{"id":54,"date":"2021-07-27T20:59:11","date_gmt":"2021-07-27T20:59:11","guid":{"rendered":"https:\/\/pressbooks.ccconline.org\/accnursing2030\/chapter\/3-5-supervision\/"},"modified":"2025-02-18T18:43:01","modified_gmt":"2025-02-18T18:43:01","slug":"3-5-supervision","status":"publish","type":"chapter","link":"https:\/\/pressbooks.ccconline.org\/accnursing2030\/chapter\/3-5-supervision\/","title":{"raw":"3.5 Supervision","rendered":"3.5 Supervision"},"content":{"raw":"The licensed nurse has the responsibility to supervise, monitor, and evaluate the nursing team members who have received delegated tasks, activities, or procedures. As previously noted, the act of supervision requires the nurse to assess the staff member\u2019s ability, competency, and experience prior to delegating. After the nurse has made the decision to delegate, supervision continues in terms of coaching, supporting, assisting, and educating as needed throughout the task to assure appropriate care is provided.\n\nThe nurse is accountable for client care delegated to other team members. Communication and supervision should be ongoing processes throughout the shift within the nursing care team. The nurse must ensure quality of care, appropriateness, timeliness, and completeness through direct and indirect supervision. For example, an RN may directly observe the UAP reposition a client or assist them to the bathroom to assure both client and staff safety are maintained. An RN may also indirectly evaluate an LPN\u2019s administration of medication by reviewing documentation in the client\u2019s medical record for timeliness and accuracy. Through direct and indirect supervision of delegation, quality client care and compliance with standards of practice and facility policies can be assured.\n\nSupervision also includes providing constructive feedback to the nursing team member. <strong>[pb_glossary id=\"349\"]Constructive feedback[\/pb_glossary] <\/strong>is supportive and identifies solutions to areas needing improvement. It is provided with positive intentions to address specific issues or concerns as the person learns and grows in their role. Constructive feedback includes several key points:\n<ul>\n \t<li style=\"font-weight: 400\">Was the task, activity, care, or procedure performed correctly?<\/li>\n \t<li style=\"font-weight: 400\">Were the expected outcomes involving delegation for that client achieved?<\/li>\n \t<li style=\"font-weight: 400\">Did the team member utilize effective and timely communication?<\/li>\n \t<li style=\"font-weight: 400\">What were the challenges of the activity and what aspects went well?<\/li>\n \t<li style=\"font-weight: 400\">Were there any problems or specific concerns that occurred and how were they managed?<\/li>\n<\/ul>\nAfter these questions have been addressed, the RN creates a plan for future delegation with the nursing team member. This plan typically includes the following:\n<ul>\n \t<li style=\"font-weight: 400\">Recognizing difficulty of the nursing team member in initiating or completing the delegated activities.<\/li>\n \t<li style=\"font-weight: 400\">Observing the client\u2019s responses to actions performed by the nursing team member.<\/li>\n \t<li style=\"font-weight: 400\">Following up in a timely manner on any problems, incidents, or concerns that arose.<\/li>\n \t<li style=\"font-weight: 400\">Creating a plan for providing additional training and monitoring outcomes of future delegated tasks, activities, or procedures.<\/li>\n \t<li>Consulting with appropriate nursing administrators per agency policy if the client\u2019s safety was compromised.<\/li>\n<\/ul>\nPlease review the following example regarding constructive feedback and task supervision\n<div class=\"textbox shaded \">\n\nNurse Sarah, an experienced RN, delegated a task to Peter, an unlicensed assistive personnel (UAP), to take the vital signs of a post-operative client, Mrs. Johnson, and report any abnormalities immediately.\n\n<strong>Sarah:<\/strong> \"Hi Peter, I wanted to discuss the task you completed earlier with Mrs. Johnson's vital signs. Thank you for your help with that. Let\u2019s review how it went.\"\n\n<strong>Was the task, activity, care, or procedure performed correctly?<\/strong>\n<p style=\"padding-left: 40px\"><strong>Sarah:<\/strong> \"First, I noticed you recorded the vital signs accurately. Good job on that. However, there was a delay in reporting Mrs. Johnson's elevated blood pressure to me. Can you walk me through what happened?\"<\/p>\n<p style=\"padding-left: 40px\"><strong>Peter:<\/strong> \"I took her vital signs, and her blood pressure was high. I was going to inform you, but I got called to assist with another client immediately after.