Essentials of Nursing Leadership and Management, 5th Edition

128 unit 2 | Working Within the Organization

Conclusion

The concept of delegation is not new. The delega-
tion role is essential to the RN-LPN and RN-UAP
relationship. Personal organizational skills are a
prerequisite to delegation. Before the nurse can
delegate tasks to others, he or she needs to under-
stand individual client needs. Using worksheets
and Maslow’s hierarchy helps the nurse understand
these individual client needs, set priorities, and
identify which tasks can be delegated to others.
Using the Delegation Decision-Making Grid helps
the nurse delegate safely and appropriately.
It is also important the nurse be aware of the
capabilities of each staff member, the tasks that may
be delegated, and the tasks that the RN needs to per-
form. When delegating, the RN uses professional

judgment in making decisions. Professional judg-

ment is directed by the state nurse practice act and

national standards of nursing. Institutions develop

their own job descriptions for UAP and other health-

care professionals, but institutional policies cannot

contradict the state nurse practice act. Although the

nurse delegates the task or activity, he or she remains

accountable for the delegated decision.

Understanding the concept of delegation helps

the new nurse organize and prioritize client care.

Knowing the staff and their capabilities simplifies

delegation. Utilizing staff members’ capabilities

creates a pleasant and productive working environ-

ment for everyone involved. Understanding delega-

tion and proper application of delegation principles

is needed in the implementation of the various

nursing practice models.

Study Questions

1.What are the responsibilities of the professional nurse when delegating tasks to an LPN or UAP?

2.What factors need to be considered when delegating tasks?

3.What is the difference between the delegation and the assignment of a task?

4.What are the nurse manager’s legal responsibilities in supervising UAP?

5.If you were the nurse manager, how would you have handled Laura’s situation?

6.How would you have handled the situation if you were Linda?

7.Bring the client census from your assigned clinical unit to class. Using the Delegation Decision-

Making Grid, decide which clients you would assign to the personnel on the unit. Give reasons for

your decision.

8.What type of nursing delivery model is implemented on your assigned clinical unit? Give examples

of the roles of the personnel engaged in client care to support your answer.

Case Study to Promote Critical Reasoning

Julio works at a large teaching hospital in a major metropolitan area. This institution services the

entire geographical region, including indigent clients, and, because of its reputation, administers

care to international clients and individuals who reside in other states. Like all health-care

institutions, this one has been attempting to cut costs by using more UAP. Nurses are often floated

to other units. Lately, the number of indigent and foreign clients on Julio’s unit has increased. The

acuity of these clients has been quite high, requiring a great deal of time from the nursing staff.

Julio arrived at work at 6:30 a.m., his usual time. He looked at the census board and discovered

that the unit was filled, and Bed Control was calling all night to have clients discharged or

transferred to make room for several clients who had been in the emergency department since the

previous evening. He also discovered that the other RN assigned to his team called in sick. His

team consists of himself, two UAP, and an LPN who is shared by two teams. He has eight clients