Pairing
Pairing is the second scenario in which one RN works with an LPN and/or a nursing assistant for the shift (Koloroutis, Felgen, Person, & Wessel, 2007). However, the RN and LPN and/or assistant are not intentionally scheduled to work the same shift each day. Although they may all work the same shift on the next day, they may not be paired on the next day to care for the same patients. For a given shift, however, they work together, or are paired, and care for the same group of patients. Delegation usually increases with pairing. In this scenario, the RN and the LPN or nursing assistant discuss how care is to be prioritized and how it is to be done, and identify expected individualized outcomes for the shift. For instance, a patient's therapeutic goal for the shift might be for the patient to ambulate the length of the hall 30 minutes after the pain medication has been administered, with a pain rating no greater than 2 on a scale of 1 to 10 at the end of the walk. The nursing assistant would report observations and the pain scale rating to the RN who would then determine if the plan for pain control is adequate. Pairing increases the delegation potential and promotes healthy relationships.