Sylvia arrives at 0700 for her morning shift. She just completed her new graduate residency and she is excited about starting her new job. She is also a little nervous to be fully on her own. She had told the charge RN that she loves working on a team although she finds it a little uncomfortable to “tell people what to do.” She is assigned a team of four patients. Two of the four patients need repositioning every 2 hours. After she receives bedside report from the night shift, Sylvia quickly becomes immersed in a patient’s request for pain medicine and forgets about the every 2 hour repositioning schedules. At 1000, she realizes she has not made a plan for the day with her assigned nursing assistant and she has not repositioned her patients. Sylvia is new to healthcare and she is not used to giving a nursing assistant specific direction. She is also not used to the fast-paced environment of the medical-surgical floor.

1.

What safety issues should Sylvia consider when planning her day?

2.

How do those safety issues influence her communication with a nursing assistant?

3.

What suggestions could the charge RN have for Sylvia in order to build her confidence level with “telling people what to do”?