Our professional knowledge
and skills are crucial to securing positive outcomes for each and every patient under our care. And given the complexity of our patients and the fast pace of our work environments, we need to make every minute count.
Yet for some of us, including recent graduates and very experienced nurses, relinquishing certain tasks is difficult. On the other hand, some of us too easily hand off tasks to others, perhaps rationalizing that we’re under pressure to provide more care to more patients in an unrealistic amount of time.
What I’m talking about is delegation, and neither of the above approaches is effective or safe. Knowing what and when to delegate to un-licensed assistive personnel (UAP) is important for many reasons. Missteps in delegation decisions can place patients at risk and jeopardize a nurse’s professional practice.
When delegation is used appropriately, it can make our working lives better by allowing us to focus on higher-level activities, such as taking the time to perform more comprehensive patient assessments and evaluating whether patients or family members truly understand what we’ve taught them about their ongoing care. Appropriate delegation creates a better work experience for the UAP to whom we delegate because they are given tasks they are competent to do and are treated as a valuable part of a well-functioning team. Moreover, appropriate delegation means that patients’ basic and high-level needs are being met in an effective and timely manner.
Delegation is a skill that comes more naturally to some people than others. But the good thing is that it can be learned and strengthened. The American Nurses Association (ANA) has some tools and resources that can help you learn more about this professional responsibility. One ANA resource is the recently revised Principles for Delegation by Registered Nurses to Unlicensed Assistive Personnel (UAP), which provides guidance and strategies, including a delegation tree, to RNs who work in all types of settings. It further addresses the accountability and responsibility that RNs have in delegating appropriately, such as knowing first and foremost what their state nurse practice act says about delegation, as well as their workplace policies and procedures. It also points to the responsibilities that employers have, including ensuring that UAP are trained in and maintain defined competencies so RNs feel confident in delegating select tasks to them.
Principles for Delegation also calls on nurse educators and professional development staff to ensure that nursing students and practicing RNs understand delegation, have opportunities to practice it, and have mentors who can help them improve this skill. Professional development staff also can periodically review the state practice act with nursing staff so they are aware of their precise delegation ability. To view the ANA Principles document, go to www.nursingworld.org/principles.
To provide nurses with more guidance, ANA is offering a webinar on March 20 called “Navigating the Complex World of Delegation,” featuring Shirley McCoy and Melanie Duffy, nurse experts who co-chaired the ANA workgroup that revised the document. ANA also offers a series of webinars on leadership, which can further help nurses strengthen their delegation, communication, and team-building skills. To see our “Navigate Nursing” offerings, go to www.navigatenursing.org.
Working in health care will continue to be filled with both opportunities and challenges. As nurses, we must do what we can to prepare ourselves and help our colleagues feel comfortable and competent to effectively delegate to other members of the healthcare team. We can’t do it alone.
Karen A. Daley, PhD, RN, FAAN
President, American Nurses Association