delegation questions

Tweety, BSN, RN · Nov 30, 2007

Welcoem to Allnurses. Since you are asking a specific question, I will move to the general nurses forum.

classicdame, MSN, EdD · Nov 30, 2007

I submitted an article on this yesterday, but I guess it has not been reviewed yet. Basically, you cannot delegate anything for which the unlicensed person cannot do by law. You cannot delegate away your own authority, which means you are still responsible for supervising (in my state the RN is responsible). Go online to your nurse practice act and search for delegation. No one can delegate to you anything outside your scope of practice. The patient's welfare is the utmost concern, so the person to whom you delegate must be competent to do the task, regardless of how long they have worked in that job. Nursing students and nursing externs are unlicensed and should have no more responsibility than the CNA (at least that is what my NPA says). Better check your NPA.

mleach11 · Nov 30, 2007

Thanks for the response, but i was actually looking for someone to present a few questions (make some up) that i could put in my quiz for presentation. I have 7 but need a few more...

anonymurse · Dec 1, 2007

Like classicdame said, the rules differ from state to state. That's why you're not getting any replies. But you don't need 'em. Just read your state's NPA.

mleach11 · Dec 1, 2007

Well upon reading my states NPA, it to me just really says that for the most part, stay within your scope of practice (nothing specific as to the guidelines), and that if your are trained and your facility allows it you can do it...Is there a place that actually lists what you can and cannot do, like specifics for IV administration and what we can and cannot hang?

anonymurse · Dec 1, 2007

There are 2 ways to look at this. In my state, there's a set of CNA skills set down in painful detail in a study manual. This is an implementation of law, not the law itself. You would want to search for such resources starting at your BoN's site. Clearly, I'm not going to delegate anything that isn't on that list to a generic CNA. However our hospital certifies some CNAs to have additional skills, like doing 12-leads, and we can use them for such things. Your hospital might certify certain LPNs to do IV pushes. Now those are tasks we're speaking of. There are also general differences we see in the NPA. For instance, only RNs can delegate in my state. That means we can't tell an LPN to delegate to a CNA, and we can't tell a CNA to swap assignments or tasks off with another CNA. In other words, we can't delegate delegation to anyone but another RN. You should also examine assessment and care planning, which require critical thinking. Look very closely at the subtle differences in the sweeping generalities covering RN, LPN and CNA duties in your NPA and you will be able to figure out most of the differences and generate questions off those principles.