Registered Nurse Delegation

Delegation

At any given time, a Registered Nurse (RN) play many roles and responsibilities. He/she often act as a caregiver, educator, communicator, manager and a leader. Sometimes a registered nurse assumes all these roles and responsibilities concurrently. Given the number, time and complexity of the tasks, she/he may not complete them satisfactorily. Such an environment may lead to instances where client care decisions are not well thought of and hurriedly implemented. This in return may expose the nurse to unsafe practices and unnecessary burnout. Luckily, some of these tasks could be safely and lawfully transferred to other members of

It is important for the delegating nurse to consider delegatee’s skills and knowledge before handing over the task. The RN delegate only those tasks for which delgatee has enough skills and the knowledge to do, considering training, experience and facility policies and procedures, and cultural competence. RN has to ensure the delegatee’s competency and education pertaining to the skill are on file, and not a mere hearsay.

3. The RN makes judgement call on whether to delegate at task or not. This decision should be based on the RN’s assessment of client’s condition, knowledge and competence of the delegatee, and the degree of supervision needed after the assignment.

4. Delegation has five basic rights which are critical for the safety of the patient during a period of delegation. The RN should use clear judgement and critical thinking in assessing these rights. The five rights are:

a). Right task: The activity should fall within the delegatee’s job description or be part of the organization’s documented policies and procedures of the nursing practice. The facility needs to ensure these policies and procedures describe the expectations and limits of the activity and provide any necessary competency training

Room D.

This room is empty but the outgoing nurse states that she received a call from the ER to get the room ready for a patient in the next few minutes. While nurse Vick was beginning a walk-in round with the outgoing charge nurse, the floor secretary called him and notified him that the ER nurse was on the phone ready to give report on the incoming patient. the charge nurse instructed the unit secretary to “take report of the incoming patient from the ER nurse.”

-This is a highly inappropriate delegation. A unit manager has no nursing training and has no nursing license either. The charge nurse should take the report himself, ask a second nurse to do so or call back and get the report after walk-in rounds.

5. Room E.

68 years old male with diagnosis of UTI, hypernatremia and is also exhibiting dementia-like symptoms. The outgoing charge nurse reports that the patient seem confused and has attempted to get out of bed all night. His provider had issued a one-time telephone order for Ativan 1 mg tablet which was given to the patient three hours ago. She further states that the medication worked for a while but the patient is now awake and is again attempting to get out of bed. The charge nurse assigned an experienced RN to watch and take care of the