Delegation in nursing is defined as to entrust or to assign to another person a responsibility for a task. As you can see, a key part of the definition is contained in the word "entrust." For delegation to occur, trust must be present. The trust that the RN has in the other staff member will determine what and how much he or she is willing to delegate. Those who delegate must also have trust in their own decision-making ability.
Delegation is a legal and management concept, an art and a skill, and a decision-making process. It is never absolute as the delegator retains final accountability for the decision-making process and the results.
The RN has significant responsibility as a supervisor of delegated or assigned activities. Each person involved in this process is accountable for his or her own actions or inaction and is potentially liable if competent and safe care is not provided. Certainly, the educational preparation and demonstrated ability of the person who will perform the designated act must be evaluated by the RN making the decision to delegate tasks to others. Inappropriate delegation may be specifically stated as grounds for disciplinary action by your Board of Nursing.
The decision to delegate essentially involves the use of the nursing process, i.e., appropriate assessment of the circumstances (staff available and patient acuity), planning, implementation, and evaluation by the delegator. It is up to the RN to make a professional judgment based upon the information available to him/her in each specific situation.
General guidelines for delegation in nursing include the following:
- Delegation of acts beyond those taught in the basic educational program for the LPN should be based upon a conscious decision of the RN. It should not be automatic nor should it be based solely on length of experience. It cannot be assumed that because someone has been a nurse for X number of years that he or she is competent in a task.
- Records of any educational activities, inservices, nursing classes that were taken, etc. which provide additional information beyond entry level capability must be maintained by the employer and the employee. Records should contain an outline of the educational content and documentation which indicates that the staff member achieved the educational objectives and demonstrated the desired skills.
- Practice must be limited to those activities addressed in the written policies and procedures of the agency. It is important for the employer to have in its job descriptions and policies functions that the LPN or unlicensed person will be expected to perform.
If you have any questions or concerns about what to delegate, your Board of Nursing is an excellent resource. Don’t hesitate to contact the Board in your state for additional information or with questions. It is always better to ask earlier about delegation in nursing than find out later that the way you handled a situation wasn’t appropriate!