An experienced practical nurse (PN) is floated to a busy acute medical unit. Upon reviewing the shift assignment, the PN notes that one assigned client is experiencing acute respiratory distress and requires continuous titration of intravenous (IV) vasoactive medications. Arrange the steps the PN must take to safely and professionally resolve this out-of-scope assignment in the correct sequential order.
- 1Approach the delegating charge nurse to communicate concerns about the assigned client's acuity.
- 2Clearly articulate that the continuous titration of IV vasoactive medications exceeds the PN legal scope of practice.
- 3Request a reassignment to a stable client whose care requirements match the PN's legal competencies.
- 4Escalate the situation to the nursing supervisor if the charge nurse declines to alter the assignment.
- 5File an objective formal report documenting the unsafe assignment request according to facility protocols.
Answer
The correct sequence is to first approach the charge nurse, articulate the scope of practice issue, request a safe reassignment, escalate to the supervisor if unresolved, and finally file a formal report.
When a PN receives an unsafe or out-of-scope assignment, they must follow a structured process to protect the client and their license. The process begins with the immediate chain of command (the charge nurse), requires clear articulation of scope of practice limitations, attempts collaborative reassignment, escalates to higher management only if unresolved, and concludes with formal documentation after the client's safety is secured.
Step-by-Step Solution
Key Concept
Client Care Assignments and Collaboration