Case Study on Delegation for Nursing Leadership
Ms. Clark, a registered nurse, arrives at work at 6:30 AM so she has plenty of time to make
out her assignment and decide who will be working with her before the report begins. As
she walks onto the unit, she hears the night charge nurse speaking on the telephone in a
rather loud and firm voice. Based on this conversation, it is clear that the charge nurse does
not believe that the unit is adequately staffed to meet the patient care needs. The charge
nurse, Ms. Viola, turns to Ms. Clark and says, Your assistant called in sick and we are trying
to get a CNA (certified nursing assistant) from another unit as a replacement; however, that
may not happen until after the shift begins. As usual, we are trying to get someone from our
sister unit, so whoever comes will be late. Sorry, thats how it is today. Ms. Clark has
worked on this unit for approximately 6 months and is anxious about working with
someone she never met before and for whom she has not observed provide patient care.
Ms. Clark, using various flowcharts, quickly assesses the patients immediate care needs
and determines what questions to ask during report. She circles tasks or activities that
normally can be completed by a CNA and that must be done before 8 AMthe earliest she
might anticipate getting some assistance. Ms. Clark is overwhelmed with her
responsibilities and what she needs to keep track of and hasnt even learned the status of
the patients since she last worked with them.
1. What could the day charge nurse do to assist Ms. Clark?
2. What should Ms. Clark do as soon as the replacement CNA arrives on the unit?
3. Is Ms. Clark making appropriate use of her time by arriving early
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