After all, if they did understand the implications of diabetes insipidus they should have been able to give Kane the care he needed. If not, they had a responsibility to get the information they needed to ensure his care was safe and effective.
When a student, I was told never to give a drug unless I knew the indication, contra-indications, side effects and normal dose; the same went for understanding a patient’s diagnosis and treatment. Indeed, if you don’t truly understand what is wrong with your patient - the underlying anatomy, physiology and pathophysiology, then how can you look after them? Without this knowledge, nursing is nothing more than tasks - and tasks without understanding are dangerous things.
Which brings me to skill mix. Recent data from national nursing research unit suggests the average proportion of registered nursing staff - compared to unregistered healthcare assistants - on day shifts is 56%. This places the onus on the registered nurse to ensure that HCAs carrying out day to day care, such as fluid management, understand the significance of patient diagnosis. This is probably easy when staffing is stable and patients are on appropriate wards, but what happens to patients who have multiple and complex conditions?
It is often claimed in the media that anyone can give someone a drink but it’s not “simple” for someone with diabetes insipidus. Anyone can wash someone but it takes a bit more thought if a patient has a fractured neck of femur. Anyone can help someone to eat but not if they have dysphagia. Nothing in nursing is really simple which is why delegation has to be managed carefully and nurses given time to ensure those giving care, who often are not nurses themselves, understand the significance of what they are being asked to do.