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A professional nurse must possess delegation skills. Delegation refers to the transfer of accountability and responsibility for performing a nursing assignment or the activity from a nurse to another individual who does not possess that authority (Finkelman, 2012). Despite the complexity involved in the acquisition of the skill of delegation, it is crucial in the role of a trained nurse. Registered nurses often work in teams; thus, they need to master the skill of delegation of some their duties (CCN, 2016). This paper will examine how nurses can perform delegation without violating the law and will provide an example that will examine some challenges associated with this process.
Health care professionals must possess adequate knowledge on legal matters that affect their practice. A clear distinction of legal terms such as malpractice, negligence, and delegation among others is equally essential (Finkelman, 2012). A licensed nurse serves as a team leader and she has the power to delegate tasks to a nurse assistant if this nurse feels that the assistant has the capacity and ability to perform the assigned task. The Nursing Practice Act differs from one state to another and sets the rules that determine appropriate delegation. Before assigning and delegating a task to a nursing assistant, the following criteria must be followed: right task, person, circumstances, direction, and suervision (Cipriano, 2010). In as much as nurses strive to give appropriate delegations, there are several barriers to the process. The quality of care, legal, experience, and licensure issues often hinder appropriate delegation.
Inappropriate delegation often results in legal issues as was noted in the case of Hicks vs. New York State of Department of Health. Hicks was a licensed practical nurse (LPN) in Daughters of Sarah Nursing home situated in Albany. The duties of the LPN included doing walking rounds to ensure the residents of the nursing home were in good condition and supervising other nursing assistants during her shift. On one occasion, the security officer on duty found an aged patient lying with half the body in bed and the other in an overturned wheelchair. Additionally, the client was in a very dark room, undressed, and covered in urine and dried stool (Weiss & Tappen, 2014). Subsequent investigations revealed that the nurse had acted in a negligent manner. Based on the state’s legislation, the Unlicensed Assistive Personnel (UAP) working under Hicks was not accountable for the negligence but the LPN herself was held responsible.
Licensed and registered nurses are always responsible for delegated tasks and their outcomes. In the given case, the rules governing nursing practice in the jurisdiction did not govern the role of UAP’s. In addittion, the licensed nurse was supposed to perform the duty assigned by the registered nurse (RN) and not further delegate it to a UAP (Cipriano, 2010). This scenario of an inappropriate delegation had led to the injury of the client, hence an adverse clinical outcome. Within a licensed nurse’s scope of practice, Hicks was supposed to supervise the assistant involved in delivering the direct patient care during her shift (Weiss & Tappen, 2014). Therefore, the action was in violation of the fundamental principles of delegation, including responsibility and accountability. Consequently, the delivery of appropriate care was hampered.
The law permits the delegation of nursing tasks to assistants. However, the delegation needs to be performed based on the capability of an individual. Registered nurses (RN) must ensure that the nursing assistants, to whom they delegate duties, have undergone adequate training and they are competent to accomplish the tasks. Additionally, it is compulsory for the RN to supervise the delegated operation to realize practical outcomes. All health care professionals must take it upon themselves to become well-versed with the elements of negligence that constitute ethical and legal issues in their practice. In conclusion, registered nurses should use their authority to delegate tasks appropriately, bearing in mind that they are accountable for the outcomes of the provided care.
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