Clinical Leadership of the Registered Nurse in a Nursing Team: Two Case Scenarios

The terms ‘delegation’ and ‘supervision’ by their very definition refer to activities that only leaders are expected to undertake. Standard number 2.6 of the Nursing and Midwifery Board of Australia (NMBA)’s Registered nurse standards for practice states that registered nurses are responsible for the achievement of desired patient outcomes through assigning tasks to others (NMBA 2016b). This they achieve through clinical leadership, a clinical nurse leader being an expert in nursing with requisite knowledge, expertise, and clinical skills to empower and lead others with confidence (Stanley et al. 2017; Davidson et al. 2006).

Clinical Scenario 1: Graduate Nurse Aarya at Westeros Aged Care             Graduate nurse Aarya is the only registered nurse (RN) on the afternoon shift with a total of fifty residents to take care of in the Winterfell Wing of the facility. She is the leader of a team comprising of herself, one enrolled nurse (EN) and six carers or assistants in nursing (AIN).

Delegation and Supervision Using the Decision Making Framework (DMF) and the NMBA’s Standards of Practice by RN Aarya in the Clinical Scenario at Westeros Aged Care             According to the Australian Nursing and Midwifery Federation [ANMF] (n.d.), the delegation of tasks by RNs must be determined by the skill mix of the delegatees. Most importantly, it must be guided by the NMBA’s Decision-making Framework for Nursing and Midwifery or DMF (NMBA 2020; ANMF n.d.).

Right tasks or activities             Aarya cannot delegate tasks requiring planning, evaluation, or assessment as they are reserved for RNs (NMBA 2020; NMBA 2016b; Barrow & Sharma 2019). The carers also can only be delegated tasks to do with activities of daily living such as feeding, because they are not registered and are not regulated by the NMBA (NMBA 2020; Barrow & Sharma 2019; ACN 2016).

Clinical Scenario 2: Postgraduate student Nurse Jade at the Surgical Ward of the General Hospital             The situation of Jade is slightly better than that of Aarya with respect to workload. She is relieving in a surgical ward with eight patients who are stable in condition. Together with her, they are a team of five. However, Ash is an AIN and Hunter is an RN student on internship. Because Ebony is the team leader, it will be assumed that she is also an RN. Olive is an EN with experience.

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