During periods of surge demand it is likely that the nursing or midwifery team will have people from a wide range of clinical backgrounds that may include registered, temporarily registered, other registered professionals such as AHPs, student, non-registered and volunteers in the workforce – for further information see skill mix and group outline sections.
Under these conditions, nursing or midwifery staff who would normally work in a particular service setting will need to consider how the ‘new’ team is managed on a day to day basis to maximise the wider team members’ knowledge and skills, to match the needs of the people they are caring for.
This includes the delegation and supervision of tasks and duties to others in the team.
It may also be necessary to care for people in a more task driven model of nursing or midwifery practice to ensure that activity requiring higher order knowledge, skills and experience, is carried out by the right staff. This should always be driven by a person-centred nursing or midwifery assessment and associated plan of care to address identified needs appropriately.
Areas for consideration include:
For additional information specific to particular care settings e.g. Private Nursing Homes, please see below.
Members of the substantive team should be easily identifiable – it may be useful to have specific name badges or a daily list available in a closed staff area identifying who is on shift including who are core team members.
It will be necessary to identify the shift team lead, who may or may not be a member of the core team and potentially sub-group leads each shift, again making them easily identifiable to all members of the clinical team.
At all times the escalation process should be clearly outlined and staff team members’ understanding checked. Escalation processes should also include the actions needed beyond the clinical setting and team, i.e. individuals to whom concerns should be escalated within the wider organisational structure and any related governance arrangements or processes. Smaller sub-groups within teams may take on delegated tasks and duties within the wider clinical environment e.g. specified members of staff may take on responsibility for delegating ward environmental cleanliness, with associated team members.
When an individual is being orientated to the clinical setting it may be helpful to outline regular tasks that he/she is likely to be asked to complete in his/her role to determine competence.
To do that the group outline on this site may be helpful for individuals to quickly self-identify their level of knowledge and skills immediately on orientation to the environment. This may be linked with a short outline of activities commonly delegated within categories as examples of the levels of knowledge and skills required.
Not everyone will be HSC Trust staff/ have worked in the organisation before – it may not be appropriate to provide handover to all members of the team. Think carefully about who should be provided with handover details. A helpful aid to assist with effective handovers can be accessed here. Where members of the team cannot be included in handover, it may be useful to outline a list of tasks for them to complete, including reporting arrangements within the wider team.
BREAKS AND REST
Evidence demonstrates that the ability to rest during and between shifts is an important factor in relation to reducing stress and burnout. This means that it is important to make sure all staff get adequate breaks and know where staff rest facilities are located – including the provision of advice relating to social distancing during breaks and using restaurants and canteens on site, appropriate to the policies of the organisation.
Some of the resources referred to in this section for HSC Trust Hospital or community based environments are applicable in Private Nursing Home settings – for example delegation and models of care.