scope of practice, competency, and previous experience.
What is the first step in de-escalating a staff argument?
Separate the individuals and create a safe, calm environment for discussion.
What is the charge nurse's role during a rapid response?
Facilitate team communication, assign roles, and manage the unit during the response.
What's one way a charge nurse can model self-care?
Taking scheduled breaks and encouraging team members to do the same.
Who is responsible if a delegated task is not completed correctly?
The nurse who delegated the task is ultimately accountable for ensuring it is done correctly.
True or False: A float nurse can be assigned high-acuity patients.
False: float nurses should be assigned within their skill level and comfort zone.
Give an example of assertive but respectful communication.
"I understand your concern, but here's why we need to proceed this way..."
What must you do during a fire (RACE acronym)?
Rescue, Alarm, Confine, Extinguish/Evacuate.
What VA program supports nurse/staff wellness?
The Whole Health for Employees program.
A CNA refuses a delegated task. What should the nurse do next?
Clarify the task, assess the reason for refusal, and provide education or escalate as needed.
What action should a charge nurse take when short-staffed unexpectedly?
Notify the nursing supervisor, redistribute patient loads, and request additional support if needed.
How can you manage a family upset over visiting hours?
Listen empathetically, explain policy, and seek possible accommodations while ensuring safety.
During a code blue, who documents the event?
The designated code recorder, typically the assigned RN or, if applicable, the charge nurse trained for documentation.
Why is promoting Whole Health important for charge nurses?
It reduces burnout, improves team morale, and supports holistic patient care.
What are the 5 rights of Delegation?
Right task, right circumstance, right person, right direction and communication, and right supervision and evaluation.
Clairvia provides acuity-based staffing recommendations and highlights workload imbalances.
Scenario: Two nurses have tension impacting teamwork. What do you do?
Mediate a private discussion, encourage professional behavior, and refer to management if unresolved.
How do you initiate unit lockdown during an elopement risk?
Notify security immediately, close exits, inform staff, and follow facility elopement protocol.
Name a quick stress-reducing technique for shift breaks.
Deep breathing, 5-minute mindfulness, or stepping outside for fresh air.
An LPN is asked to assess a post-op patient. Delegate or not?
Not appropriate to delegate; assessment of a post-op patient requires RN-level judgement.
A nurse complains about an unfair assignment. What's your response?
Acknowledge the concern, explain the rational behind the assignment, and explore solutions collaboratively.
What VA resource can a charge nurse use for workplace conflict?
The Employee Assistance Program (EAP)
Scenario: There's a fall with injury and no witnesses. What's your next step?
Initiate RRS, assess the patient, notify the provider, complete incident report.
Scenario: A nurse is overwhelmed mid-shift. How do you support them?
Check in with the nurse, adjust assignment if possible, and provide emotional support or relief.