Nursing Delegation

Nursing Delegation

Delegation is an important key factor in teamwork in providing quality of health care and patient
outcomes. The National Council of State Board of Nursing (NCSBN) defines delegations as
“transferring to a competent individual authority to perform a selected nursing task in a selected
situation. The nurse retains the accountability for delegation” (as cited in Finkelman & Kenner,
2014). The nurse is responsible of knowing one’s professional role and appropriately assess and
address the healthcare needs for the patients. To effectively delegate, the registered nurse (RN)
should consider the five rights of delegation: Right task, right circumstances, right person, right
direction/communication and the right supervision. . The focus of this discussion is generally RNs
delegating to nursing team of License Practical Nurses (LPN) and unlicensed assistive personnel
(UAP).
There are several barriers to an effective delegation. The RN does not have enough professional
experience, a lack of trust and lack of proper communication. Often new nurses are nervous upon
delegating tasks to an UAP. With lack of experience shows a lack in confidence and trust to delegate
to UAPs. A nurse excessive over monitoring on a UAP, makes the assistant feel as if there is a lack of
trust (Finkelman & Kenner, 2014). This work can provide a negative impact on the teamwork. In
other sense, if a RNs doesn’t trust their other team member’s skill level, it is likely that they are
reluctant to delegate care (Mueller, 2013). In these cases the right direction/communication and the
right supervision failed to succeed.
Assessing the assistance understanding of expectations, providing clarification and verifying
comprehension on tasks are important to an effective delegation (NCSBN, 2005). Routine tasks such
as weighing patients are often delegated to nursing assistants. For example, an assistant is told to
weight a congested heart failure (CHF) patient daily at a certain time and day. By educating the
assistant that monitoring weight in CHF will help prevent signs of an acute exacerbation, gives the
aide an understanding of the importance of the task. When a nursing assistant has more knowledge
and understanding about the importance of the task, the outcome is more likely to be positive
(Mueller, 2013). This gives the unlicensed personal opportunities to learn and grow. The right
direction/communication is demonstrated in this example. The RN’s communication to the UAP is
clear, concise and complete.
When delegation is used effectively, the nursing team will provide a safety in quality of health
care and patient outcomes. By following the five rights of delegation: right task, right circumstances,
right person, right direction/communication and the right supervision, a nurse is able to have a basic
check list in effective teamwork outcomes. Failure to consider one of the rights puts the RN at risk of
authority, responsibility and accountability of outcomes.



References
Finkelman, A., & Kenner, C. (2013). Professional nursing concepts: competencies for quality leadership
(2nd ed.). Burlington, MA: Jones & Bartlett Learning.
Mueller, C. (2013). Effective delegation: Understanding responsibility, authority, and accountability.
Journal of Nursing Regulation, 4(3), 20-27. Retrieved January 27, 2014, from the CINAHL
Plus with Full Text database.
National Council of State Boards of Nursing (NCSBN). (2005). Working with others: A position paper.
Retrieved January 27, 2014, from https://www.ncsbn.org/Working_with_Others.pdf