Delegation

Delegation Order Description Welcome to Discussion 5. discussion focuses on the concept of delegation. Delegation can be a difficult for some nurses due to a variety of factors. Remember when you delegate, you as the delegator retain accountability, which means you must trust in the ability and competence of the delegate. Remember you cannot delegate the nursing process, so in other words you cannot delegate assessment, analysis of the assessment, establishing a nursing diagnosis, creating a plan of care or evaluation of effectiveness. Another important piece to always remember for delegation is to provide the appropriate level of supervision whenever you delegate. This is going to depend on the task being delegated as well as who you are delegating to. Finally, evaluation is always a critical component to delegation. You are the accountable individual who must evaluate the performance of the delegate as well as evaluate whether or not the desired outcome was achieved. For our discussion this week, I want you to consider the following situation: Mandy is a staff RN on a medical-surgical unit of an acute care hospital. She just finished report from the previous shift. Mandy looks over her assignments for the shift, she sees that the nurse manager has scheduled an LPN to float over from the postpartum unit. Mandy is assigned to supervise the LPN and orient her to the unit. Mandy also has a nursing assistant, with whom she has worked closely for a year, assigned to work with them. Mandy reviews their assignment load and discovers they have seven patients. Three patients are receiving intravenous antibiotics and need lab results monitored. A newly diagnosed diabetic patient will be discharged tomorrow and needs continued patient education about diabetes management. Two postoperative patients need dressing changes and assistance with ambulating. A patient who is post–cerebrovascular accident (CVA) with stable vital signs was just transferred from the medical intensive care unit. He needs a nursing assessment and a care plan. The routine activities of patient assessments, updating care plans, taking vital signs, assisting with each patient's personal hygiene, giving scheduled and PRN medications, passing meal trays, stocking supply carts, and answering call lights must also be accomplished. In addition to all of these tasks, Mandy knows that she will have to spend time orienting the LPN to the unit. How should Mandy proceed? What are the essential aspects to orient the LPN to? What are the five “rights” of delegation for Mandy to consider? What should be delegated to the LPN and why? What should be delegated to the nursing assistant and why? What are specific activities that must not be delegate and why? What are the benefits to delegation? What are the risks to delegation?