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The Role of Delegation in Nursing
Kiara Porter
Chamberlain College of Nursing
NR: 103
Winter January 2018
The Role of Delegation in Nursing Delegation plays an integral role in the nursing profession. In fact, delegating tasks to other appropriate staff members (e.g. patient care techs, LPNS) can be the key component in making sound clinical judgements as a registered nurse; as it also determines the hierarchy of care. However, there are many misconceptions in the art of delegation: it all depends on the right person, right circumstance, and right task. As a nurse you must also know what tasks un-able to be delegated as well? An example of task that should not be delegated are patient assessment, patient teaching and nursing judgment. The goal is for the registered nurse to recognize when specific task are too be delegated.
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This patients surgical procedure has put them in great agony and they are complaining of a pain score of six out of ten with ten being the worst. In addition, five of your six patients are scheduled for medications, one fall risk patient is requesting to be assisted to the restroom and a family member is requesting for her husband's tracheostomy to be suctioned. You are then left with the overwhelming questions of who do you see first? What task would you consider a priority? And most importantly out all of these tasks, which one is the most appropriate to delegate to an LPN or nurses aid? Well, if you guessed taking a patient to the bathroom in this scenario then, you are right! Other task such as suctioning the patients tracheostomy can be delegated to the LPN, but pain management should remain your responsibility as you are in charge of the patient
Without doubt, there are two variables that should be considered when evaluating the benefit of shared governance in long term/nursing home settings. First, obtaining consent from the nursing assistant to volunteer for the leadership role for the duration of one year, and the nursing assistant employment status at the time of consent. Second, the effectiveness of the shared governance project to reduce falls, weight loss, in-house acquired pressure injury, and nosocomial infection rates for the sake of the resident’s comorbidity.
The Role of the Registered Nurse in relation to delegation. One of the vital skills required by the Registered Nurse is the skill to assign tasks to subordinates (Saccomanos and Pinto-Zipp 2011). When tasks are delegated to subordinates, the RN remains accountable (Nursing and Midwifery Council 2008). On the other hand, an individual who has been given a task also bears responsibility for the task and is answerable to the RN.
The National Council of State Boards in Nursing defines delegation as “transferring to a competent individual the authority to perform a selected nursing task in a selected situation” (National Council of State Boards of Nursing, Resources section, 4). When delegating, the registered nurse (RN) assigns nursing tasks to unlicensed assistive personnel (UAP) while still remaining accountable for the patient and the task that was assigned. Delegating is a management strategy that is used to provide more efficient care to patients. Authorizing other individuals to take on nursing responsibilities allows the nurse to complete other tasks that need tended to. However, delegation is done at the nurses’ discretion and is a personal choice. Nurses must make careful decisions regarding delegation, taking into account the skill and training of the UAP, the difficulty and risk of the task, and the patient’s condition. The expected outcomes, a time frame for completion, and any limitations should be explained to the UAP at the time that the task was delegated.
This also includes creating personal connections this is knowing how to be approachable and engage with groups and listen attentively. Understanding the importance and what is emotional intelligence and developing this to help these management and leadership skill to develop and ensure the application of these kills is shown ( (Beauvais, Brady, & O’Shea, 2011). It is important that newly qualified nurses understand their own emotional intelligence to develop these skills as leadership and management skills are used in all areas of clinical care. In the workplace newly graduate nurses will undertake the care and responsibility of patients that are critically ill. In these settings changes in the patient’s condition can rapidly change in a
Nurses have a considerable amount of responsibility in any facility. They are responsible for administering medicines and treatments to there patient’s. While caring for there patients, nurses will make observations on patient’s health and then record there findings. As well as consulting with doctors and other healthcare professionals to plan proper individual patient care. They teach their patients how to manage their illnesses and explain to both the patient and the patients family how to continue treatment when returning home (Bureau of Labor Statistics, 2014-15). They also record p...
