Deciding on a course of treatment for their patients
Nursing News January 15, 2019

By Sarah Stasik

Delegation in Nursing: 4 Ways To Perfect Delegation in Nursing

The importance of delegation in nursing can't be denied. A single RN can't do everything for every patient, and when emergencies arise, you can't split yourself to attend to two issues at one time. 

Delegation in nursing is a way nurses at all levels can be good stewards of the healthcare resources available, but you do have to follow some best practices to ensure sharing out the workload is fair and appropriate in each situation. 

Check out the four tips for perfecting delegation skills as an RN. 

4 Tips for Delegation in Nursing 

The American Nursing Association calls delegation a complex process that requires accountability and clinical judgment to ensure appropriate patient care.  

Examples of delegation in nursing go beyond asking someone to grab a specific supply for you, though even that isn't as simple a request as it might seem.  

In fact, the importance of delegation in nursing is so high (and the topic so complex), it's even addressed on the NCLEX-RN licensing exam. 

Here are four tips for ensuring delegation in nursing works for you and the patient.

1. Delegate according to jurisdiction law 

The National Council of State Boards of Nursing has published guidelines for delegation in nursing but also encourages nurses at all levels to understand the law in their state.  

Depending on where you work, you may not be able to delegate certain tasks to other nurses or clinical staff that doesn't have credentials equal to yours, for example. This is especially true when RNs delegate to LPNs or CNAs. 

2. Be fair when delegating 

Shantay Carter, the founder of Women of Integrity, says that nurses should strive to be fair in delegation. That doesn't always mean workloads are perfectly equalized in the moment, but obviously RNs in leadership roles should never pick on a specific person or assign one person all the least desirable tasks. 

In fact, says Carter, you should only delegate the tasks that you can't actually perform and avoid sharing out work simply because it's unpleasant to you.

3. Opt for delegation in nursing before you become overwhelmed 

Carol Huston, MSN, DPA, FAAN, notes in writing for Nursing 2018 that RNs should try to foresee the need for delegation ahead of time rather than dole out tasks once they're overwhelmed. Delegation in nursing when you're overwhelmed increases the chances for mistakes, and it can also create resentment among coworkers. 

Huston uses the example of bed baths — if you delegate all those at the end of your shift because a crisis came up earlier and you couldn't get to them, your coworker may not be pleased. Instead, try to delegate tasks throughout the shift as soon as you see you won't be able to get to all of them. 

4. Follow the five rights of delegation 

The NCSBN lays out four rights that nurses should follow when delegating:

  • Right circumstance. Don't delegate when the patient is not stable.
  • Right person. Ensure the person has the right skills and training to handle the task.
  • Right direction and communication. Provide instruction and ensure the person understands them.
  • Right supervision and evaluation. As the licensed nurse, you're responsible for ensuring the outcome of any work delegated to support staff.

Ultimately, delegation in nursing is an important way to ensure healthcare resources are used appropriately. 

Whether you're the RN sharing tasks or a float nurse picking up the slack, working through the delegation process is critical to being part of a strong team.

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