Rules Of Delegation

The first consideration a registered nurse should determine is if “The Right Task (Cherry 355-356)” is being delegated to the right staff member. Delegation to the right staff member must be in their scope of practice and have proven to competent to complete. An individuals’ scope of practice will be set forth by the facility in which they work. In addition to individual facility polices the nurse must adhere to the scope of delegation set forth in the Nurse Practice Act of Maryland. Per the Nurse Practice Act of Maryland the task to be delegated must be “within the area of responsibility of the nurse delegating the act (Code of Maryland Regulations 10.27.11.03).” An example of incorrect delegating would be having an unlicensed individual, CNA or LPN to

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’

Delegation is widely acknowledged to be an essential element of effective management (Yukl, G. 1994). Delegation is basically a process of assigning responsibility, sharing authority, and producing accountability in organizations. It is a managerial instrument that allows managers to nurture subordinates to capitalize the subordinate’s potential and ability to meet organizational goals and objectives. As a form of employee involvement in decision-making, delegation describes a category of leader behavior that entails assignment of new responsibilities to subordinates and additional authority to carry them out (Yukl, G. 1998). Managers usually find it easier to speak about delegation of

Nurses play many roles in the healthcare field, can have many duties to fulfill under their licensure. It is important for a nurse of any degree, or licenses to know all of the duties that can be performed under their scope of practice. Olin (2012) states, “Scopes of practice are the same for every nurse at a basic level and very different by specialty.” Therefore, it is important to understand the scope of practice, that the nurse is licensed for. A nurse has many roles under the scope of practice that the nurse is licensed under. There are times when a nurse is asked to perform a task that isn’t under the nurse’s scope of practice and guidelines, and it is very important not to fulfill the task at hand if it

Delegation is a formal process through which a regulated health professional (delegator) who has the authority and competence to perform a procedure under one of the controlled acts delegates the performance of that procedure to another individual (delegatee) (College of Nurses of Ontario, 2014).

The State of Tennessee Board of Nursing’s Rules and Regulations of Registered Nurses, Rule # 1000-01-.13-1r states that unprofessional conduct is defined in part by "failing to take appropriate action in safeguarding the patient from incompetent health care practices" (State of Tennessee, 2011). There are a number of arguments in this case study that incompetent health care practices are being performed, from the decision to place a patient on a ventilator for an oxygen saturation of 88%, circumventing the patient’s written and verbal advanced directives, utilizing an unauthorized family member to get consent for

In nursing, delegation helps in making use of the talent or skills of another person. One nurse transfers interventions which are under his/her practice roles to another to another member of the healthcare team who lacks such powers authorized under their scope of practice. Delegation can only take place if it is in patient’s best interest.

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

Under the scope of practice of an RN from the New York State Education Department, an RN can diagnose and treat human responses to actual or potential health problems. To be able to perform those tasks a care plan must be made for each client. An RN manages the health care services such as observing and assessing the health status of clients and implementing/assessing nursing care. This all falls under the initial assessment of a client, which is within the scope of an RN. An RN uses information gathered as part of client assessment, they then have the capacity to assign client care to other members of the nursing team, RNs and LPNs, and assign tasks to other care providers such as nurse’s assistant. Even though there are parts of the nursing process that may be delegated to qualified personnel, the initial assessment is the RNs responsibility. The initial assessment is the basis for safe and appropriate client care, which makes it so vital and why not just anyone can perform it. RNs hold the overall responsibility in the nursing

8. Nurse Educator will give handouts and teach the UAP to encourage and provide nutrition and fluids. Encourage the patient to eat good foods and lots of fluids. Every time you are with patient, ask them if they would like a drink of water or juice.

A professional nurse is one who puts the needs and importance of patient care above all others. While striving for professionalism, nurses need compassion, patience, empathy, strong moral and ethics, accountability and the commitment to always act in the best interest of their patients. Nurses are held accountable for providing quality, safe, and effective nursing care (Hood, 2014). A professional nurse has the responsibility to continually improve and implement nursing standards while maintaining integrity by involving themselves in various tasks. Regular involvement in reading professional literature and sharing of evidence- based research with other healthcare personal helps increase knowledge and skills. This nursing ability can be used to encourage the actions of others in the healthcare team resulting in improved patient care. Nurses should encourage each other to become involved in hospital committees, provide an environment to encourage the discussions of ethical dilemmas, promote professional growth of nurses to voice their concerns and share viewpoints to address issues. “A professional nurse should expect to commit to a life of continuous learning growth and development”. (Hood, 2014, pp. 29). Nurses choose this profession to help others. As professional nurses we must maintain our ethics, values, characteristics, and commitment to drive our profession forward (CCN, 2015). Nurses must be autonomous, accountable, and be able to delegate to unlicensed assistive personnel. Being autonomous as a nurse means having control over their practice (Hood, 2014). It allows a nurse to take risks while being held accountable for ones’ actions (Hood, 2014).

For example, RN might be assigned for patients’ assessments, LPN assigned for certain medication administration and nursing assistant helps with care/bathing and feeding patients. All this done under supervision of a team leader another RN (Currentnursing.com, 2015).

What is delegation? According to Bateman, delegation "is the assignment of authority and responsibility to a subordinate at a lower level." (Bateman

Urgency of acute care varies depending on the situation but can range to anything from emergency surgeries, to injuries, chronic illnesses, and also for the recovery of those procedures. Majority of the patients in acute care settings are critically ill. Nursing responsibilities in acute care settings are vital to patient’s recovery due to the front line position nurses play as well as the wide variety of tasks carried out. Assessments are made during every encounter the nurse has with the patient along with monitoring the patient’s progress. Nurses are responsible for recognizing symptoms the patient may be experiencing due to illness or injury and whether they fall in the spectrum of normal reactions. Vital signs are measured routinely and can be indicators of the patient’s current status. When vitals are questioned diagnostic tests can be arranged to further assess possible comorbidities the patient may have. Care plans are made to plan interventions the health care team can take to help patients through challenges they face, both physical and mental. Nurses administer medications as well as first aid as needed. They are responsible for maintaining special equipment patients may require including monitors and ventilators are well.