Natalie Stewart: Chain Of Command In Nursing Practice
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Chain of Command in Nursing Practice
Natalie Stewart
Lipscomb School of Nursing
The chain of command is a universally recognized and applied principle of authority de-scribed as "A series of command, control, executive, or management positions in hierarchical order of authority"(Judith, 2013. p. 544). The chain is used in hospital settings as a line of re-sponsibility to provide appropriate patient care, as well as results from perceived impact and ap-propriateness of care (Patient safety and authority, 2010). There are several different facets of healthcare that warrant the use of the chain of com-mand. Examples of these are refusal to adhere to established procedures, delayed response of staff, impairment of a coworker,…show more content… The chain of command is a safety net for hospital policy and provides pre-established outlines for staff responsibility. It helps with the resolution of difficult situations, and can protect a nurse’s license if negative outcomes arise. Nurses and other health care providers face challenging confrontational situations every day, therefore effective communication skills are essential. The use of assertive communication, or stating a position with assurance, focuses on solving problems and is imperative to patient safety, but can also help invoke the chain of command (Issues in Nursing, 2010). Not only is a chain of command an important authoritative hierarchy, it also enables each individual in their position to enforce standers of accountability and authority (Kabuye,…show more content… If a conflict management situation arises and policies do not have, or fail to outline, structured communication techniques or guidelines, intimidating behaviors may hin-der communication between the healthcare clinicians (Patient safety and authority, 2010). Often times, these behaviors without proper management can lead to adverse workplace and clinical events (Patient safety and authority, 2010). Rosentine also proposes that hospitals "develop an organizational process to address in-timidating and disruptive behaviors that solicits and integrates substantial input from an interdis-ciplinary team of medical and nursing staff, administrators, and other employees" (Patient safety and authority, 2010). This effectively translates to a combined effort from all staff in the hospital to establish a process to handle unwanted behaviors in the