Journal Assignment: Problems In 36-Step Down Unit


Critical Thinking Exercise

It 2:30 p.m. & the end of shift on a busy, 36-bed Step-Down Unit. It has been a bad day on the floor. There have been five new admissions and several crises as patients decompensated. The patients families are complaining about the food and the cleanliness of the rooms. Charge Nurse Danielle Nau has a headache. Three of the seven evening shift personnel have called in sick. She cannot get them replaced, and the decision has been made to float in one RN and two aides from another unit.

Nurse Nau found out that the RN coming to cover for the shift has no experience in the specialty area. Nurse Nau knows that her staff hates floats, and floats hate to come to her unit. In the past, her strongest RN, who is assigned to the oncoming shift, has stated a preference for Nurse Nau to stay and cover sick calls instead of covering the unit with floats. However, Nurse Nau promised her daughter that she would make it to her 5:00 p.m. recital.

In your journal assignment for the week, answer the following. Cite examples from clinical/practice that illustrate your points.

  1. What are the problems? List the problems, in order of priority, and identify why you prioritized them that way.
  2. Who owns each problem?
  3. What should Nurse Nau do in this situation?
  4. What leadership and management styles are best suited to the situation?
  5. What delegation issues are present in the situation?
  6. What issues of legal liability are operating?
  7. How should Nurse Nau handle the strong RN?