As charge nurse, which patient requires an RN assessment rather than delegated staff?

• A. A patient with stable postoperative vitals and a simple dressing check
• B. A patient with chest pain suspected myocardial infarction
• C. A patient needing routine bathing and mobility assistance
• D. A patient with a stable urinary tract infection on antibiotics

Answer: (B)

Life-threatening changes take priority, so a patient with chest pain and suspected myocardial infarction must be assessed by an RN rather than delegated staff. The RN assessment is needed to rapidly evaluate acuity, monitor vital signs, interpret symptoms, perform or order an ECG, and initiate emergency protocols or escalation as indicated. Stable postoperative patients with a simple dressing check, routine bathing and mobility assistance, and a patient with a stable urinary tract infection on antibiotics all involve routine or stable conditions that can be delegated to LPNs or UAP under supervision. The key concept is that RN assessment is required whenever there is potential for rapid deterioration or need for decision-making and initiation of emergent care, whereas routine tasks can be safely delegated.