Delegation In Nursing

In response to the issues of care delivery, budget restrictions, the continuous advancement of medical technologies and an aging citizenry – health care systems over the years have increasingly used a variety of unlicensed personnel such as Nursing Assistants and Student Nurses to work in patient care areas, with a licensed registered nurses (RN) supervising and directing these less skilled workforces. The registered nurses are relied on to make independent decisions regarding the delegation of nursing tasks. (McInnis & Parson, 2009)
Often time’s patients may find it difficult to differentiate between the registered nurse and the nursing assistant or student nurse. In response Jackie Smith, Nursing and Midwifery Council claimed, “We need to see whether the code of conduct puts patients’ first and makes clear that nurses should delegate
appropriately. If that is not clear then we should look at strengthening it and making it clearer.” (Sprinks & Kendell-Raynor, 2013).
Delegation in nursing is the process of a registered nurse assigning tasks to their staff based on the needs of the patient and family (NCSBN, 1995, p.1). However, nurses must be mindful of their colleagues’ capabilities and limitations when delegating these responsibilities. The complexity of the work must also be considered (Weydt, 2010).
Successful delegating involves effective communication, empowering staff to make decisions based on their judgment and support from all levels of the health care setting.
Also considering the five rights of delegation: the right task, right circumstance, right person, right direction or communication and right supervision (McInnis & Parson, 2009). And being mindful of the registered nurse, and student nurse and or nursing assistance’s specific responsibilities within the delegation process (National Council of State Boards of Nursing, 2015).

Effective task delegating optimizes the registered nurses’ time for activities that cannot be delegated. Research shows that the ability to delegate effectively improves satisfaction relative to nurse decision-making on the job and affords promotional opportunities within the organization.
Quallich concluded that effective delegation improved nurse’s job satisfaction, reduced burnout, enhanced time management, and clarified accountability.
A study by Curtis and Nicholl confirmed that effective nurse delegation provides personal and professional advancement in the organization. (McInnis &
Parsons)

The medical faculty will be able to analyze the students’ capabilities and limitations care in caring for multiple patients and in turn, the students will recognize their ability to respond to complex client health situations and identify patterns of health and illness in the context of the person and the person’s unique situation. (Nowell, 2016)

However, research was conducted on Kansas’ school nurses revealing that school nurses were academically prepared but many lacked clinical sense (Tetuan & Akagi), in turn this can result in poor delegation and create missed or neglect in nursing care delivered such as feeding, toileting and ambulating (Bittner and Gravlin, 2009 and Gravlin and Bittner, 2010). This presses further on how important it is for the registered nurses in authority to be aware of his or her student nurses and nursing assistant’s capabilities and limitations.