Page 129 - Essentials of Nursing Leadership and Management, 5th Edition

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116 unit 2 | Working Within the Organization CikguOnline
Linda is a new graduate and has just finished her process or outcome of the task remains with the
orientation. She works from 7 p.m. to 7 a.m. on a delegator, or the person delegating the activity.
busy, monitored neuroscience unit. The client census Nightingale referred to this delegation responsibil-
is 48, making this a full unit. Although there is an ity when she inferred that the “head in charge”does
associate nurse manager for the shift, Linda is the not necessarily carry out the task but still sees that
charge nurse. Her responsibilities include receiving it is completed.
and transcribing orders, contacting physicians with An assignment is not the same as delegation.
any information or requests, accessing laboratory In an assignment, power is not transferred.
reports from the computer, reviewing them and giv- Assignments refer to practical or routine functions
ing them to the appropriate staff members, checking that are part of a job description or client needs.
any new medication orders and placing them in the For example, the team leader assigns three clients
appropriate medication administration records, to the licensed practical nurse (LPN). That is part
relieving the monitor technician for dinner and of the job description for the LPN. However, giv-
breaks, and assigning staff to dinner and breaks. ing medications to all the clients on the team is a
When Linda comes to work, she discovers that one delegated responsibility.
registered nurse (RN) called in sick. She has two According to the ANA, specific overlying prin-
RNs and three unlicensed assistive personnel (UAP) ciples remain firm regarding delegation. These
for staff. She panics and wants to refuse to take include the following:
report. After a discussion with the charge nurse from
■ The nursing profession delineates the scope of
the previous shift, she realizes that not taking report
nursing practice.
is not an option. She sits down to evaluate the acu-
■ The nursing profession identifies and supervises
ity of the clients and the capabilities of her staff.
the necessary education, training, and use of
ancillary roles concerned with the delivery of
Introduction to Delegation
direct client care.
■ The RN assumes responsibility and accountabil-
Delegation is not a new concept. In her Notes on
ity for the provision of nursing practice.
Nursing, Florence Nightingale (1859) clearly
■ The RN directs care and determines the
stated: “Don’t imagine that if you, who are in
appropriate utilization of any ancillary personnel
charge, don’t look to all these things yourself, those
involved in providing direct client care.
under you will be more careful than you are....” She
■ The RN accepts assistance from ancillary nurs-
continued by directing, “But then again to look to
ing personnel in delivering nursing care for the
all these things yourself does not mean to do them
client (ANA, 2005, p. 6).
yourself. If you do it, it is by so much the better
certainly than if it were not done at all. But can you
Nurse-related principles are also designated by the
not insure that it is done when not done by your-
ANA.These are important when considering what
self? Can you insure that it is not undone when
tasks may be delegated and to whom.These princi-
your back is turned? This is what being in charge
ples are:
means. And a very important meaning it is, too.
The former only implies that just what you can do ■ The RN has the duty to be accountable for
with your own hands is done. The latter that what personal actions related to the nursing process.
ought to be done is always done. Head in charge ■ The RN considers the knowledge and skills of
must see to house hygiene,not do it herself”(p.17). any ancillary personnel to whom aspects of care
are delegated.
Definition of Delegation ■ The decision to delegate or assign is based on
By definition, delegation is the reassigning of the RN’s judgment regarding the following: the
responsibility for the performance of a job from condition of the client; the competence of the
one person to another (American Nurses members of the nursing team; the amount of
Association [ANA], 1996). RNs maintain account- supervision that will be required of the RN if a
ability for supervising those to whom tasks are del- task is delegated.
egated (ANA, 2005). Although the responsibility ■ The RN uses critical thinking and professional
for the task is transferred, the accountability for the judgment when following the Five Rights of