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The Art of Delegating | What Nurses Do

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According to the American Nurses Association and the National Council of State Boards of Nursing, delegation can be defined as the process for a nurse to direct another person to perform nursing tasks and activities. Delegating tasks effectively can improve coworkers’ ability to work together as a team.

by JeanstarMSN JeanstarMSN (New)

Specializes in MedSurg. Has 21 years experience.

Why should Nurses delegate?

The Art of Delegating | What Nurses Do

Any nurse, new or seasoned, can feel overwhelmed at times at work. It can be a challenge to learn the art of delegation. Without it though, a nurse can become fatigued, stressed, and depressed. On the other hand, delegating tasks effectively can improve coworkers’ ability to work together as a team. Not only that, but delegating can improve the response time to patients’ needs, which in turn, improves patient satisfaction. Isn’t that why we’re all doing what we’re doing, to make patients feel cared for and  feel better?

Delegation

Entrusting and empowering someone else to do a part of your job is a learned skill. As a nurse, when you delegate, you are showing your coworker that you have trust and confidence in their abilities. You are giving them a chance to become better at what they do and improve their skills. Delegation, however, has an accountability piece to it that means that you, as the nurse, must follow up and make sure the task was done completely and correctly. Patient safety and patient well-being are the focus here. At the end of the shift, you are responsible for everything that happens with your patients’ nursing care. If you are working with a nursing assistant that is new to working with patients, you have to do more follow up. This can also give you a chance to give that assistant a pat on the back or some supportive direction. We are all a team and must learn to work together for the benefit of the patient.

Plan Ahead

There are many things to consider before the delegation process begins. Here’s a checklist you can use the next time you want to delegate efficiently:

  • Decide what task you want to delegate.
  • Choose who should carry out the task, are they capable, is it in their scope of practice.
  • Decide when the task needs to be done; is the patient ready, is there a deadline like getting a patient bathed before a procedure.
  • Explain how the task needs to be done such as documenting all input and output for a patient, encourage the coworker to ask for help if needed.

In a recent correlational research study1, with a convenience sample of 362 nurses, ambulating and feeding patients on time and doing mouth care were the tasks most missed by nursing care. The reasons behind it were short-staffing, lack of material resources, and communication. These tasks are some of the most basic needs that we can do for our patients. These are also some of the most basic tasks that can be delegated.

Example

You go into work one day, get your assigned patients, and realize the unit is short-staffed that day because a nurse and an aide called out sick. Their replacements won’t be there for another four hours. So for those first four hours, you’re slammed!! Quickly you have to think on your feet! Findings2 revealed a tendency for nurses to delay the decision to delegate but no one nurse can do it all. So you start to think about delegating to your competent coworkers. Make sure they understand what they need to do for the patient and follow up to make sure it gets done. Our patients depend on us at their most vulnerable times to take care of them. It’s not their fault that we are short-staffed. We need to work together as a team and support each other in the process.

Delegating can be often easier said than done. You as the nurse have to uphold the accountability that your patients are receiving quality nursing care on your watch. Ensure that each team member is aware of what the task is that they are being asked to do and what is expected of them. At the same time, be approachable in case the coworker needs help. Help team members understand the level of commitment that you want from them but don’t be a mean nurse. There is nothing worse than working with someone who has no respect for their other team members. Remember, the nursing field is not just a job but its a commitment to our patients. Provide support to your team members and give positive feedback to a job well done.


References

Five Rights of Nursing Delegation

1Missed nursing care and its relationship with confidence in delegation among hospital nurses

2Improving patient care outcomes through better delegation-communication between nurses and assistive personnel

JeanstarMSN has 21 years experience in Med/Surg nursing. I teach nursing part-time.

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6 Comment(s)

In order to delegate, you need someone there to delegate to in the first place!

RNperdiem, RN

Has 14 years experience.

2BS Nurse, I remember in my first job, some of the aides would do a disappearing act. The rest of the aides were easy to delegate to, but a few were on perpetual breakfast, lunch or smoke break.

OUxPhys, BSN, RN

Specializes in Cardiology. Has 4 years experience.

Can't delegate when you don't have someone to delegate to or they end up not doing it correctly or at all. Better off getting it done myself.

Orion81RN

Has 7 years experience.

This is some BS gaslighting stuff right here. During Covid at that? I’m not delving into all the problematic stuff here, so I’ll point out 1 thing. You aren’t short staffed bc someone called off shift. You are short staffed bc your organization designed its workplace to be that way. My commitment to my patients, which is just my job, involves calling out toxic nurse gaslighting so that we can focus on who the real perpetrators of patient neglect are. 

On 9/7/2021 at 8:00 AM, JeanstarMSN said:

You go into work one day, get your assigned patients, and realize the unit is short-staffed that day because a nurse and an aide called out sick.

Unfortunately I would phrase as follows:

You arrive to work again today, get your assigned patients and realize the unit is short-staffed because that is someone's idea of lean and efficient business practice.

So you run around doing your best to make sure patients receive their assessments and medications and tests as well as trying to take care of numerous other side issues.

The employer, while hiding behind the idea that the idea that floor RNs delegate the day to day work, has already told the assistive personnel what tasks they are authorized to do, so the one who is there (the only one scheduled) rushes around trying to prioritize those things on their own.

The End.

I definitely delegate when I have somebody to delegate to.  Unfortunately that’s not often and if there is, they have 11 other nurses trying to delegate to them as well.  In a perfect world we have a few techs, 95% of the time, that’s not the case.