Scenario 1:
Tower 4 West is a 36-bed medical unit. The nurse leader, Renee, is a new leader, and one of the measures of her performance is based on the number of medication errors reported on her unit. As a result, she has told everyone very clearly that she will not tolerate errors and that she wants the unit to have zero medication errors each month. When an error does occur, she meets individually with the nurse, writes up the nurse’s error, and puts a report in the nurse’s performance review files. She has put two nurses on performance probation thus far. As a result, the nurses on the unit are afraid to report when an error occurs, and they have begun to cover for each other and not report errors. You are a staff nurse on the unit and you want to serve as a leader and create a blame-free environment.
In your response, address the following:
Explain whether Renee’s leadership approach toward medication errors on the nursing unit is appropriate and explain why. Then, provide at least one outcome result from Renee’s leadership approach on the nursing unit.
Explain leadership steps you would take to effect change on the nursing unit. Explain how a Just Culture might influence the outcome of medication errors on the unit.
Scenario 2:
You are the charge nurse and the nursing assistant comes to you with the following question concerning an assignment she has been asked to carry out by one of the other RN’s on the floor. “Sam asked me to go to the medication room and get the patient’s bottle of Digoxin out of the medication box and bring it to her because she is so far behind. Am I allowed to do that?”
In your response, address the following:
Explain your response to the nursing assistant citing the applicable legal principles for delegation and promotion of drug safety on the nursing unit.
Explain the education that would need to be provided regarding delegation principles, including the identification of items that can be delegated and items that cannot be delegated to Sam; and, explain why the delegation educational plan you suggest is appropriate.
Recommend team building strategies that should be implemented on the nursing floor to help develop consistency with delegation. Explain how you would apply these team-building strategies to enhance nursing roles and responsibilities for patient quality and safety as described in the scenario.
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