Considerations
When delegating and assigning patient care, certain nursing and personnel aspects need consideration. Chief among them as per the scenario is the appropriateness of staff or clinical competence of the same in terms of experience regarding caring for and preparing breast cancer patients for surgery. Nurse James Fair is a recruit who is yet to have experience regarding handling or preparing patients going to mastectomy surgery. Another key consideration should be the delicateness of the patient and the overall situation. The charge nurse knew that the patient was non-verbal and was heading to a delicate surgery. Also, communication ability of the patient is a fundamental consideration, and a nonverbal patient requires an experienced nurse. As such, Sherry, the charge nurse should not have assigned him to the 78-year-old patient.
Dimensions of Power and Conflict
According to Sepasi et al. (2016), the concept of power in nursing is purposeful and flourishes in the context of human, moral, and caring nature of the nursing profession and according to its needs. Thus, in the scenario, power is evidenced through the relational aspect between Sherry and James. Despite James not being experienced in preparing and caring for breast cancer patients heading to surgery, Sherry delegates or assigns him the caring duty anyway. This showed her power as the nurse in charge over James, making him undertake a responsibility he is not comfortable with. Here, the source of Sherry’s power (legitimate power) is her position. Conflict, on the other hand, stems from a difference or a threat; whether perceived or real that actuates a clash between two parties. In the scenario, Sherry, as the nurse in charge, seemingly forces the caring responsibility on James regardless of him telling her he has no experience –in essence, she trivializes his concerns. Thus, Sherry fails to listen to her subordinate’s concerns, which is also a dimensional source of conflict.
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Problems in the Case
From the dimensions of conflict, one observable problem is ignorance by Sherry regarding the concerns raised by James about his inexperience in caring for and preparing breast cancer patients for surgery. On the same vein, Sherry fails to realize the implications of James inexperience, which is poor leadership. Also, the scheduled surgery comes after the shift change meaning that the current shift is not adequately prepared and psychologically ready for the operation. This could result in errors and even injury to the patient by the inexperienced nurses such as James. Also, the patient is nonverbal, which infers a barrier to communication that could be deleterious.
Possible Solutions
One of the strategies pertinent to power and conflict resolution is negotiation. Seeing that James is uneasy and unsure regarding the delegation, Sherry should negotiate by asking what James would prefer and reach a bargain such as working together on the assignment so that he can learn. Here Sherry should remain neutral and not assert her authority or invoke her power as this would result in further conflict. Also, Sherry should consider delegating the caring responsibility to Julie, a nursing assistive personnel with professional experience in caring for all kinds of patients. By so doing Sherry should attach James to Julie to learn from her.
According to Alshammari & Dayrit (2017), communication conflict often results in interpersonal conflicts such as that between Sherry and James. Thus, proper communication and feedback that involves active listening to the other party are salient to resolving the duo’s conflict. In essence, if Sherry actively listens to James’ concerns, she can better negotiate on the way forward beyond their impasse. Also, rather than generalizing that the patient’s preparation is no different from other cases that James has handled before, Sherry should communicate the overall information needed and guide James through the process or tasked Julie to guide him as a means of building his confidence and knowledge.
Delegation
In essence, since Julie is a NAP with professional experience in caring for patients, the caring and physical preparation such as changing her clothes as well as administering IV should have been tasked to her. Further, she is of the same gender as the patient, a facet that will promote comfort to the patient. On the other hand, because of his inexperience, James should have been tasked with filling the forms through either Sherry or Julie’s help as he generally learns how to prepare such patients.
Trader’s Options
On refusal to comply with the delegations, Sherry Trader can inquire from the nurses why they have refused and what can be done to change their minds and get back to work. This is putting the 78-year-old patient first, along with the other eight patients to avoid harm. However, upon adamant refusal, Sherry can file a report or complaint regarding the nurses to senior management. Subsequently, she can either perform the tasks on her own or request for additional staff from the night shift to help her out.
References
Alshammari, H. F., & Dayrit, R. D. J. (2017). Conflict and conflict resolution among the medical and nursing personnel of selected hospitals in Hail City. Journal of nursing and health science: IOSR, 6 (3), 45-60. DOI: 10.9790/1959-0603014560
Sepasi, R. R., Abbaszadeh, A., Borhani, F., & Rafiei, H. (2016). Nurses’ perceptions of the concept of power in nursing: A qualitative research. Journal of clinical and diagnostic research: JCDR , 10 (12), LC10 – LC15. Doi: 10.7860/JCDR/2016/22526.8971
