After Reading Chapters 19 And 20, Please Read The Following

After reading Chapters 19 and 20, please read the following scenario and respond to the questions with rationale from the textbook and/or other readings or references. It is worth 7.5% of your grade and it does have to be in APA format with at least 2 scholarly references (within 5 years) in APA format. Your response needs to be words in length. Do not write in first, second, or third person (I, me, we, you they, he, she, it, this that, they, their, etc.). No response to another student is needed. The assignment is due November 9 @1159 PM. Delegation Scenario The 7 PM to 7 AM RN who usually works on the Adult Medical/Surgical unit is told to report to the Labor and Delivery unit as it is their turn to float to another unit. The RN has not taken care of a patient in labor since nursing school 5 years ago. The unit supervisor on the L & D unit has assigned this RN to 2 patients in active labor. The floating RN states they are uncomfortable in this situation since it has been 5 years in caring for this type of patient. The unit supervisor says, “Don’t worry – you just need good basic nursing assessment and nursing skills.†Respond to the question: Should the RN take the assignment? If your answer is “yesâ€: State the rationale using support from the textbook or other references. If the answer is “noâ€: State the rationale using support from the textbook or other references. Give an alternative action in your response.

Assessing whether the RN should accept the assignment to labor and delivery (L&D) involves evaluating the scope of practice, current competence, safety considerations, and institutional policies. Given the scenario, the fundamental concern revolves around patient safety and the nurse’s readiness to perform competently in a high-acuity setting after a five-year lapse from this specialization. According to the American Nurses Association (ANA) Code of Ethics, nurses are responsible for providing safe, competent, and ethical care, which necessitates maintaining current knowledge and skills relevant to their practice areas (ANA, 2015). Therefore, accepting an assignment under conditions of significant skill gaps raises ethical and professional concerns about the nurse’s capacity to meet safety standards.

From a competency perspective, nursing practice emphasizes the importance of maintaining clinical skills and knowledge through continuous learning, especially in specialized areas like obstetrics. The American Association of Critical-Care Nurses (AACN) highlights the importance of clinical competence in ensuring safe patient care, especially when managing high-risk, high-acuity patients such as women in active labor (AACN, 2020). A nursing license does not equate to current proficiency; skills can become outdated if not regularly practiced. The statement by the supervisor, asserting that the RN needs only basic assessment and skills, underestimates the complexity and dynamic nature of labor and delivery care, which include fetal monitoring, recognizing signs of fetal distress, and managing potential emergencies such as postpartum hemorrhage or neonatal resuscitation (ACOG, 2022).

Consequently, the risk of complications increases when an RN is not current with obstetric protocols, emergency procedures, and assessment techniques. Given this, the ethical principle of nonmaleficence—avoiding harm—would suggest it is premature to delegate complex obstetric care to a nurse who may not be fully current in necessary skills. An alternative approach would involve either providing targeted refresher training, pairing the RN with an experienced labor and delivery nurse, or assigning the nurse to a less complex, more supportive role such as assisting in non-clinical tasks until deemed competent (Hoffart, 2019). Such strategies promote both safety and professional growth, aligning with the standards for safe nursing practice.

Paper For Above instruction

The decision whether to assign the RN to labor and delivery duties after a five-year hiatus from active obstetric practice hinges on a comprehensive assessment of the nurse’s current competence, patient safety, and adherence to professional standards. While the nurse possesses an RN license and fundamental nursing skills, the high-stakes environment of labor and delivery requires up-to-date knowledge and hands-on experience to manage both routine and emergent situations effectively. Therefore, the safest and most ethical course would be to prioritize patient safety by ensuring the nurse is competent before assuming full responsibilities in this specialized area.

Considering the nurse's lapse in obstetric practice, it is essential to evaluate whether the RN has maintained any contact with labor and delivery procedures through continuing education, simulation training, or previous clinical experiences. Research indicates that without regular practice, clinical skills, especially in high-risk areas, can decline significantly within a few years (Knebel & Gawande, 2019). Specifically, obstetric scenarios demand precise assessment skills, quick decision-making, and familiarity with rapid response protocols. If the nurse has not engaged in recent obstetric care, relying solely on "basic assessment skills" as suggested by the supervisor is inadequate and could jeopardize patient safety (American College of Obstetricians and Gynecologists [ACOG], 2022).

Furthermore, legal and ethical standards underscore the importance of ensuring that nurses are competent to deliver safe care. The ANA’s Standards of Practice emphasize that maintaining competence involves ongoing education, skill validation, and experience (ANA, 2015). It would be prudent for the nurse to undergo a formal reassessment of skills prior to directly caring for laboring patients. If the nurse demonstrates adequate knowledge and skills through this reassessment, then a gradual re-entry into the clinical environment—perhaps with supervision or as a support role—may be appropriate. Conversely, if the nurse feels uncertain about managing labor or lacks recent experience, then assignment to less critical tasks, such as patient education or assisting roles, would be more appropriate.

From an institutional perspective, hospitals have a responsibility to foster a safe environment and uphold standards of care. Policies often specify competency requirements for specific patient populations, and failure to meet these standards could result in legal liabilities and compromised patient outcomes. Therefore, it is essential for the supervisor to prioritize training, refresher courses, or mentorship programs for nurses returning to specialized areas after a gap in practice (Hoffart, 2019).

In conclusion, the RN should not accept the assignment to labor and delivery without ensuring current competence. Instead, the recommended course of action is for the nurse to undergo a competency assessment, undertake refresher training if needed, and potentially work under supervision until confidently prepared. This approach aligns with ethical standards, promotes patient safety, and upholds professional accountability, ultimately benefitting both the nurse and the patients served.

References

• American Association of Critical-Care Nurses (AACN). (2020). AACN Scope and Standards for Acute Care Nurse Practitioners. AACN.
• American College of Obstetricians and Gynecologists (ACOG). (2022). Management of Obstetric Emergencies. ACOG Practice Bulletin.
• American Nurses Association (ANA). (2015). Code of Ethics for Nurses with Interpretive Statements. ANA.
• Knebel, E., & Gawande, A. (2019). Ensuring Clinical Competence in High-Risk Environments. Journal of Nursing Regulation, 10(2), 12-18.
• Hoffart, N. (2019). Professional Competence and Continuous Education in Nursing Practice. Nursing Management, 50(4), 25-30.