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Comment on new policy "Principles for Delegation"

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NRSKarenRN has 43 years experience as a BSN, RN and specializes in Vents, Telemetry, Home Care, Home infusion.

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[color=#333399]why we need your comments the ana congress on nursing practice and economics is seeking comments on the "ana principles for delegation". the principles note registered nurses (rns) are responsible to the public for providing safe and effective nursing care for patients in a variety of settings across the continuum of health care, including hospitals, long term care facilities, nursing homes, community and public health centers, schools, and ambulatory clinics. rns often delegate tasks to other team members but retain accountability for the outcome of delegation. please use this opportunity to read, review, reflect, react, and respond with your recommendations and comments about this document

complete info:

http://www.nursingworld.org/practice/

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BBFRN has 15 years experience as a BSN, PhD and specializes in Trauma,ER,CCU/OHU/Nsg Ed/Nsg Research.

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A couple concerns (and I am currently a LPN getting ready for RN boards, so maybe some of you here can educate me if I'm off base):

The RN must monitor the patient and evaluate the outcome of the delegated task.

The RN should consider barriers and benefits to delegating a specific task. If the task is technical, and includes daily amenities, there is a benefit to delegating to a UAP, so the RN is then able to complete other professional duties.

Is it feasible to require this of RNs in the midst of a shortage? My RN coworkers don't have the time to come behind me and check my work. Isn't short-staffing a "barrier" to delegating tasks if the RN doesn't have the time to make sure the task was done properly? This sounds like the RN should have to assess and reassess every LPN-covered patient to ensure proper care.

The tasks being delegated by an RN to a UAP must be a function that is of a technical assistive nature or provides amenities to the patient and must not require

critical thinking or professional judgment. The RN holds the UAP responsible for the completion of the task.

Well, this leaves out any kind of nursing care to be done by a LPN. I can't think of any nursing care I've done in the past 8 years in acute care that didn't require critical thinking. I work in a teaching hospital, and it is July, if you get my drift.

The RN is accountable for the delegation decision, the process and the resulting outcomes of nursing care.

This calls to mind that thread about the LPN who was fired when the RN was reprimanded (man was an active GI bleed and found dead after found on the floor 4 hours later. The LPN was fired because this was a patient that was considered stable enough for the LPN to care for. LPN was found at fault by the hospital). If that hospital took this view into account, then the RN would have been fired, and the LPN reprimanded, right- because the RN would've been responsible for the ultimate outcome of care received? Even though the LPN would be responsible for the care received?

It seems that the point here is that a LPN is responsible for his/her actions, but not the outcomes of those actions. That doesn't jibe with me, and I don't think my RN coworkers would be too happy with that view on their level of responsibility when they work with me. Is there something I'm not getting?

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A couple concerns (and I am currently a LPN getting ready for RN boards, so maybe some of you here can educate me if I'm off base):

The RN must monitor the patient and evaluate the outcome of the delegated task.

The RN should consider barriers and benefits to delegating a specific task. If the task is technical, and includes daily amenities, there is a benefit to delegating to a UAP, so the RN is then able to complete other professional duties.

Is it feasible to require this of RNs in the midst of a shortage? My RN coworkers don't have the time to come behind me and check my work. Isn't short-staffing a "barrier" to delegating tasks if the RN doesn't have the time to make sure the task was done properly? This sounds like the RN should have to assess and reassess every LPN-covered patient to ensure proper care.

The tasks being delegated by an RN to a UAP must be a function that is of a technical assistive nature or provides amenities to the patient and must not require

critical thinking or professional judgment. The RN holds the UAP responsible for the completion of the task.

Well, this leaves out any kind of nursing care to be done by a LPN. I can't think of any nursing care I've done in the past 8 years in acute care that didn't require critical thinking. I work in a teaching hospital, and it is July, if you get my drift.

The RN is accountable for the delegation decision, the process and the resulting outcomes of nursing care.

This calls to mind that thread about the LPN who was fired when the RN was reprimanded (man was an active GI bleed and found dead after found on the floor 4 hours later. The LPN was fired because this was a patient that was considered stable enough for the LPN to care for. LPN was found at fault by the hospital). If that hospital took this view into account, then the RN would have been fired, and the LPN reprimanded, right- because the RN would've been responsible for the ultimate outcome of care received? Even though the LPN would be responsible for the care received?

It seems that the point here is that a LPN is responsible for his/her actions, but not the outcomes of those actions. That doesn't jibe with me, and I don't think my RN coworkers would be too happy with that view on their level of responsibility when they work with me. Is there something I'm not getting?

just a student here but i was under the impression that LPN's aren't considered UAPs (unlicensed assitive personel) LPN's have a license and I was told that RN's don't "delegate"(teach/train and check for competency) in the true sense of the word to LPN's because the Lpns are already trained in most nursing skills (those within their scope). (though they do decide on patient assignments etc.. for them) Though the RN would still have ultimate responsibility for the patient, it is a different level of responsibility when dealing with UAPs than with LPNs. This is what i was taught when i was a Health assistant anyway.

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BBFRN has 15 years experience as a BSN, PhD and specializes in Trauma,ER,CCU/OHU/Nsg Ed/Nsg Research.

3,778 Posts; 24,188 Profile Views

Smkoepke- duh, thanks...lol. I should have read their definition of UAP. I am smacking my forehead right now...lol

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