Directions:
Provide a brief summary of the case. Be sure to apply an appropriate problem-solving/decision-making model (Traditional Problem-Solving Process, Managerial Decision-Making Model, The Nursing Process, or the Integrated Ethical Problem-Solving Model) in determining what you should do. Justify your decision with supporting evidence.

Learning Exercise:
You are a senior nursing student completing your final leadership practicum. Your assignment today is to assume leadership of a small team composed of the registered nurse (RN), one licensed vocational nurse/licensed practical nurse, and one certified nursing assistant (CNA). The RN preceptor has agreed to let you take on this leadership role in her place, although she will shadow your efforts and provide support throughout the day.
Almost immediately after handoff report, a patient puts on the call light and tells you that she needs to have her sheets changed as she was incontinent in the bed. Because you are just beginning your 8:00 AM med pass and are already behind, you ask the CNA if she has time to do this task. She immediately responds, “I’m busy and you’re the student. Do it yourself! It would be a good learning experience for you.” When you try to explain your leadership role for the day, she walks away, saying that she does not have time anyway.
A few minutes after that, a physician enters the unit. He wants to talk to the nurse about his patient. When you inform him that you are the student nurse caring for his patient that day, he responds, “No—I want to talk to the real nurse.”
You feel frustrated with this emerging authority–power gap and seek out the RN to formulate a plan to make this gap smaller.

ASSIGNMENT:
Identify at least four strategies you might use to reduce the size of this authority–power gap. Would you involve the RN in your plan? Do you anticipate having similar authority–power gaps in the new graduate role?


 

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