A nurse is delegating tasks to an LPN for a stable patient with a chronic tracheostomy. Which task supports continuity of care and is appropriate to delegate?

Therapeutic communication in nursing is based on patient-centered interviewing, active listening, verbal facilitation techniques, and information exploration strategies, which promote accurate data collection, patient trust, and comprehensive understanding of symptoms such as vertigo, which may have vestibular, neurological, or cardiovascular origins.

Rationale:

A. Sending a PCA to assess dizziness is inappropriate because it bypasses the nurse–patient therapeutic relationship and delegates assessment communication in a non-therapeutic and clinically unsound manner. It also risks inaccurate symptom interpretation without nursing assessment.

B. Writing notes while avoiding eye contact and giving reassurance without assessment limits therapeutic engagement. This behavior reflects non-therapeutic communication, reduces patient trust, and prevents exploration of symptom characteristics necessary for clinical evaluation of vertigo.

C. Using open-ended questions is the most therapeutic approach because it encourages detailed patient responses, promotes elaboration of symptom characteristics such as onset, duration, triggers, and associated symptoms, and enhances accurate clinical data collection during nursing assessment.

D. Turning away from the patient demonstrates non-verbal disengagement and lack of active listening. This behavior decreases rapport, limits patient disclosure, and interferes with effective therapeutic communication needed to assess complex symptoms like vertigo.

Effective delegation requires continuous supervision and clear communication between the nurse and unlicensed assistive personnel (UAP). When a delegated task is not completed, the nurse must engage in re-evaluation to identify barriers, ensure accountability, and maintain the integrity of the nursing process.

Rationale:

A. Completing the task yourself undermines the delegation process and encourages future role confusion. While the specimen is important, the nurse's priority is to manage the personnel they are supervising to ensure team efficiency. This action fails to address the underlying issue of non-compliance.

B. Providing direct feedback allows the nurse to investigate why the task was not performed and correct the behavior. This is the priority because it promotes professional growth and identifies if the UAP faced unforeseen clinical obstacles. Communication is the key to maintaining accountability.

C. Issuing a verbal warning as a first step is an aggressive management style that bypasses necessary inquiry. A nurse should first determine if the UAP lacked the resources or understanding to complete the collection. Discipline should only follow if corrective feedback fails to resolve the issue.

D. Asking another nurse to perform a UAP's task is an inappropriate use of clinical resources and shifts the burden to another professional. This avoids the conflict rather than resolving it and disrupts the workflow of the entire unit. It fails to hold the original delegate accountable.