Safe and Effective Care Environment Q 5
Which nurse should be assigned to care for the postpartum client with preeclampsia?
A. The RN with 2 weeks of experience in postpartum
B. The RN with 3 years of experience in labor and delivery
C. The RN with 10 years of experience in surgery
D. The RN with 1 year of experience in the neonatal intensive care unit
Correct Answer: B. The RN with 3 years of experience in labor and delivery
The nurse with 3 years of experience in labor and delivery knows the most about possible complications involving preeclampsia. Registered nurses need to know their rights and responsibilities when considering a patient assignment. The nurse-patient assignment process is also often a manual process in which the charge nurse must sort through multiple decision criteria in a limited amount of time.
Option A: The nurse is a new staff to the unit hence lacking the experience needed. Most nurse-patient assignment models have focused on balancing patient acuity measures. This focus on patient acuity concentrates workload measures on direct patient care activities. While this is very important for the care of the patient, it does not necessarily take into account all of the activities comprising a nurse’s workload.
Option C: The nurse with experience in surgery does not have the same experience in labor and delivery. Balancing workload among nurses on a hospital unit is important for the satisfaction and safety of nurses and patients. To balance nurse workloads, direct patient care activities, indirect patient care activities, and non-patient care activities that occur throughout a shift must be considered.
Option D: This nurse lacks sufficient experience with a postpartum client. Limitations in experience and knowledge may not require refusal of the assignment, but rather an agreement regarding supervision or a modification of the assignment to ensure patient safety. If no accommodation for limitations is considered, the nurse has an obligation to refuse an assignment for which she or he lacks education or experience.