How to Delegate
Only an R.N. can delegate. To delegate is to entrust or transfer the power, authority, or responsibility to perform a task to someone else. In nursing, it is usually “per occurrence” and should be limited to care of patients who are stable or who have a predictable outcome. You should never delegate care for an unstable patient.
In delegating care, it is essential for the R.N. to understand the scope of practice and/or job description of those to whom she is delegating. She must also have an understanding of the level of skills of the person to whom she has delegated a responsibility. The R.N. retains responsibility for any task that he delegates.
No one is expected to do it all. In fact, if you find yourself doing things that could or should be done by someone else then you are wasting time and resources. However, if the other person is busy and the job needs to be done, then anyone available who can do the job should be helping out.
Delegation is an art that will take some time to learn. To some, it comes more naturally than to others. But for an R.N., it is an essential part of the job. In addition to specific tasks, you may need help in aspects of a patient's care including assessment, identifying problems and goals, planning and implementing a strategy for the patient's care, maintaining safety, dealing with emergencies, and evaluating the effectiveness of the care. These responsibilities would not be delegated away, but rather you would be looking for input from other staff in making decisions and implementing patient care.
Understanding the scope of practice or job description and skills of those to whom you delegate is essential to the quality of patient care. You don't want to put anyone at risk. That includes you, your coworker, the patient, your supervisor, and the facility, among others.
In the performance of your assignment, you may find tasks that you need assistance with; for example, an IV medication has not been dispensed from the pharmacy. You could ask the unit secretary to call and check on it for you and to pick it up if necessary. If one of your patients needs some assistance in eating and you have a dressing to change and an IV to start, you could ask an aide or tech to help feed the patient. You could ask the LVN to dispense a PRN medication if you need to attend to a task and the patient is in need of the med right now.
Remember, nonlicensed persons such as nursing aides, UAPs, and techs will not have a scope of practice as defined by law. Instead they will function under a job description as written by the facility. Ask for a copy of each and know what they can and cannot do before delegating.
These are ways to begin to learn how to delegate. Start with small, uncomplicated tasks that you could certainly do yourself. If delegating these kinds of tasks frees you up to complete a larger, more difficult task and don't overburden someone else, then they can easily be delegated away. As you become more comfortable with delegating, when you have a more complicated task that you need to pass on in order to admit a new patient, then you can begin to delegate more. Always say thank you and whenever possible do something to return the favor.
