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Discussion

I need help with delegation

Above is a list i put together to help me understand what an RN, an LPN/LVN, and a UAP/CNA can do.

I've been pretty good with delegation so far.

Now I'm starting to see different kinds of RNs and LPNs and it's throwing me off.

I know that RNs floating from another unit are treated like LPNs. And I know that if gender is specified, that means there is a patient who has gender preferences.

But how do I, as the charge nurse, go about delegating tasks to:

  • experienced RNs
  • experienced LPNs
  • experienced nursing assistants
  • nursing students
  • and an LPN/LVN who is fuctioning under the supervision of an RN

What is within their scopes of practice?

Featured Replies

Delegation is tricky because it requires you, the charge nurse, to be able to safely and accurately assess the staff member that a patient is delegated to. When answering questions on a test, it's a bit more tricky because your information is limited. Attempt to isolate what the question is really asking- i.e. what is the task being delegated. Once you know that, you can proceed with determining who gets the job. Anything that has a patient that might crash or have an abrupt change in condition needs the RN. If the patient requires monitoring or a focused assessment requires at least an experienced LPN, float or new RN. If the patient has expected outcomes an LPN or new/float RN is ok as well. If there is a simple procedure that doesnt involve assessment, a CNA or UAP is ok. If the patient is immediate post op, RN... If >24hr postop, new RN or float OK.

If its NCLEX that's asking ignore the "experienced" if it's RN vs LVN, the RN gets it if its complicated or can crash.

Posting from my phone, ease forgive my fat thumbs! :)

  • Author

Anything that has a patient that might crash or have an abrupt change in condition needs the RN.

If the patient requires monitoring or a focused assessment requires at least an experienced LPN, float or new RN.

If the patient has expected outcomes an LPN or new/float RN is ok as well.

If there is a simple procedure that doesnt involve assessment, a CNA or UAP is ok.

If the patient is immediate post op, RN...

If >24hr postop, new RN or float OK.

one of the best explanation all day! thank youuu!!!!! :)

oh question, when the patient might have an "abrupt change in condition," knowing this change might happen is an EXPECTED outcome, but if you didn't see it coming then that's an UNEXPECTED outcome. right?

one of the best explanation all day! thank youuu!!!!! :)

oh question, when the patient might have an "abrupt change in condition," knowing this change might happen is an EXPECTED outcome, but if you didn't see it coming then that's an UNEXPECTED outcome. right?

If they are going to have an abrupt change its am unstable pt. look at it that way instead, much easier

Posting from my phone, ease forgive my fat thumbs! :)

  • Author
If they are going to have an abrupt change its am unstable pt. look at it that way instead, much easier

Posting from my phone, ease forgive my fat thumbs! :)

okay. thank you :D

  • Author

What can nursing students​ do?

What can nursing students​ do?

Depends, you working there, at clinical or volunteering? All have different tasks

Posting from my phone, ease forgive my fat thumbs! :)

  • Author
Depends, you working there, at clinical or volunteering? All have different tasks

Posting from my phone, ease forgive my fat thumbs! :)

Sorry, i mean nursing students in the NCLEX world. what can they do?

Depends, you working there, at clinical or volunteering? All have different tasks

Posting from my phone, ease forgive my fat thumbs! :)

NCLEX never asked me about students, only LVNs and CNAs (UAP)

Posting from my phone, ease forgive my fat thumbs! :)

Just FYI reading through other responses and they're spot on to what I would have said! Never been asked about a nursing student on NCLEX and never heard anyone else having a similar question. Even if your knowledge tells you to expect an abrupt change (i.e. CHF exacerbation or sudden tamponade) as the previous poster stated, it's an unstable patient and that would go to an RN.

Sorry, i mean nursing students in the NCLEX world. what can they do?

I don't recall ever seeing a nursing student mentioned (in terms of delegating tasks) on any NCLEX type questions, nor on my NCLEX test.

If it were to come up I'd have to go with they would be treated as an UAP. They are neither an LPN nor RN.

(scratch that, they could be an LPN in an LPN to RN program, but it would still stand as a UAP in the circumstance of being a nursing student. I am an LPN but while I am at my RN clinicals I am looked at as just a nursing student. I am not allowed to do any of the things I can as an LPN..ie: I still need to have an instructor present when administering meds etc, but when I am out of the student setting, I can legally pass meds at my job as a staff nurse at a LTC)

Pixie I think you're spot on- I'd treat a nursing student as a UAP because they haven't yet been assessed in their knowledge to enter basic practice. Great post!

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