Delegation

Concept: Delegation

Case Study

You are working the night shift on a medical unit and have been assigned charge nurse responsibilities. You are working with four RNs, one LPN, and two UAPs. A client becomes pulseless and is not breathing, and the nurse assigned to the client’s care calls a code. The nurse is occupied at this client’s bedside for 1.5 hours until the resuscitation effort is completed, and the client is transferred to the intensive care unit. This nurse also has four other assigned clients. In addition to the nurse assigned to care for the client requiring resuscitation, two of the other nurses working on your unit are assisting in the code.
Review the case study and write an essay (suggested length of 2–3 pages, excluding title page and reference page) in which you do the following:

Discuss what tasks could you delegate to the UAPs?
The LPN working on the unit is a new graduate and has been employed for only 4 weeks. How would you collaborate with this nurse when delegating tasks for completion?
Discuss how you will maintain the safety of the other clients on your unit while three nurses are occupied with the client requiring resuscitation?
Explain how might effective delegation to other team members contribute to care of the clients on the unit? (Remember, this is not a question about the patient that is coded, but how you will handle the unit while you are short staffed).

ANSWER

Delegation

According to the American Nurses Association, Delegation is the process of a nurse directing another person to perform nursing tasks and activities. Delegation involves at least two individuals. The delegator is the registered nurse who distributes a portion of patient care to the delegate, who, on most occasions, is a UAP or LNP. As a registered nurse in this situation, I would delegate routine tasks such as supervising patient ambulation, assisting the patients to get cleaned up and feeding the patients (Barrow & Sharma, 2020). This will help ease the work for the nurses in the unit and help the other nurses to concentrate on the more urgent cases like the coded patient.

The LPN can help out in more serious cases, such as monitoring patients’ blood pressure and performing routine tasks with predictable outcomes. LPNs are within the range of practice where they can help the RN with tasks such as collecting data and monitoring client findings. In the scenario above, I could use the LPN as the supervisor for the UAPs and ensure that the tasks delegated to the UAPs are performed flawlessly. LPNs can also delegate some tasks to the UAPs. The tasks that were supposed to be carried out by the three nurses can also be done by the LPN. The LPN is allowed to delegate tasks to the UAPs, and, therefore, I would leave the ward to the LPN and let the tasks be delegated accordingly.

Patient safety is an integral part of the nursing practice. It is therefore essential that the tasks delegated to the LPN and the UAPs are tasks that they can easily carry out. Tasks such as injecting patients intravenous medication should not be delegated to the LPN and UAPs. Improper delegation could land the UAPs and the LPNs in trouble with the law and could also expose the patients to danger. Delegation is challenging and could lead to legal consequences, but when the RN is faced with a situation where they are short-staffed, the RN needs to make prompt decisions on delegating duties to ensure all the patients are getting the required care (Yoon et al., 2016). Delegation does not mean that the RN does not supervise the work of the UAPs and the LPNs. To ensure the safety of the patients, the RN can closely inspect the work being done by the delegators and make sure the proper care is being provided.

Effective delegation works well in healthcare because it helps the patients and the nurses. Effective delegation ensures all patients are getting the proper care and the nurses are not overworked. It also helps in situations where the health facility is understaffed and the registered nurses are occupied with other urgent tasks (Campbell et al., 2020). In the case study, effective delegation ensures that the patient is resuscitated and taken to the ICU, and while the nurses were helping in the resuscitation, their tasks were handled effectively by the UAPs and LPNs. Delegation helps the team members and builds teamwork within the ward as the nurses know they are covered and that some tasks that do not require much medical attention, such as feeding the clients, are covered. The clients are also safe because any time they need attention, there will be someone available to cater for their needs, and in case there is a code red; the nurses will react promptly because there is someone available. Delegation is also likely to reduce the number of hospital injuries because the patients always have someone with them.

References

Barrow, J. M., & Sharma, S. (2020). Five Rights of Nursing Delegation. In StatPearls [Internet]. StatPearls Publishing.

Campbell, A. R., Layne, D., Scott, E., & Wei, H. (2020). Interventions to promote teamwork, delegation and communication among registered nurses and nursing assistants: An integrative review. Journal of Nursing Management, 28(7), 1465-1472.

Yoon, J., Kim, M., & Shin, J. (2016). Confidence in delegation and leadership of registered nurses in long‐term‐care hospitals. Journal of Nursing Management, 24(5), 676-685.