When Should a Nurse Delegate?
Depending on the role of the nurse (NP, RN, LPN), nurses can delegate tasks to the appropriate level depending on their scope of practice. A nurse can essentially delegate any time when help is needed; however, they may only do so if the task is appropriate for their skill level.
Delegating Up and Down
A nurse can delegate to a higher or lower scope. An example of delegating to a higher scope might include an RN asking an NP for a diagnosis so the RN can provide care instructions. An RN might also ask an NP to diagnose for the purposes of treatment. For example, if a patient arrives at urgent care complaining of a sore throat, and the RN assesses and feels the patient may have strep throat, he or she may ask the NP to examine and diagnose so the patient can be treated.
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Another example of a nurse delegating to a higher scope is if a charge nurse encounters problems with a coworker that is not resolved by speaking to him or her. The charge nurse may escalate the issue and ask the nurse manager to intervene.
Nurses may also delegate tasks to those with a more narrow scope of practice. For example, an RN might delegate PO med passes to the LPN. An LPN may delegate tasks such as ambulating or feeding a patient to the CNA.
The question of when a nurse should delegate is dependent on many factors. Usually, nurses delegate when they need help to prevent patient care delays. For example, an RN might be tied up with admitting a patient and ask the LPN to pass PO meds for him or her. In the example above involving a charge nurse and problematic coworker, the nurse delegated when action was needed that fell out of his or her scope of practice.
Delegation Tips For Nurses
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Other Instances Where Delegation Might Be Necessary
Another example of when a nurse can delegate is if a task conflicts with personal beliefs or other personal issues. For example, a nurse who strongly opposes birth control may delegate the task of birth control counseling to someone else. A nurse who may be asked to care for a patient in comfort care may ask to switch assignments if he or she has experienced a recent loss.
When delegating tasks, it's important that nurses are familiar with the scope of practice laws in their state. Asking someone to perform a task, or agreeing to do a task that is outside one's scope of practice can lead to discipline by the appropriate board of nursing and possibly by the employer. However, nurses inherently want to help, both patients as well as each other. Therefore, appropriate delegation benefits both nurses and patients.
Delegation Tips For Nurses
- Know your team: Understand the strengths, skills, and limitations of each member of your healthcare team. This knowledge will help you delegate tasks more effectively by assigning them to the most appropriate team member.
- Prioritize tasks: Identify which tasks require immediate attention and which ones can be delegated to other team members. Prioritize tasks based on patient needs, urgency, and the skill level of available staff.
- Communicate clearly: When delegating tasks, clearly communicate your expectations, including the specific details of the task, desired outcomes, and any relevant patient information. Encourage open communication and be available to answer questions or provide clarification as needed.
- Provide adequate training: Ensure that the team member you are delegating tasks to has the necessary knowledge and skills to perform the task safely and effectively. Offer training and support as needed, and be willing to provide guidance and feedback along the way.
- Foster teamwork: Promote a collaborative and supportive work environment where team members feel comfortable asking for help and offering assistance to each other. Encourage mutual respect and appreciation for each other’s contributions to patient care.
- Delegate authority, not just tasks: Empower team members to make decisions within their scope of practice and authority. Trust their judgment and encourage autonomy, while still providing oversight and guidance as needed.
- Follow up: After delegating tasks, follow up with team members to ensure that they understand the task and are able to complete it effectively. Provide feedback on their performance and address any concerns or issues that arise.
- Be flexible: Recognize that delegation is not a one-size-fits-all approach and be willing to adapt your delegation style based on the needs of the situation and the capabilities of your team members.
- Lead by example: Demonstrate effective delegation skills by being willing to delegate tasks yourself and by showing appreciation for the contributions of your team members. Lead with integrity, professionalism, and a commitment to quality patient care.
