When to delegate vital signs?

VANurse2010 · Feb 15, 2016

Think about your rules of delegation. What types of patient are most appropriate for a UAP to do vitals?

vintagemother, BSN, CNA, LVN, RN · Feb 15, 2016

Our school really emphasizes teaching us how to delegate. For a stable pt you can delegate VS as long as you are sure the UAP accepts and is competent to measure them.

On a non stable pt, new admit, or for med parameters to give meds, you probably want to take them yourself.

That is in the NCLEX world. As a former UAP and a current nurse, I don't think this is how delegation always occurs IRL, though.

TheCommuter, BSN, RN · Feb 15, 2016

Think about your rules of delegation. What types of patient are most appropriate for a UAP to do vitals?

Yes, it is time to utilize critical thinking. Would a prudent nurse delegate the task of vital sign checks to a hemodynamically unstable patient?

Kuriin, BSN, RN · Feb 15, 2016

Our school really emphasizes teaching us how to delegate. For a stable pt you can delegate VS as long as you are sure the UAP accepts and is competent to measure them.
On a non stable pt, new admit, or for med parameters to give meds, you probably want to take them yourself.
That is in the NCLEX world. As a former UAP and a current nurse, I don't think this is how delegation always occurs IRL, though.

Ding, ding, ding. :-p

DiscGolfNurse, BSN · Feb 18, 2016

For NCLEX world purposes, delegating vitals fora stable patient is okay. In the real world, or at least at my hospital, RNs do the first set of vitals along with their assessment so the nurse has a baseline of the patients condition.

Kuriin, BSN, RN · Feb 19, 2016

For NCLEX world purposes, delegating vitals fora stable patient is okay. In the real world, or at least at my hospital, RNs do the first set of vitals along with their assessment so the nurse has a baseline of the patients condition.

It's the same for both real world and NCLEX world. You do not delegate the first set of vital signs. After that, you delegate to stable and unchanging procedures.

Lev, MSN, RN, NP · Feb 21, 2016

You can delegate vitals signs whenever you want. You are the nurse. However, you have to know who you can trust to inform you if something is abnormal. For NCLEX purposes, the first set of vitals signs done on the shift or when a patient arrives to the unit is considered a nursing assessment and cannot be delegated to an LPN or UAP.

In the real world, delegation depends on your level of comfort with who you are delegating to and the stability of the patient. In the ER, I do 95% of my vital signs myself, but I will delegate them to the tech for a stable patient. In med surg, I depend on the tech's vital signs, but if something is abnormal, I may do the repeat set myself or give very specific instructions to the tech as to when I want the vital signs rechecked and to come to me right after they are taken.

mikayyCNA_ · Feb 21, 2016

This is such an interesting thread for me as a current PCT. I'm still in my first month of PN school so we haven't learned a whole lot about delegation. Anyway, I work on a behavioral health unit and even admission vital signs are taken by us techs. I've recently gotten to float to a med surg floor and the nurses like to take retakes themselves. However, I still believe they have their techs take admission vitals as well? Is this a no no?

Lev, MSN, RN, NP · Feb 21, 2016

It is not a no no in the real world, but on NCLEX it is.

mindofmidwifery, ADN · Feb 21, 2016

This is such an interesting thread for me as a current PCT. I'm still in my first month of PN school so we haven't learned a whole lot about delegation. Anyway, I work on a behavioral health unit and even admission vital signs are taken by us techs. I've recently gotten to float to a med surg floor and the nurses like to take retakes themselves. However, I still believe they have their techs take admission vitals as well? Is this a no no?

I work in the ER as a PCT and I often do triage vitals, initial vitals when patients are roomed, vitals in between, and discharge vitals. Not sure if delegation rules are different in different units or if the nurses really trust me, haha

Lev, MSN, RN, NP · Feb 21, 2016

I work in the ER as a PCT and I often do triage vitals, initial vitals when patients are roomed, vitals in between, and discharge vitals. Not sure if delegation rules are different in different units or if the nurses really trust me, haha

In NCLEX, the first sets of vitals would have to be done by an RN.

Our techs also do vitals when a patient is first triaged but when a patient comes back to a room we often repeat them. BPs and HRs tend to be lower than the initial triage set. I never fully trust a high triage BP.