Nurse Delegation

The Nurse Practice Act of Maryland defines “Delegation” as “The act of authorizing an unlicensed individual, a certified nursing assistant (CNA), licensed practical nurse (LPN) or a medication technician to perform acts of registered nursing or licensed practical nursing (Code of Maryland Regulations 10.27.11.02)”. As a registered nurse there are many instances that delegation to an unlicensed individual will be essential in order to provide optimal care to the patient and learning how to be successful in delegation is perhaps one of the hardest things to learn. To ensure that the delegation process is done as safely and smoothly as possible, there are five (5) rights of delegation that should be followed.

One possible obstacle in the facilitation of interdisciplinary care is that staff members simply do not know about the available resources that they can offer to their clients. They may be aware that a nutritionist is on the staff, but are unclear how the nutritionist can help a client such as Ms. R, who may need advice about modifying her diet to ensure a healthy pregnancy. From the very beginning of their tenure at the organization, all new staff members should be oriented in the resources available at the facility. Regular meetings should be held involving all staff members to discuss how to better coordinate care for patients, and common issues all staff members deal with serving the community at large. To facilitate the teamwork from 'day one' of a staff member joining the clinic, an orientation program in basic concepts regarding intercultural concerns; healthcare in a multicultural context, and team communication on a theoretical and practical level should be given.

ABSTRACT: Delegation refers to the practice of a registered nurse assigning certain tasks and activities to other people while still maintaining responsibility for the actions of the others to whom responsibility has been delegated. The act of delegating assumes that the delegator has a certain amount of trust in the person to whom they delegate. Additionally, quality communication is paramount in maintaining superior patient care when delegating tasks to others. One signifigant obstacle to delegation is ensuring that the proper tasks are delegated to the appropriate individuals. The organizational structure and leadership

It is no secret that communication is key when providing direct patient care in a skilled nursing facility. However, there is a noticeable lapse in the communication between the care team when providing care to the individual or groups of individuals. Two main parts of any care team are the registered nurse and the certified nursing assistant, as these are the two people whom have the most direct and impactful roles with residents in a skilled facility. The Registered Nurse and the Certified Nursing Assistant play similar roles in providing patient care, but have different roles in its entirety. The role of the Registered Nurse (RN) is defined as having the competency and skill to provide direct and indirect health care to individuals, their families, and communities around them. Services are also provided designed to give out medications, to promote comfort or healing, promote healing, and to also provide the dignity of their patients and patient’s families (American College of Rheumatology, 2015).

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’

It is up to the nurse/delegator to determine the delegatee’s knowledge, skills, abilities, and any training that will ensure that the task will be handled appropriately and safely. If it is necessary the nurse/delegator must provide instruction and direction to the delegatee. The nurse/delegator or another qualified nurse must be available to supervise the delegate and delegated task. The level of supervision needed will be determined by the training, capability, and willingness of the delegate to perform the task. A delegate may not delegate to another person or expand the delegated task without the permission of the nurse/delegator. Once the delegated task is completed the nurse must evaluate the delegated task, patient’s health status, determination if the goals are being met and if the delegation of the task may be continued (UT Admin Code R156-31b. Nurse Practice Act Rule, 2013). In section R156-31b-704 the rules for the recognized scope of practice of an RN are outlined. It states that the RN, RN managers, and RN administrators should practice

On the other hand, the nurse who is delegating must avoid these assignments for new, float or traveling nurses and for LVN/LPNs: New onset/sudden/acute, new admission, transfer, newly diagnosed, discharge, require education/teaching or unstable patients, such as: high risk of sudden respiratory failure, or requires frequent assessments and changes in therapy, like electrolyte imbalances (NCSBN, 1995). In other words, the Nursing activities that may not be delegated include:

The nursing field is becoming more challenging now our days than the ancient times, too many challenges and high expectations of care needed by our communities and family at large. Nurses are being required to take on much more care giving responsibilities as well as document management. Striking a balance between providing a good quality of patient care and maintaining a proper assessment and documentation with regards to State and Federal regulations are become overwhelming particularly for (ADN’S) who are limited in their scope of education to perform such tasks. ADN’S face some difficulties in performing

Our nursing team provides individualized care during the scheduled visits and also provide support and valuable information to family members on how to care for their loved one. Members of our nursing team add that personal touch to professional services that make our care compassionate. RN Case Manager will be responsible for your overall care and managing your needs along with DON. Nurses visit the patient as often as necessary and coordinate delivery of medication and equipment to helping hands to patient and family.

I liked what you communicated in your post about improving the patients' experience of care is done by the nurse executive's role through their interpersonal skills and collaboration. According to Bradley (2014), "system nurse executives are positioned in to ensure that nursing is represented and strategically engaged in decisions that will reshape our healthcare system and improve the health of the communities we serve"(p. 621). I envision that it will be exciting as nursing administrators we will be able to aid in the transformation of our future health care system with innovative ideas.

Growing number of skilled and practicing nurse practitioners and nurse anesthetists should be given more autonomy, as

Nursing as a profession is being overwhelmed with challenges ranging from global understaffing to policy reform. Amidst all of this, the nursing workforce is attempting to meet the needs of their patients. One might describe this period as an era of transformation for nursing. There are endless opportunities for impact. Including, but not limited to specialization or becoming advanced practicing registered nurses. However, due to understaffing and a significant increase in regulatory oversight, the nursing profession is finding it more difficult to preserve the quality of the nurse-patient interaction. Direct-care nursing may be experiencing the volatile effects of these challenges and opportunities more than other areas of nursing.

Registered Nurses play a big role when it comes to patient care in the health care system. Registered nurses use a systemic, dynamic way to collect and analyze data about a client (The Nursing Process, ANA, 2014). As a nurse you are not just seen as a caregiver, you are also seen as an advocate to patients who need to be cared for. We as Nurses have responsibilities such as knowing the laws, EMTALA, HIPPA, ADA and so on. Each of those laws give us as a nurse the guidelines of what we are expected as nurses.

Thank you for your post. I enjoyed reading about your experiences with your nurse leader. I have worked with two laissez-faire leaders. Marquis and Huston (2015) characterized this type of leaders as being permissive, providing little direction, dispersing decision-making throughout the group, and someone who does not criticize. The first manager I encountered with this style of leadership when I was a pediatric intensive care unit nurse. Many times the staff would get frustrated with her because it seemed like she did not give much direction. Later, I joined the pediatric transport team, and this same person was also the manager of the transport team. The staff of this department liked her style of leadership. This group was a highly

The health care sector in the last decade has experienced tremendous changes in its settings and service delivery system. Some of these changes include implementation of electronic health records and complies with Affordable Care Act requirements (American Nurses Association, 2015). These rapid changes in the health care system coupled with an increase in population and shortage of nurses, calls for the redesigning of professional ethics, regulations and mind set of health care practitioners to conform to these changes and meet the needs of patients adequately. As such, there is an urgent need to position health practitioners with right information and tools to overcome barriers and challenges posed by the new environment in the health sector. Notably, it is the right time for nurses take lead and offer professionalism in care delivery to meet the demands of clients and advance the health care sector in general. On the other hand, a large portion of health care workforce is made up of nurses who are primary care givers and front runners when it comes to giving care to patients. Thus, nurses play a critical role in ensuring the goals and objectives of changes to health care are met effectively. Therefore, “The future of Nursing: Leading change, Advancing Health report” by Institute of Medicine (IOM) provides a framework on how nurses can improve and transform the health care sytem in the United States by offering safe, high quality and customized services which are patient