DO any of you have any advice on how to study appropriate delegation? I have never had any practice at this, and I have not heard anything about it in school other than that it is the RN's legal responsibility to know to whom s/he can delegate. I have no clue how/what to do! Any study tips?
Thanks in advance!
Dec 14, '03
Your best bet is to start with your state's nurse practice act. It should delineate what can and can't be delegated, when it is appropriate (or not) to delegate, etc. Then do a literature search for articles dealing with delegation. Should give you lots of info to look at and learn from.
Dec 14, '03
There is a section of your states nurse practice act that states what tasks are able to be delegated, should be online, or you can call your state BON. We discussed this a lot in one of our classes in school as well and so we had a lot of paperwork on it. My suggestion would be to get a hold of your nurse practice act, review it, and use common sense. If it seems like you shouldn't delegate it, you probably shouldn't. Assessment is solely the RNs responsibility (seems like that came up a lot...).
Dec 21, '03
This was a difficult area for me to study during NCLEX review because I was an LPN first, and I know what I used to do compared to what "they say" you can do. I learned most of my delegation questions from Kaplan. Here are some tips that I remember from them:
The RN CANNOT delegate patient teaching or assessment to the LPN. What you are assigning to the LPN must have a predictable outcome. An example of this is not allowing the LPN to do discharge teaching, and another example is this:
Mr. Jones has an order to walk 100 feet down the hall. You may assign the LPN to walk Mr. Jones, but you must be specific in this. You cannot say "walk him down the hall and let me know how he does". You have to say "walk him down the hall, and if he gets short of breath or dizzy, sit him down on the floor and notify me"
You wouldnt assign the LPN to change a fresh post-op dressing because you the RN need to assess the wound. If the patient is 5 days post op, you probably can unless they give you some kind of hint that the wound needs to be assessed.
You can delegate medication administration to the LPN. I dont believe they will ask you anything about IV push or IV medications at all during this part, because that varies from state to state, and they cant ask something that isnt clearly definable. Ditto for blood administration, although the LPN is allowed to moniter the patient throughout blood administration such as taking vital signs and reporting any potential adverse reactions. If the scenerio gives you a heads up that this patient will have/is having complications during the blood administration, than I wouldnt delegate this. I wouldnt assign the LPN to take a telephone order (although in real life they do, I dont think in the nclex world they are allowed to). I wouldnt assign the LPN to hang chemo.
You usually wouldnt delegate simple patient care tasks to the LPN because thier rationale is that you can delegate that to a CNA. The only time I would choose an answer like this is when the other choices seem way too risky for you to delegate.
If I think of any more I will post. I hope this helps!
Dec 22, '03
Thank you! I don't have any way to study this for NCLEX. I will be practicing in Texas, and thier nurse practice act asks a series of questions to determine whether or not an RN can delegate, so it's not really specific. I think I understand what I can do in the real world, but NCLEX world is something else! I think I might just try a Kaplan book to see how I like it. Thanks!
Dec 26, '03
If your studying for the nclex....Kaplan RN study book had a whole section on how to determine if a certain thing can be delegated. I used it for when i took the nclex in june and it helped me. Good Luck
Dec 31, '03
I also practice in Texas, but that has nothing to do with NCLEX as the test is not state-specific. BTW: you do not delegate to licensed personnel (LVN). The RN may assign duties to licensed personnel but will delegate to unlicensed. Watch out for that subtle difference. LVN's may "evaluate" but not "assess".
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