NUR 302 Leadership in Clinical Practice

Clinical scenario:Scott Mawsonrecently finished his graduate year, and currently workingat CaseyAged Care Home whichis a 100-bed facility with a secure dementia wing comprising of 40 beds for residentsliving with dementia. Scott is the charge nurse on the morning shift on Easter Sunday. This is going to be a challenging shift for Scott. The Clinical Nurse and General Manager are on holidaysand he has been given a hotline number of the Regional Manager in case he needed to consult someone for advice. A hotel quarantine breach has also triggered another 3-day lockdown for South East Queenslandat this time. This means thatno visitors would beallowed in the aged care home, andfamilies can only makecontact with their loved ones via phone calls/ face time/ skype calls. Today his nursing team is comprised of two enrolled nurses, eightpersonal care workers and two second year nursingstudents currently there on placement. As it is Easter (public holiday), the Diversional Therapist (DT) is not rostered on this weekend. Scott took handover from the night RN who informed him that one of the residents Mr Daviswas exhibiting behavioural and psychological symptoms of dementia (BPSD) since early morning has been quite unsettled. The night RN had to administer PRN anti-psychotics to settle him down but now Mr Daviswas bit drowsy and napping on the lounge chair. She suggested that they will need to keep an eye on him as he seemed to be a little bit unsteady on his feet. She remindedScottthat Mrs Merkel in room 13 was due for IDC change andshe has a history of recurrent UTI. Overnight, Mr Macquariewas complaining of a severe pain in his back and required PRN opioid analgesic. He will need to be reviewed again by the RN at 0930. Finally, she informed Scott that Mr Macron was expecting a call from his niece who lived in France around 1000 hrs. Due to the ongoing pandemic, vital signs were being taken once every shift for 100 residents. There are also the usual showers, meals, morning medication rounds with BGLs and administering insulin to 4 residents prior to breakfast and lunchto be done. Also due to it being Easter and the lockdown, a high volume of calls will be coming in so the nursing team members will need to be ready to relay those calls to the residents.Scott willneed to consider his registered nurse leadership role & responsibilities in prioritising care, delegation and supervision within the nursing team. He will also need to apply his understanding of the NMBA Registered Nurse Standards for Practice in identifying leadership responsibilities for safe and quality care.

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