Dec 15 2023 by Myrna B. Schnur, MSN, RN
Fundamental skills such as the ability to prioritize, multi-task, and delegate are essential for nurses to care for their patients safely and effectively. Over time, I learned how to prioritize and multi-task, but delegation proved to be very challenging for me for many reasons. First, I didn’t want to appear incapable of handling my assignment and I certainly didn’t want to burden anyone with my work. I needed to prove that I belonged in the intensive care unit and had to earn my position on the team. Second, I felt responsible for every aspect of my patient’s care and was afraid to relinquish control. Lastly, I didn’t necessarily feel empowered to delegate to any of the nursing assistants; they were my peers and I didn’t want to tell anyone what to do. I always felt that their tasks should be delegated by the charge nurse, or someone else in a leadership position. As I gained more experience, I grew more comfortable with delegation. However, nurses of all levels need to have a clear understanding of what they can delegate and who they can delegate to.
The National Council of State Boards of Nursing (NCSBN) and the American Nurses Association (ANA) developed guidelines to standardize the delegation process for boards of nursing (BONs), health care employers, community-based settings, professional associations, nurse educators, nurse leaders, staff nurses, and delegated individuals (or delegatees).
What is nursing delegation?
According to the ANA (2019), nursing delegation can be summarized by the following:
- The delegatee (person being delegated to) may complete a nursing activity, skill or procedure that is legally appropriate and allowed by the facility’s policies.
- The delegatee has had education and training needed to perform the delegated task.
- The licensed nurse who delegates the task maintains overall accountability for the patient.
- The delegatee is responsible for the delegated activity or procedure.
- Clinical reasoning, nursing judgement, and critical decision-making shouldn’t be delegated.
- Nursing responsibilities can be delegated by someone who has the authority to delegate.
- The delegated task must be within the delegator’s scope of practice under their state nurse practice act (NPA).
These guidelines apply to:
- Advanced practice registered nurses (APRNs) when delegating to registered nurses (RNs), licensed practical nurses/vocational nurses (LPN/VNs), and unlicensed assistive personnel (UAP)
- RNs when delegating to LPN/VNs, and UAP
- LPN/VNs (as permitted by their state) when delegating to UAP
It is important to note that states have different laws, NPAs, and regulations about delegation. Clinicians are responsible for knowing what is legally permitted in their state.
What are the benefits of delegation?
According to the ANA (n.d.) there are many benefits of delegation in nursing such as:
- Empowering employees
- Decreasing burnout
- Increasing commitment
- Improving job satisfaction
Five rights of nursing delegation
The process of delegation includes “five rights” to remember. These are summarized in the table below.
| Five Rights | Nursing Considerations
(ANA, 2019; NCSBN, 2019; ANA, n.d.) |
|---|
| Right task | - Delegate tasks that are legally appropriate and allowed by your facility’s policies.
|
| Right circ*mstance | - Assess the patient’s needs prior to delegating the task to ensure all resources and supervision are available.
- The patient’s medical condition must be stable.
- The delegatee must communicate any changes in condition to the licensed nurse who must then reassess if the delegation is still appropriate.
|
| Right person | - Ensure the delegatee has the skills and knowledge to perform the activity; identify the individual who is best able to complete the job.
|
| Right direction and communication | - Provide clear information on what the task involves, when it needs to be completed, documentation, patient limitations, and expected outcomes, and allow the delegatee to ask clarifying questions.
- The delegatee must agree to accept the delegated task and not make changes to the task without consulting the licensed nurse.
|
| Right supervision and evaluation | - Provide appropriate supervision for all tasks delegated and be ready to intervene when needed.
- Monitor the delegated activity, evaluate patient outcomes, and complete documentation when the activity is completed.
- The delegatee must communicate patient information to the licensed nurse.