\"<\/p>\n<strong>Were the expected outcomes involving delegation for that client achieved?<\/strong>\n<p style=\"padding-left: 40px\"><strong>Sarah:<\/strong> \"Ultimately, we did address the elevated blood pressure, but the delay could have impacted her care. It's crucial to report such abnormalities immediately.\"<\/p>\n<strong>Did the team member utilize effective and timely communication?<\/strong>\n<p style=\"padding-left: 40px\"><strong>Sarah:<\/strong> \"While you communicated the vital signs correctly, the timing was off. In future, if you can't find me immediately, please inform any available nurse or use the intercom system.\"<\/p>\n<strong>What were the challenges of the activity and what aspects went well?<\/strong>\n<p style=\"padding-left: 40px\"><strong>Peter:<\/strong> \"The challenge was managing multiple tasks at once. I did feel confident in taking and recording the vital signs accurately, though.\"<\/p>\n<p style=\"padding-left: 40px\"><strong>Sarah:<\/strong> \"It sounds like you\u2019re balancing a lot of responsibilities well, but prioritizing urgent communications is key. You handled the technical part perfectly.\"<\/p>\n<strong>Were there any problems or specific concerns that occurred and how were they managed?<\/strong>\n<p style=\"padding-left: 40px\"><strong>Sarah:<\/strong> \"The main concern was the delay in reporting the elevated blood pressure. Fortunately, there were no serious consequences, but it\u2019s a potential risk we need to manage better. Let\u2019s create a plan to support you moving forward.\"<\/p>\n<strong>Recognizing difficulty of the nursing team member in initiating or completing the delegated activities:<\/strong>\n<p style=\"padding-left: 40px\"><strong>Sarah:<\/strong> \"I recognize that you were busy with multiple tasks. It\u2019s important to prioritize client safety over other duties.\"<\/p>\n<strong>Observing the client\u2019s responses to actions performed by the nursing team member:<\/strong>\n<p style=\"padding-left: 40px\"><strong>Sarah:<\/strong> \"I will check on Mrs. Johnson's response to ensure there are no ongoing issues, and I\u2019ll keep exploring how we can improve this process.\"<\/p>\n<strong>Following up in a timely manner on any problems, incidents, or concerns that arose:<\/strong>\n<p style=\"padding-left: 40px\"><strong>Sarah:<\/strong> \"I\u2019ll follow up with you soon to see how you\u2019re managing your other tasks, and we can address any challenges you\u2019re facing.\"<\/p>\n<strong>Creating a plan for providing additional training and monitoring outcomes of future delegated tasks, activities, or procedures:<\/strong>\n<p style=\"padding-left: 40px\"><strong>Sarah:<\/strong> \"We\u2019ll arrange some additional training on prioritizing tasks and urgent communication. Let's monitor the outcomes of your delegated tasks over the next few weeks to ensure you\u2019re supported.\"<\/p>\n<strong>Consulting with appropriate nursing administrators per agency policy if the client\u2019s safety was compromised:<\/strong>\n<p style=\"padding-left: 40px\"><strong>Sarah:<\/strong> \"Fortunately, Mrs. Johnson is fine, but if there were any safety concerns, we\u2019d need to report it according to our policy. Keep this in mind for the future.\"<\/p>\n<p style=\"padding-left: 40px\"><strong>Sarah:<\/strong> \"Peter, you're doing a great job with your responsibilities, and with a bit more focus on communication priorities, I\u2019m confident you\u2019ll excel even more. Let\u2019s touch base again in a week to see how things are going. Feel free to come to me with any questions or concerns in the meantime.\"<\/p>\n<p style=\"padding-left: 40px\"><strong>Peter:<\/strong> \"Thank you, Sarah. I appreciate the feedback and will work on prioritizing urgent communications.\"<\/p>\n<p style=\"padding-left: 40px\"><strong>Sarah:<\/strong> \"Great. Keep up the good work, and let\u2019s keep improving together.\"<\/p>\n\n<\/div>","rendered":"<p>The licensed nurse has the responsibility to supervise, monitor, and evaluate the nursing team members who have received delegated tasks, activities, or procedures. As previously noted, the act of supervision requires the nurse to assess the staff member\u2019s ability, competency, and experience prior to delegating. After the nurse has made the decision to delegate, supervision continues in terms of coaching, supporting, assisting, and educating as needed throughout the task to assure appropriate care is provided.