Nurses have many responsibilities — sometimes so many that it compromises their ability to care for their patients adequately. Nursing shortages only exacerbate this stress. The ability to hand off or delegate tasks to available colleagues spreads the work among the healthcare team, ultimately leading to a more efficient unit that works collaboratively. As a result, productivity often soars, as do the satisfaction scores of patients and employees.
What Exactly Is Nursing Delegation?
Delegation is a common managerial tactic used by an organization and its employees to address clients’ needs. In nursing, delegation is a time-management skill that is perfected over time. It helps nurses maintain a higher quality of patient care and better meet emergent needs.
According to the National Council of State Boards of Nursing (NCSBN), nursing delegation is defined as “allowing a delegatee to perform a specific nursing activity, skill or procedure that is beyond the delegatee’s traditional role and not routinely performed.” For example, say a stable 48-year-old patient needs a urine sample taken from his indwelling Foley catheter. The patient is assigned to an RN, but she is behind on charting and must still make hourly rounds. The RN delegates the urine collection to a certified nursing assistant (CNA).
Each facility and state may have rules about delegation. Still, in general, “it begins with decisions made at the administrative level of the organization and extends to the staff responsible for delegating, overseeing the process and performing the responsibilities,” says NCSBN. Nurses who have completed an RN to MSN online program and moved into managerial, administrative or educator roles are likely to be involved in delegation oversight and creating and enforcing such policies.
What Are the Benefits of Delegation in Nursing?
The primary benefit of delegation in nursing is that it allows a qualified healthcare worker, like an RN, to transfer routine and low-risk duties to nursing assistive personnel. This frees up the RN’s time to address more pressing matters, including critical patients and tasks.
When used appropriately, delegation is safe and effective and does not compromise the patient experience. It lessens the likelihood of staff burnout and can reduce preventable harm incidents that can occur when an RN is overwhelmed.
Guidelines for Delegation in Nursing
Delegation is a highly regulated process that “must be consistent with state practice acts, institutional policy and nursing standards of practice,” according to the American Nurses Association’s (ANA) Code of Ethics for Nurses.
To avoid unsafe practices and any legal and ethical pitfalls, nurses should always abide by the Five Rights of Delegation:
- The right task
- Under the right circumstances
- To the right person
- With the right directions and communication
- Under the right supervision and evaluation
As outlined in a joint statement by the ANA and NCSBN, RNs may only delegate elements of care and not the entire nursing process. Nurses should use their best judgment when considering the patient’s needs, which tasks to delegate and to whom. They must determine the level of supervision required and should observe and verify that the individual to whom they delegate has the appropriate knowledge and skills to perform the tasks.
Although the RN relinquishes the responsibility and authority of the task to the assistive personnel, the RN is ultimately accountable for the overall patient outcome. Clear and frequent communication among all parties is vital.
Effective delegation is a worthwhile skill to learn. It is an excellent tool for addressing staffing challenges as it lessens the demand on individual nurses and ensures patient needs are met. Satisfaction, across the board, usually improves, as do patient outcomes.