Why Does Delegation Exist

Accountability means:” being accountable for one’s own action”. The American Nursing Association (ANA) states in its code that the nurse will assume accountability for individual nursing judgments and actions. Professional nurses are accountable in several areas including accountability to the public, client, profession, employer, and self (Hood, 2010, p. 307). All professional nurses have the responsibility to work within their scope of practice to provide the best possible care to patients. Nurses’ should have a thorough knowledge about their accountability in specific areas of practice. The level of responsibility and accountability depends on professional levels. A nursing supervisor has more responsibility than a charge- nurse. A

Delegation in nursing practice will be discussed in this essay. Delegation will be clearly and concisely defined and described as following:

Delegation as defined by the State of Michigan Public Health Code as “…means an authorization granted by a licensee to a licensed or unlicensed individual to perform selected acts, tasks, or functions which fall within the scope of practice of the delegator and which are not within the scope of practice of the delegatee and which, in the absence of the authorization, would constitute illegal practice of a licensed profession” (RN Accountability For Delegation Decisions). What this states is that the RN has the legal right to delegate appropriate tasks to LPN/LVN and UAPs (unlicensed assistive personnel) or CENA’s. The importance of delegation of care is vital to the success of the patient’s outcome to leave the acute hospital setting. The RN must be agile in overseeing that the tasks assigned are done correctly and accurately due to the fact that they are ultimately responsible and accountable for that patient. In the acute hospital setting, the RN may delegate to the LPN/LVN

Under the regulations of the California Nurse Practice Act, a Licensed Vocational Nurse has the ability to delegate tasks to unlicensed assisted personnel (UAP) according to individual facility policy. Delegation as stated in Hill & Howlett is defined as, “transferring the authority to perform nursing duties that are in the job description of the LVN charge nurse.” Prior to carrying out this important nursing duty, it is important for the LVN to recognize the difference between assigning tasks and delegating tasks. As explained in an article in the Journal of Nursing regulation titled; National Guidelines for Nursing Delegation. Assigning tasks would involve performing “routine care, activities, and procedures that are within the authorized scope or practice of the LVN or part of the routine functions of the UAP. Delegating tasks on the other hand is defined as “allowing a delegate to perform a specific nursing

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

Delegating is one of the most valuable leadership skills a charge nurse possesses.   Effective delegation skills are essential for proper patient care and safety. Delegation is defined as when a nursing professional entrusts the performance of a nursing task to someone who is qualified, competent, and able to perform the assigned task (Q1).  In order for the charge nurse to delegate effectively,  he or she must take into consideration the patient's needs as well as the capabilities of the nursing professional for whom he or she is delegating the task to. The American Nurses Association outlines The Five Rights of Delegation as a guideline for nursing professionals.  The first right is for the professional to determine if the task is one to

Among the professional skills that a registered nurse (RN) must possess; the skill of delegation is vital. Both the nursing shortage and the need for more cost effective care has resulted in the use of more unlicensed staff and licensed practical nurses (LPNs) in the healthcare setting. This increase has led to the need for the RN to possess delegation skills. This necessity then leads to a requirement of definition and regulation of the delegation that occurs in order to keep it safe and effective.

No history of skin disease. Skin is pink, dry, and void of bruising, rashes, or lesions. No recent hair loss; head is normocephalic. Pupils equally reactive to light; no history of glaucoma or cataracts. Ears are in normal alignment; no history of chronic infections, hearing loss, tinnitus, or discharge. Nose and sinus history includes clear nasal discharge “since last October”, and occasional nose bleeds; states she use to get nose bleeds often as a child. Mouth and throat are absent of lesions; no bleeding gums, sore throat, dysphagia, hoarseness, or altered taste. Neck is void of pain, swelling,

She states it had been causing her pain for a couple of days and the pain got unbearable. DG has a medical history of stroke, encephalopathy, cataracts and macular degeneration, COPD with chronic respiratory failure, type 2 diabetes, peripheral vascular disease, neuropathy, and GERD. The client also has a surgical history of cataract removal, hysterectomy, angioplasty (2011), sixth toe amputation, and right, above the knee amputation performed in April of 2017. DG has no known allergies.

Her medical history was significant for chronic kidney disease stage 4 on hemodialysis, hypertension, coronary artery disease, stable angina, respiratory failure on 2 L oxygen via nasal cannula, anemia in chronic kidney disease, and diabetes mellitus Type II with hyperosmolarity. She also had history of Staph epidermidis in June 2014.

The American Nurse Association defines delegation as “the transfer of responsibility for the performance of an activity from one individual to another while retaining accountability for the outcome” (Cherry, 2011). Delegation is an essential tool used by the registered nurse to routinely distribute responsibility and allow them to effectively complete more tasks during their daily routine. With this shared responsibility comes accountability for the registered nurse to know how, when and to whom he or she must appropriately distribute these tasks. To safely delegate patient care, the registered nurse must follow his or her own state

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’

I understand why attitudes can be a barrier because nurses’ can say, why delegate if the nurse will be held accountable if the task does not get completed or if it is done incorrectly. I realized as a nurse you cannot do everything and you need to work as a team with your colleagues, so the client can receive the best client care. Therefore, the nurse should delegate appropriate tasks to competent staff and make the staff feel comfortable to voice concerns if their not competent to complete the task. If this results, the nurse can send the staff member to in service to gain education on the skill they do not

This article discusses about the process of nursing delegation. For the process of nursing delegation, it must have strong communication, empowered staff, and organizational support. The guidelines identify 5 rights of delegation, which include right task, right circumstances, right person, right direction & communication, and right supervision & evaluation. When a delegator, such as a nurse, delegates, they will remain responsible for the tasks that were delegated. Delegation of an action/task is done based on the patient’s safety and their quality of care. Following the process enables a nurse to appropriately delegate to benefit the care of the patient.

Nurses demonstrate the value of autonomy by acting on their own intuition daily to improve the quality of all aspects of human life. This is evident when a patient arrives into an urgent care center with an asthma attack. A prudent nurse will act autonomously by giving the patient a nebulizer treatment, place him on oxygen, or take the time to find out if there are standing orders and carry them out without a doctor’s order.