'Doing the writing' and 'working in parallel': how distal nursing affects delegation and supervision in the emerging role of the qualified nurse

Johnson, M; Magnusson, C; Allan, H; Evans, K; Ball, E; Horton, K; Curtis, K; Westwood, S

Abstract

Background: The role of the acute hospital nurse has moved away from the direct delivery of patient care and more towards the management of the delivery of bedside care by healthcare assistants. How newly qualified nurses delegate to, and supervise, healthcare assistants, is important, as failures can lead to care being missed, duplicated and/or incorrectly performed.
Objectives: The data described here form part of a wider study which explored how newly qualified nurses recontextualise knowledge into practice, and develop and apply effective delegation and supervision skills.
This article analyses team working between newly qualified nurses and healthcare assistants, and nurses' balancing of administrative tasks with bedside care.
Methods and Analysis: Ethnographic case studies were undertaken in three hospital sites in England, using a
mixed methods approach involving: participant observations; interviews with 33 newly qualified nurses, 10
healthcare assistants and 12 wardmanagers. Data were analysed using thematic analysis, aided by the qualitative software NVivo.
Findings: Multiple demands upon the newly qualified nurses' time, particularly the pressures to maintain records, can influence how effectively they delegate to, and supervise, healthcare assistants. While some nurses and healthcare assistants work successfully together, others work ‘in parallel’ rather than as an efficient team.
Conclusions: While some ward cultures and individual working styles promote effective team working, others lead to less efficient collaboration between newly qualified nurses and healthcare assistants. In particular the need for qualified nurses to maintain records can create a gap between them, and between nurses and patients. Newly qualified nurses require more assistance in managing their own time and developing successful working relationships with healthcare assistants.

Citation

Johnson, M., Magnusson, C., Allan, H., Evans, K., Ball, E., Horton, K., …Westwood, S. (2015). 'Doing the writing' and 'working in parallel': how distal nursing affects delegation and supervision in the emerging role of the qualified nurse. Nurse Education Today, 35(2), e29-e33. https://doi.org/10.1016/j.nedt.2014.11.020

• Journal Article Type: Article
• Acceptance Date: Nov 21, 2014
• Online Publication Date: Dec 2, 2014
• Publication Date: Feb 1, 2015
• Deposit Date: Jan 14, 2015
• Publicly Available Date: Apr 5, 2016
• Journal: Nurse Education Today
• Print ISSN: 0260-6917
• Electronic ISSN: 1532-2793
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 35
• Issue: 2
• Pages: e29-e33
• DOI: https://doi.org/10.1016/j.nedt.2014.11.020
• Publisher URL: http://dx.doi.org/10.1016/j.nedt.2014.11.020
• Related Public URLs: http://www.nurseeducationtoday.com/
• Additional Information: Funders : GNC Trust; Projects : Aark Project