Nursing delegation: Leadership guidance and support will help nurses avoid liability

One of my readers asked me about delegating responsibilities in nursing and why it might be such an enormous dilemma for nurses during breaks at work.

It’s natural for a charge nurse to query her job status when her employer requires a 30-minute unpaid lunch. The policy allows a nurse to depart the power for a break, however the nurse must pass on her project to a different nurse. And if the lunch break will not be taken, the nurse have to be penalized. This situation creates a dilemma for nurses because there are sometimes no other nurses on the unit who can take over patient care.

Delegation in nursing has all the time been a responsibility for nurses. And the shortage of licensed nurses or support staff to whom a nurse can delegate makes things very difficult.

These guidelines may help

The American Nurses Association and the National Council of State Boards of Nursing have issued joint position statementNational Guidelines for Nursing Delegation to assist “standardize the nursing delegation process based on research and evidence.” The guidelines discuss nurses’ roles and responsibilities in delegation, resembling:

• Nurses are accountable for understanding what the Nurse Practice Act and implementing regulations of their state say about delegation of authority.
• The registered nurse is accountable for ensuring that every delegated task is accomplished completely and appropriately. This implies that the person delegating is accountable for delegating.
• The Five Laws of Delegation have to be followed.
• Clinical reasoning, nursing judgment, or critical decision-making can’t be delegated.

The responsibilities of the employer/nursing leader include:

• The healthcare facility should develop policies and procedures regarding delegation and delegated responsibilities.
• Nursing leaders who’re accountable for overseeing delegation have to be identified by the employer. The nursing leader identifies which nursing responsibilities might be delegated, to whom, and under what circumstances.

The responsibilities of a licensed nurse include:

• Determining when and what to delegate.
• Contacting the delegate and the patient after completion of delegated activities.
• Providing the delegate with information concerning the patient and his/her care needs.

Who is responsible?

As indicated in the rules, policies and procedures needs to be implemented to assist nursing staff make appropriate decisions regarding delegation of tasks.

The CNO or other nurse leaders in the power where the nurse works should be informed of the alternatives the nurse (and sure other facility staff) faces every day in order that guidance might be provided that’s consistent with established facility policies and procedures.

In addition to informing the CNO or other nursing leaders concerning the difficulty of delegating care to a patient when a professional nurse will not be available, the “penalty factor”—the memo—have to be eliminated. In most cases, nurses will decide to forgo the time-out fairly than expose their patients to the danger of harm from a colleague who will not be competent to offer the care needed throughout the time-out. This is a clever decision from a possible liability perspective, however it will not be helpful in the long run. The risk manager must also be told of the dilemma that nurses face. Because risk management is meant to cut back the danger of economic loss to the power, the danger manager have to be involved in resolving any nursing delegation issues to make sure that the power doesn’t face a lawsuit for negligent delegation and neglect of care. As the rules say, “delegation should be assigned based on the nurse’s judgment regarding the patient’s condition, the competence of the nursing team, and the degree of supervision required by the nurse.” But it takes a team to be sure that that every one obstacles to proper delegation are removed. Make sure you understand your role in delegating care by reading your facility’s policy, national guidelines, your skilled organization’s position paper on delegation, and your state’s nursing practice laws and regulations. Then incorporate those principles into your practice once you delegate tasks to other members of your nursing staff.

Sign up for the next delegation courses:

Nurses have a responsibility to remain current on current issues regarding the regulation of nursing practice, not only in their very own states but in addition across the country, especially as their nursing practice crosses state lines. Because nursing practice is a right granted by the state to guard those in need of nursing care, nurses have a responsibility to their patients to practice in a protected, competent, and responsible manner. This requires that a licensed nurse practice in accordance with the statutes and regulations of their state. This course provides information on nurse practice laws and their impact on nursing practice. The skill and art of delegation to effectively utilize unlicensed assistive personnel (UAP) is a critical nursing competency, yet many nurses still feel uncomfortable with delegation. This learning activity will address the role of delegation in providing high-quality care in a collaborative environment and supply strategies for effective delegation. From taking telephone orders to transferring a patient to a different department, all healthcare professionals face situations every single day that involve potential communication problems. This module discusses the importance of clear, accurate, and timely communication, each verbal and written, in providing protected and effective patient care. It discusses unacceptable medical abbreviations, acronyms, and symbols, communication during handoffs, and timely and accurate reporting of critical test results.