<\/p>\n<p>The nurse is accountable for client care delegated to other team members. Communication and supervision should be ongoing processes throughout the shift within the nursing care team. The nurse must ensure quality of care, appropriateness, timeliness, and completeness through direct and indirect supervision. For example, an RN may directly observe the UAP reposition a client or assist them to the bathroom to assure both client and staff safety are maintained. An RN may also indirectly evaluate an LPN\u2019s administration of medication by reviewing documentation in the client\u2019s medical record for timeliness and accuracy. Through direct and indirect supervision of delegation, quality client care and compliance with standards of practice and facility policies can be assured.<\/p>\n<p>Supervision also includes providing constructive feedback to the nursing team member. <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_54_349\">Constructive feedback<\/a> <\/strong>is supportive and identifies solutions to areas needing improvement. It is provided with positive intentions to address specific issues or concerns as the person learns and grows in their role. Constructive feedback includes several key points:<\/p>\n<ul>\n<li style=\"font-weight: 400\">Was the task, activity, care, or procedure performed correctly?<\/li>\n<li style=\"font-weight: 400\">Were the expected outcomes involving delegation for that client achieved?<\/li>\n<li style=\"font-weight: 400\">Did the team member utilize effective and timely communication?<\/li>\n<li style=\"font-weight: 400\">What were the challenges of the activity and what aspects went well?<\/li>\n<li style=\"font-weight: 400\">Were there any problems or specific concerns that occurred and how were they managed?<\/li>\n<\/ul>\n<p>After these questions have been addressed, the RN creates a plan for future delegation with the nursing team member. This plan typically includes the following:<\/p>\n<ul>\n<li style=\"font-weight: 400\">Recognizing difficulty of the nursing team member in initiating or completing the delegated activities.<\/li>\n<li style=\"font-weight: 400\">Observing the client\u2019s responses to actions performed by the nursing team member.<\/li>\n<li style=\"font-weight: 400\">Following up in a timely manner on any problems, incidents, or concerns that arose.<\/li>\n<li style=\"font-weight: 400\">Creating a plan for providing additional training and monitoring outcomes of future delegated tasks, activities, or procedures.<\/li>\n<li>Consulting with appropriate nursing administrators per agency policy if the client\u2019s safety was compromised.<\/li>\n<\/ul>\n<p>Please review the following example regarding constructive feedback and task supervision<\/p>\n<div class=\"textbox shaded\">\n<p>Nurse Sarah, an experienced RN, delegated a task to Peter, an unlicensed assistive personnel (UAP), to take the vital signs of a post-operative client, Mrs. Johnson, and report any abnormalities immediately.<\/p>\n<p><strong>Sarah:<\/strong> &#8220;Hi Peter, I wanted to discuss the task you completed earlier with Mrs. Johnson&#8217;s vital signs. Thank you for your help with that. Let\u2019s review how it went.&#8221;<\/p>\n<p><strong>Was the task, activity, care, or procedure performed correctly?<\/strong><\/p>\n<p style=\"padding-left: 40px\"><strong>Sarah:<\/strong> &#8220;First, I noticed you recorded the vital signs accurately. Good job on that. However, there was a delay in reporting Mrs. Johnson&#8217;s elevated blood pressure to me. Can you walk me through what happened?&#8221;<\/p>\n<p style=\"padding-left: 40px\"><strong>Peter:<\/strong> &#8220;I took her vital signs, and her blood pressure was high. I was going to inform you, but I got called to assist with another client immediately after.&#8221;<\/p>\n<p><strong>Were the expected outcomes involving delegation for that client achieved?<\/strong><\/p>\n<p style=\"padding-left: 40px\"><strong>Sarah:<\/strong> &#8220;Ultimately, we did address the elevated blood pressure, but the delay could have impacted her care. It&#8217;s crucial to report such abnormalities immediately.&#8221;<\/p>\n<p><strong>Did the team member utilize effective and timely communication?<\/strong><\/p>\n<p style=\"padding-left: 40px\"><strong>Sarah:<\/strong> &#8220;While you communicated the vital signs correctly, the timing was off. In future, if you can&#8217;t find me immediately, please inform any available nurse or use the intercom system.&#8221;<\/p>\n<p><strong>What were the challenges of the activity and what aspects went well?<\/strong><\/p>\n<p style=\"padding-left: 40px\"><strong>Peter:<\/strong> &#8220;The challenge was managing multiple tasks at once. I did feel confident in taking and recording the vital signs accurately, though.&#8221;<\/p>\n<p style=\"padding-left: 40px\"><strong>Sarah:<\/strong> &#8220;It sounds like you\u2019re balancing a lot of responsibilities well, but prioritizing urgent communications is key. You handled the technical part perfectly.