Were you taught not to ‘pass the buck?’ 

This misinformed teaching creates confusion for NCLEX testers. 

Here is just one recent example:

Question #36: (Copyright F.A. Davis)

Mental Health: #36. A young child, Joey, was admitted to the pediatric unit with a fractured jaw, bruises, and multiple cigarette burns to the arms. The mother reported the father hurt the child. A man comes to the nurse’s station saying, “I am Joey’s father; can you tell me how he is doing?” Which statement is the nurse’s best response?

  1. “Your son has a fractured jaw and some bruises but he is doing fine.”
  2. “I am sorry I cannot give you any information about your son.”
  3. “You should go talk to your wife about your son’s condition.”
  4. “The social worker can discuss your son’s condition with you.”

 

Student Question: For mental health management, question #36, I thought that sending the father to speak to the social worker about his son was ‘passing the buck’. Please if possible explain again why that will be the answer. For answer #2, I thought that the nurse shouldn’t give any info because he hurt the kid. And if he did, then he didn’t care much about the kid to hurt him in the first place.

 

What would you do? What is the nurse’s best response?

“Passing the buck” is one of the worst things taught in test prep! Healthcare is a TEAM effort. You cannot manage care alone. This is the social worker’s role, not the nurse’s role and you are required to assign this task appropriately. If you chose #2, what are the chances you have a violent man who doesn’t like that answer? You just put yourself, your staff, and your client in danger. #2 is not a true statement. At this time, it’s uncertain if the father has legal rights (most likely) or has lost his parental rights in court because of a past incident (possibly.) Clearly, he needs to be referred to the social worker. 

The keyword is BEST so the question is asking you to choose policy, not opinion.

The correct answer is #4.

The definition of “passing the buck” is to shift blame on someone else because you didn’t take responsibility to make a critical judgment. You are responsible to delegate and assign when appropriate.

I can’t stress enough how important it is to let go of the misinformed teaching to ‘pass the buck.’ 

Focus on learning the rules of delegation and assignment. This begins with knowing what your priorities are.

Were you taught not to ‘pass the buck?’

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