nursing assistants. All the delegation needs to be within the scope of practice. The registered
Delegation has been a very important element of nursing for some time now and has become more and more important over the years. In this article, it goes over the reason for the sudden interest and importance of delegation as part of the nursing process. Delegating is one of the many nursing tasks that is sometimes neglected to be taught. To delegate it takes an RN to remain accountable for a task that she assigns to a nurse’s aide. In the article the Board of Nursing Examiners rule and regulations states delegation as, “the act of authorizing an unlicensed person to provide nursing services while retaining accountability for how the unlicensed person performs the task”(Saccomano, 2011). Basically, this means that even though the RN is giving
Nurses are responsible for their own practice and the care that their patients receive (Badzek, 2010). Nursing practice includes acts of delegation, research, teaching, and management. (ANA, 2010). The nurse is responsible for the following standards of care in all practice (Badzek, 2010). The individual nurse is also responsible for assessing their own competence and keeping their practice within the standards of the current standards of care for the specialty which they are practicing and the state nursing practice acts (ANA, 2010). As the roles of nursing change, nurses are faced with more complex decisions regarding delegation and management of care (Badzek,
According to the National council of state board of nursing (2005), the task should be performed if it can be performed with a predictable outcome and does not endanger a client’s life or well-being. For example, the nurse can delegate to the nursing assistant to collect and measure urine output and report it to the RN. This is a non-invasive task and would not harm the patient. However, if the patient were requiring straight catherization to collect a urine specimen, it would be delegated to the LVN since this is an invasive procedure that requires skills and knowledge of performing this procedure. Right circumstance is the next right of delegation. Even though the RN can delegate to nursing assistant to have the patient ambulate, if the patient is recovering from hip surgery and had issues with bleeding during surgery, it would not be appropriate for the nursing assistant to do. The RN should do this task, since the patient is at a risk of being unstable (NCSBN, 2005). The third right of delegation is the right person. After determining what is the task or assignment that needs to be completed, the nurse should decide who would be the best person to do it. Factors that influence the RN’s decision are the knowledge and skill of the person who is performing the task (NCSBN, 2005). Most facilities check skills at the
Additionally, the LPN cannot push medications into a peripheral intravenous line if the patient “weighs less than 80 lbs, is prenatal, pediatric, or antepartum”, although given that the situation is on a general med-surg floor it is unlikely these patients would be under Sarah’s care at this time. (Rules and Regulations of Practical Nurses. 2015) Sarah can delegate the postoperative patients who need dressing changes and ambulating them to the LPN, but Sarah should assess the wounds for complications initially and serve as resource to the LPN if she has questions about the wounds. Additionally, she could help the nursing assistant with answering calls and serve as a reference for the nursing assistant to ask questions or help with tasks if Sarah is not available. With regards to supervision, the LPN would need continuous supervision given that the working relationship is new. (Cherry and Jacob, 2014) Sarah should be available and willing to answer any questions or address any concerns the LPN
Select one of the essential nursing values of altruism, autonomy, human dignity, integrity, and social justice, to discuss the challenges professional RNs face in demonstrating the expected professional behaviors. Give a clinical example. In Professional Nursing Concepts and Challenges, the concept of autonomy is explored. Autonomy is defined as the principle that “asserts that individuals have the right to determine their own actions and the freedom to make their own decisions” (Black 2014). This is important to ensure, particularly in the hospital setting.
have to make decisions that are needed at that moment. Not only is the patient the focus but
Prioritizing care is one of the first things that nurses learn in their career. Prioritizing requires critical thinking whether it comes to discharging a patient, caring for a patient, or delegating a task to a LPN or CNA. As the charge nurse they must look at the whole picture and not just the tasks that need to be done. The charge nurse is the one makes the assignments for the individual nurses, so if there happens to be a float nurse from a different department they might give them the patients with the lowest acuity depending on the nurse’s experience. The charge nurse must know which patients could be discharged if there was an emergency to arise or not enough hospital beds for those patients who need to be admitted. For example, the nurse is not going to recommend someone who came in with a heart attack; they would most likely recommend someone who is two days post op and is being discharged to a rehab facility in a couple of days. It is the charge nurses duty to make that everyone providing great and safe care to the patient.
Although those tasks are not done at the same time by each nurse who has a specific patient, it requires clear communication and making an effort for the benefit of other team members. For example, a hand off report is very important so that the continuation of care from nurse to nurse can transition smoothly with each shift. That means that each nurse should make an effort to gather all pertinent data about the patient’s status, orders or procedures to anticipate, and anything that will help the nurse coming on to provide good care without having to jump through hoops to figure out what was done and what should follow. The other way in which nurses help each other is by maintaining their documentation as clear and thorough as they can. Not only does it paint a picture of where the patient is at that moment, but it also provides a safety net for legal
Overall delegation is get familiar with the national guidelines,state guidelines, job descriptions,scope of practice being accountable and responsible for the tasks who delegated. Nurses need good critical thinking skills, respect, trust for one another to maintain good relationships and to realize we are a team. This way any nurse can delegate with confidence.