Describe a current or past clinical situation where delegation from leadership/management lead to conflict between staff, staff, and management or both.
Leadership and management are two nursing areas often confused with each other due to near similar roles. Leadership is the capacity to lead people by controlling or dealing with people or things, while management involves organizing and coordinating things. Leaders and the management delegation play a vital role in the running of organizations, particularly healthcare facilities. However, their delegation sometimes brings conflict between staff, staff, and management or both (Marquis & Huston, 2015) . I experienced a conflict between staff and management last year at a community health center, where I worked as a volunteer nurse.
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The incident involved an LPN, an RN, and nurse manager. The registered nurse, tasked with the role of administering medicine to a patient, instructed the LPN to administer insulin to a diabetic patient so that she could attend a catch up with her friend who visited the hospital. As the LPN is not experienced and lack clearance to administer medicine, he administered a wrong dose, causing the patient to go into a coma. The nurse manager who responded to help the LPN nurse conflicted with him as he performed duties that he had no clearance. This problem was experienced since the rights of the delegation were not followed.
Identify how the 5 rights of delegation were or were not applied.
In this case, the five delegation rights were not followed. First, the right to the task was not followed. The RN administered the task of medication administration to an LPN, although it was against the organization's policy. LPN's cannot perform the tasks of an RN. The right to circumstances was not regarded since the RN failed to perform her roles for personal issues. Additionally, she failed to provide clear directions on the patient's dose, which could have eliminated the possibility of a wrong dose. Also, the right to person was ignored. The delegator must ensure that the delegate has knowledge and experience about the task (Barrow & Sharma, 2020) . The RN did not consider whether the LPN had the requisite knowledge to complete the delegated task successfully and safely.
Moreover, the right to supervision was ignored by the RN. In case she was unwilling to administer the medicine, she should have supervised the LPN to ensure that the physician's instructions regarding the medicine administration were followed. Finally, the right to direction and communication was not considered. According to Mathebula & Barnard (2020), a task delegator must ensure that they provide the right directions and communication to the delegate. In this case, the RN failed to provide proper direction and communication to the LPN, resulting in the medication error.
What conflict resolution strategies were used?
In the incident, the conflict was resolved through compromise. Compromising involves finding an acceptable solution that partly and not fully satisfied the involved parties (Ozyildirim & Kayikci, 2017) . The nurse manager took action against the RN and the LPN, where each was suspended. The matter did not escalate further, since the patient did not press charges.
Describe how legislation and a union or collective bargaining unit did or could have played a role in this situation.
The delegation of medication administration to the LPN resulted in an error. In this case, legislation and union were involved as it was a case of negligence. The RN knew that the LPN was not eligible to administer medicine, but went ahead and allowed him to administer it. The patient did not sue the LPN or the RN, and instead, the case was resolved internally. The union was involved since the LPN and the RN were suspended. The union was involved in determining the period for suspension.
Reflect on this situation and describe how you would have managed the conflict.
The situation, in this case, was extreme in terms of patient safety violations. An LPN cannot administer medicine to a patient as they lack the knowledge and experience. The conflict that arose between the LPN and the nurse manager was genuine and reasonable. I would have resolved this conflict by involving the RN, LPN, and the patient, whereby I would ensure that everyone is satisfied with the situation.
What conflict resolution strategies you would have utilized?
I would apply compromise as a conflict resolution strategy to develop an acceptable resolution that would satisfy all parties' concerns either fully or partly. In this case, I would ensure that the patient's concerns are fully satisfied, while those of the LPN and RN are partially satisfied. I would take the action of suspending the LPN and RN and giving a stern warning about the occurrence of such a situation in the future.
References
Barrow, J. M., & Sharma, S. (2020). Five Rights of Nursing Delegation. Treasure Island, FL: StatPearls.
Marquis, B. L., & Huston, J. C. (2015). Leadership Roles and Management Functions in Nursing: Theory and Application (8th ed.). New York: Lippincott Williams & Wilkins.
Mathebula, B., & Barnard, B. (2020). The factors of delegation success: accountability, compliance, and work quality. Journal of Management and Business Research, 14 (3), 2-5.
Ozyildirim, G., & Kayikci, K. (2017). The Conflict Management Strategies of School Administrators While Conflicting. European Journal of Education Studies, 3 (8), 1-20.