- Offer advice and support, and provide feedback upon task completion.
|
Successful delegation requires effective communication, collaboration, competence and knowledge of the delegatee, and role clarity (NCSBN, 2019). Continue to work on your delegation skills and share your stories with us in the comments below.
| More Resources |
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| GUIDELINE SUMMARY | BLOG | COLLECTION |
| Nursing Delegation | Communication: 4 Steps Toward A Healthier Work Environment | Nursing Tips |
FAQs
The 5 rights of delegation serve to guide appropriate transfer of responsibility for the performance of an activity or task to another person. These "rights" are defined as having the right task, right circ*mstance, right person, right direction/communication, and right supervision/evaluation.
What are the 5 rights of delegation? ›
The 5 rights of delegation serve to guide appropriate transfer of responsibility for the performance of an activity or task to another person. These "rights" are defined as having the right task, right circ*mstance, right person, right direction/communication, and right supervision/evaluation.
What are five 5 key principles of delegation? ›
Here are the five mandatory principles at the heart of successful delegation.
- Clarify the Task(s) You Want to Delegate. ...
- Choose the Right Delegate for the Task. ...
- Communicate Thoroughly. ...
- Make Sure Your Delegate Has Necessary Authority. ...
- Give Praise and Feedback as You Go.
Q-Chat
- Right task. Appropriate activities delegated must fall within the respective scope of practice.
- Right circ*mstances. Appropriate patient setting, available resources, and other relevant factors considered.
- Right person. ...
- Right direction and communication. ...
- Right supervision.
Therefore, the American Nurses Association developed the five rights of delegation to assist nurses in making safe decisions.
What are the 5 rights for direction and delegation? ›
Five Rights of Delegation
- Right task.
- Right circ*mstance.
- Right person.
- Right supervision.
- Right direction and communication[1]
Rule 1: Clarify The Task In Your Own Mind
Clarify what the task is before you ask someone to complete it. There are some important questions to ask yourself. When you have the answers, then delegate the task.
What are the key points of delegation? ›
There are three elements of Delegation: responsibility being assigned, authority being granted, and accountability being created.
What are the five rights of delegation case study approach? ›
The '5 Rights of Delegation' in nursing are: Right Task (delegate appropriate tasks), Right Circ*mstance (consider patient's health and resources), Right Person (assign tasks to qualified individuals), Right Direction/Communication (provide clear and accurate instructions), and Right Supervision/Evaluation (monitor ...
What is the first rule of delegation? ›
If you can only manage to make one change, ensure you follow the first rule, as it is the golden rule of delegation: Learn when to delegate. Rule 1: Just because you can do something doesn't mean you should.
The correct answer is B. Right circ*mstance is not one of the 5 Rights of Delegation in healthcare. The 5 Rights of Delegation in healthcare are: Right task: Ensuring that the task being delegated is appropriate for a particular healthcare worker to perform.
What are the major five principles of delegation? ›
As a manager, your efforts to become a good manager rests on the five principles of delegation of authority: selecting the right task, clarifying the desired result, choosing the right circ*mstance, identifying the right person for the task, and providing the right supervision.
What are the rules of delegation? ›
The 10 Rules of Successful Delegation
- Be Patient. The first time you delegate any task, it is almost certainly going to take longer than doing it yourself. ...
- Don't Over-Delegate. ...
- Pick the Right People. ...
- Explain Why You're Delegating. ...
- Be Specific. ...
- Provide Training. ...
- Touch Base. ...
- But Don't Micromanage.
They can include resource selection, understanding employees' strengths, effective feedback and problem-solving, among many others. While there are plenty to choose from, Indeed lists three of the most essential delegation skills as: communication, time management, and trust.
What are the 5 rights of medication? ›
Most health care professionals, especially nurses, know the “five rights” of medication use: the right patient, the right drug, the right time, the right dose, and the right route—all of which are generally regarded as a standard for safe medication practices.
What are the 3 golden rules of delegation? ›
Identify the right time to delegate a task. Chose the right person to delegate a task to. Provide the right supervision.