&#8221;<\/p>\n<p><strong>Were there any problems or specific concerns that occurred and how were they managed?<\/strong><\/p>\n<p style=\"padding-left: 40px\"><strong>Sarah:<\/strong> &#8220;The main concern was the delay in reporting the elevated blood pressure. Fortunately, there were no serious consequences, but it\u2019s a potential risk we need to manage better. Let\u2019s create a plan to support you moving forward.&#8221;<\/p>\n<p><strong>Recognizing difficulty of the nursing team member in initiating or completing the delegated activities:<\/strong><\/p>\n<p style=\"padding-left: 40px\"><strong>Sarah:<\/strong> &#8220;I recognize that you were busy with multiple tasks. It\u2019s important to prioritize client safety over other duties.&#8221;<\/p>\n<p><strong>Observing the client\u2019s responses to actions performed by the nursing team member:<\/strong><\/p>\n<p style=\"padding-left: 40px\"><strong>Sarah:<\/strong> &#8220;I will check on Mrs. Johnson&#8217;s response to ensure there are no ongoing issues, and I\u2019ll keep exploring how we can improve this process.&#8221;<\/p>\n<p><strong>Following up in a timely manner on any problems, incidents, or concerns that arose:<\/strong><\/p>\n<p style=\"padding-left: 40px\"><strong>Sarah:<\/strong> &#8220;I\u2019ll follow up with you soon to see how you\u2019re managing your other tasks, and we can address any challenges you\u2019re facing.&#8221;<\/p>\n<p><strong>Creating a plan for providing additional training and monitoring outcomes of future delegated tasks, activities, or procedures:<\/strong><\/p>\n<p style=\"padding-left: 40px\"><strong>Sarah:<\/strong> &#8220;We\u2019ll arrange some additional training on prioritizing tasks and urgent communication. Let&#8217;s monitor the outcomes of your delegated tasks over the next few weeks to ensure you\u2019re supported.&#8221;<\/p>\n<p><strong>Consulting with appropriate nursing administrators per agency policy if the client\u2019s safety was compromised:<\/strong><\/p>\n<p style=\"padding-left: 40px\"><strong>Sarah:<\/strong> &#8220;Fortunately, Mrs. Johnson is fine, but if there were any safety concerns, we\u2019d need to report it according to our policy. Keep this in mind for the future.&#8221;<\/p>\n<p style=\"padding-left: 40px\"><strong>Sarah:<\/strong> &#8220;Peter, you&#8217;re doing a great job with your responsibilities, and with a bit more focus on communication priorities, I\u2019m confident you\u2019ll excel even more. Let\u2019s touch base again in a week to see how things are going. Feel free to come to me with any questions or concerns in the meantime.&#8221;<\/p>\n<p style=\"padding-left: 40px\"><strong>Peter:<\/strong> &#8220;Thank you, Sarah. I appreciate the feedback and will work on prioritizing urgent communications.&#8221;<\/p>\n<p style=\"padding-left: 40px\"><strong>Sarah:<\/strong> &#8220;Great. Keep up the good work, and let\u2019s keep improving together.&#8221;<\/p>\n<\/div>\n<div class=\"glossary\"><span class=\"screen-reader-text\" id=\"definition\">definition<\/span><template id=\"term_54_349\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_54_349\"><div tabindex=\"-1\"><p>Supportive feedback that offers solutions to areas of weakness.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><\/div>","protected":false},"author":32,"menu_order":5,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[48],"contributor":[],"license":[],"class_list":["post-54","chapter","type-chapter","status-publish","hentry","chapter-type-numberless"],"part":42,"_links":{"self":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-json\/pressbooks\/v2\/chapters\/54","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-json\/wp\/v2\/users\/32"}],"version-history":[{"count":2,"href":"https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-json\/pressbooks\/v2\/chapters\/54\/revisions"}],"predecessor-version":[{"id":548,"href":"https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-json\/pressbooks\/v2\/chapters\/54\/revisions\/548"}],"part":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-json\/pressbooks\/v2\/parts\/42"}],"metadata":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-json\/pressbooks\/v2\/chapters\/54\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-json\/wp\/v2\/media?parent=54"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-json\/pressbooks\/v2\/chapter-type?post=54"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-json\/wp\/v2\/contributor?post=54"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/accnursing2030\/wp-json\/wp\/v2\/license?post=54"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}