Case Study: Improper Delegation

Location: Nursing home

Situation: The new nurse manager in the nursing home has decided to adopt a laissez-faire leadership approach in order to help staff become more self-directed.  She believes that by being less hands-on, she will empower her employees to become better problem solvers and goal setters.  The staff is having a hard time adjusting to the new style since their previous manager was a pacesetting leader. 

Today, both UAPs that work on the floor have called in sick and all the RNs and LPNs on the floor are scrambling to get everything done.  In order to increase efficiency, the nurse manager intervenes and delegates some patient care tasks to an LPN.  She tells the LPN to turn the patient in bed 7 on his left side in fifteen minutes. 

Unfortunately, the LPN does not understand English very well.  She is afraid that if she speaks up, she will be fired; so she decides to just guess at what she was told to do.  She thinks that the nurse manager told her to turn the patient before she leaves to go home in eight hours.

The floor continues to be busy and the nurse manager does not follow-up with the LPN because she trusts that the LPN did what she asked.  When the patient’s family comes to visit that night, they notice that there is a reddened area over the patient’s sacrum that does not go away with time.  The family is very upset because now they believe their loved one is being neglected in the nursing home.  They notify the nurse manager about the injury right away and the nurse realizes that the patient was never repositioned.

1.  How did the nurse manager delegate improperly?  What should she have done differently?

2.  Is a laissez faire leadership style appropriate when delegating?  Why or why not?

3.  How would this scenario have been different if the nurse manager was using a pacesetting leadership style or a quantum leadership style?

4.  What change theories could a new nurse manager use to facilitate a smooth transition when arriving on a new floor?

5.  How could diversity management have changed the outcome of this scenario?

6.  What cultural resources could the nurse manager have used to communicate better with the LPN if she had known the LPN did not speak English well?

7.  Now that improper delegation has occurred, what should the nurse manager do next?  What can be done to improve the situation and ensure it does not happen again?