The R.N. Is Responsible for the Team
In the process of delegation, the R.N. remains responsible for the task that was delegated. You need to follow up and evaluate the procedure or task. If you asked the aide to feed your patient, it is your responsibility to follow up and see that it was done, and to see how much the patient ate and how well the patient tolerated the food. How much was the patient able to participate? Did the LVN give the PRN medication? How long ago? And did it help with the symptoms?
As noted above, as an R.N., you are responsible for your team. Perhaps you have an aide and an LVN working with you. You have your own assigned patients, but perhaps you are expected to oversee the patients assigned to these two as well. Or perhaps your job is to supervise the aide and the LVN and oversee the care for all the patients they are caring for without an additional specific assignment of patients yourself.
You could find yourself in charge of your unit for a shift sooner than you think possible as well. This is more likely to happen for the B.S.N.-R.N., but depending on the availability of staff, being placed in charge of a unit could happen to anyone. Be prepared.
Remember, the shortage of nurses is expected to worsen over the next fifteen to twenty years. Sometimes facilities seemingly care more about making money and staying afloat than in protecting nurse's licenses or providing the best care to patients. One issue raised here is staffing ratios, which are being debated all across the country. You need to look out for your license and be sure to protect your patients' rights.
Each day you need to have a clear understanding about your assignment including whom you are responsible for. If you are unsure, ask. Never assume anything. You are expected to know.
If you are an LPN, you most likely won't find yourself in charge unless you don't work in a hospital, but you could be responsible for supervising an aide or two and reporting to the R.N. The ultimate responsibility will fall to the R.N., but your assignment in supervising should be clear to you. No matter what level you are on the nursing ladder, you are always responsible for your own actions. Your goal is always to provide the best care possible and to be mindful of your own scope of practice and job description.
