Wilk: Sorrentino's Canadian Textbook for the Support Worker, 5th Edition
Chapter 10: Working With Others: Teamwork and Delegation
Chapter 10
Working With Others:
Teamwork and Delegation
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The Health Care Team
Health team members support each other,
understand each other’s scope of practice,
and communicate with each other effectively.
Goal: To provide client with the best possible
care and support.
Health team members must conduct
themselves professionally at all times.
Individual team members on health care team
will vary depending upon place of
employment.
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Benefits of Working on a Team
Opportunities for collaboration
Opportunities for communication
Opportunities for mentorship
A wide array of abilities, skills, and
perspectives
Better decision making and problem solving
Positive, trusting atmosphere
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Challenges of Working on a
Team
Recognizing role boundaries—never attempt
any task you are not allowed to perform
Being flexible
Handling conflict—the way it is handled
affects the entire team
Expressing your needs and views—not being
intimidated by physicians and nurses
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Teamwork in Community
Settings (1 of 2)
Home care team
Usually includes the client, family members,
the case manager, the family physician,
nurses, and support workers and their
supervisors.
Social workers and therapists may also be on
the care team.
Case manager or team leader is usually a nurse,
social worker, or other regulated health care
provider (occasionally the client is the case
manager).
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Teamwork in Community
Settings (2 of 2)
Community day programs
Rehabilitation program team
Recreational team
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Slide 6
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Teamwork in Facilities (1 of 3)
Team may consist of a nurse and support
worker only.
Hospital teams vary from unit to unit and
many use a multidisciplinary team approach.
An interdisciplinary team includes health care
providers from a variety of backgrounds and
specialities.
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Teamwork in Facilities (2 of 3)
Long-term care teams often include a
physician, nurses, support workers,
therapists, the client, and the client’s family.
Hospice and palliative care teams may
consist of nurses, support workers,
physicians, social workers, volunteers,
dietitians, the client, and the client’s family.
Long-term care facilities are facilities but are also
considered community-based services.
Outreach programs
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Slide 8
Teams in Facilities (3 of 3)
Family conference (care conference)
A meeting attended by the health care team and
family members to discuss the client’s care and to
ask questions, express feelings, and make
decisions
Assisted-living facilities
Number of staff is usually small
Team members involved depends on needs of
clients
Teams usually include a supervisor and one or
two support workers
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Working Under Supervision
(1 of 3)
Support workers are responsible to their
supervisor, their clients, and their co-workers.
They are accountable to their supervisor—RN
or PN
Other names of supervisors include team leader,
charge nurse, or case manager
The client and family can also be your supervisor
in a private contract.
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Working Under Supervision
(2 of 3)
In a facility:
Team leader is usually an RN (can be the charge
nurse)
Has overall responsibility and accountability for
the clients care and work of other team members
In a community setting:
Team members work for an agency that is
accountable for actions of employees.
There is a case manager; there may be a nurse.
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Slide 11
Working Under Supervision
(3 of 3)
Working directly for a client:
There is no agency supervisor.
The client is the supervisor.
Written contracts that outline responsibilities,
rate of compensation, hours of work, etc., are
advisable.
The contract should be acceptable to you and
your client.
The contract must be signed by you and your
client.
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Slide 12
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Conflict in the Workplace
Avoid discussing details about workplace
conflicts with co-workers who are not involved.
Avoid talking to others about your clients or
co-workers.
Try not to be negative, even if co-workers
complain about a policy or a situation.
Instead, if you are unhappy with a situation,
talk to your supervisor.
See textbook Box 10.2: How to Effectively Resolve
a Conflict with a Co-Worker
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Slide 13
Assigning and Delegating (1 of 2)
Assigning—appointing someone to take on a task or
responsibility that is within his or her scope of
practice
Task—a function, procedure, or activity that you
assist the client with or perform for the client
Activities of daily living (ADLs) and instrumental activities
of daily living (IADLs)
Social and recreational activities
Household management
Basic support care tasks
Delegation—the transfer of function
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Assigning and Delegating (2 of 2)
Controlled acts
Nurse practice acts give RNs and RPN/LPNs
certain responsibilities and the authority to perform
nursing tasks.
The delegating nurse remains accountable for the
delegated task.
Support workers are not allowed to delegate
tasks.
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The Delegation Process (1 of 2)
Delegated tasks for one client are not
transferable to other clients—each situation is
unique.
Guidelines for delegation acts vary, so you
must know the laws of the province or
territory in which you are working.
See textbook Box 10.3: Delegation in British
Columbia, Alberta, Nova Scotia, and Ontario
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Slide 16
Delegation Process (2 of 2)
The client’s circumstances are central factors
in making assignment and delegation
decisions.
See textbook Box 10.4: Factors Affecting
Delegation Decisions for the Nurse
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Slide 17
Delegation in a Facility
When RNs delegate a task, they must be
confident that the support worker:
Understands what the responsibilities are when
performing the task
Knows when and whom to ask for assistance
Knows when, how, and to whom to report the
outcome of the task
Your employer’s policies and guidelines, your
job description, and provincial or territorial
legislation all determine what tasks can be
delegated to you.
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Delegation in the Community
Follows same process as in facilities
Some agencies have educational programs
or workshops for support workers.
Never perform a task that is beyond your
scope of practice.
If asked to do so by a client, explain that you are
not allowed to perform the task without permission
from your supervisor.
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Five Rights of Delegation
The RN or supervisor must review the:
Right task
Right circumstances
Right person
Right directions and communication
Right supervision and evaluation
Do not be offended or angry if you are not
allowed to perform a task that you usually do.
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Your Role in Delegation (1 of 2)
Although the nurse is responsible for
teaching, supervising, and monitoring your
performance, you are still responsible for your
own actions.
Two choices:
Agree to task, or
Refuse to do the task
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Your Role in Delegation (2 of 2)
See textbook Box 10.5: Should You Accept the
Delegation?
You have the right to say no when:
You are concerned about your ability to do the
task
The task is beyond your scope of practice
The client’s condition has changed
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Refusing a Task
Use common sense.
Do not ignore an order or request.
You must communicate your concerns to the
nurse.
You must have a sound reason for your
refusal
Not liking or wanting to complete the task is not a
sound reason for refusal.
Remember that what you do or do not do can
harm a client.
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