Delegation of Authority
University of North Carolina at Charlotte
All nurses delegate tasks while at work. Some guidelines are provided in the article to direct you in the process of delegating, including the five rights of delegation. The subject of responsibility for delegated tasks to unlicensed assistive personnel (UAPs) is discussed. Signs to success in delegation is overviewed. The issue of trust and leadership skills is touched upon.
Today as a nurse, it seems like there is so much to do, so little time to do it, and more added to your workload every day. Thank goodness there are unlicensed assistive personnel (UAPs) to help out with those simple, yet time-consuming tasks that must be done daily. Knowing what all UAPs are capable of doing and to what extent is very important. Thatís where the issue of delegation comes in - an ongoing topic in nursing leadership and management. All nurses delegate tasks while at work, and may not even realize it. Just asking a UAP to assist in feeding, bathing, or other activities of daily living helps save time tremendously, and is considered a daily delegation task. Clearly defined, the generally recognized definition of nursing delegation is entrusting the performance of a selected nursing task to an individual who is qualified, competent, and able to perform such tasks (Habgood, 2000).
There are some guidelines to direct you in the process of delegating. These five rights include: the right task for the individual to perform; the right circumstance for the patient to receive the care; the right person to perform the care for the patient; the right information to describe desired patient outcomes; and the right supervision to ensure the task is carried out safely (Cohen, 2000). When you have concluded that all of these components are in place, then you are ready to delegate. Your hospitalís policies and the UAPs job description determine the type of tasks you may delegate as well. It is important to read them frequently, as job descriptions may change over time. You should talk with the UAPs and ask what tasks they can perform, make sure they understand what you asked them to do, and be specific when you delegate tasks to them. You need to develop a trusting relationship with the UAPs you work with, making it clear that they can only accept assignments within the parameters of their training and experience, and be honest if they are unable to do an assignment (Fisher, 2000). This openness will probably provoke a pleasant atmosphere, and the UAPs may even become more willing to assist and share their needs with you, the nurse.
Nurses remain responsible for any and all delegated tasks. Inappropriate delegation may lead to liability claims against the nurse, disciplinary actions, or license revocation. Nurses must supervise UAPs while they are performing these tasks to ensure adequate resources to support, direct, and evaluate the activity (Sheehan, 2001). The nurse is responsible for all care provided to a patient by the UAP, and the nurse is accountable if the task is not completed or done properly, so it is important to follow up on the assigned tasks (Ahmed, 2000). No one wants to lose their nursing license over a delegated task, so it may be a good idea to double-check as you give patients medicines or treatments and assess them. According to Palmier, UAPs need to be assigned to a nurse, not to patients or to tasks, as they are to be under the supervision or direction of a registered nurse. The most cost-effective care belongs to a single person-a RN, who requires less supervision, and reduces costs through shorter lengths of stay and decreased mortality rates (1998). As a result of managed care and budget constraints, the use of UAPs have increased at a startling rate, as they are performing increasingly complex tasks, and RNs, in turn, are undertaking increased responsibility for supervising the care UAPs provide (Habgood, 2000). As the UAPís supervisor, you should know what they can and cannot do, and assign only those tasks you know they can perform competently. Before delegating any tasks, you should assess each patient to determine whether the care to be provided should be assigned to a UAP or performed by an RN (Brown, 1999). Even though the UAPs provide a great deal of help, it may seem just as time-consuming to check that they completed their tasks efficiently and review their competencies. Overall, UAPs are an important aspect to the medical team and cannot be overlooked.
There are several signs that you have been successful at delegating, which may include confidence among staff, updated job descriptions, annual staff competency process, and a staff that is educated on delegation and individual accountability (Cohen, 2000). Delegation is an on-going topic that is enhanced everyday with practice and patience, and you cannot expect to be perfect when starting out. Nor can you expect the UAPs to do a task as you would yourself. When evaluating the individual's performance, don't give low marks just because they didn't do it the same way you would have, praise the employee if it was completed correctly. As you gain trust and learn the strengths of your employees, you can increase the difficulty of the tasks you delegate (Puetz & Thomas, 1998).
In conclusion, entrusting others will only enhance the care of patients, so we must take advantage of what they have to offer that contributes to the provision of healthcare. Those who have experience and self-confidence to delegate comfortably will need to be role models for the less experienced nurses as they gain confidence in their ability to delegate tasks (Patton, 2001). Delegation strategies incorporated into practice can provide the RN with more time for professional nursing roles, and enhance job satisfaction in the areas of decision-making and promotional opportunity (Parsons, 1998). The skills pertinent to a manager also apply to a delegator, as a delegator needs to learn and acquire leadership skills that empower others, establish a direction, align people, motivate and inspire, encourage self-observation and self-evaluation, and are generous in their use of questions to their staff and verbal rewards (Palmier, 1998). The skills of delegating can be kept with you and enhanced over your lifetime, and even help you grow professionally. The delegated task may be small, but has a large overall impact for all involved.
Ahmed, D. S. (2000). Itís not my job. AJN, 100(6), 25.
S. M. (1999). Advice of council:Your liability when delegating to UAPs. RN,
S. M. (1999). Advice of council:Your liability when delegating to UAPs. RN,
Cohen, S. (2000). Managerís fast track: Pass it on? Nursing Management, 31(8), 24-25.
Fisher, M. (2000). Do you have delegation savvy? Nursing 2000, 30(12), 58-59.
Habgood, C. M. (2000). Ensuring proper delegation to unlicensed assistive personnel.
AORN Journal, 71(5), 1058.
for the future? ConceRN, 27(1), 16-17.
L.C. (1998). Delegation skills and nurse job satisfaction. Nursing
Patton, S. (2001). President's message: April 2001. Nursing News (New Hampshire), 25(2), 3.
Puetz, B. E., & Thomas, D. O. (1998). Help line: To delegate effectively, believe in your staff. RN, 61(8), 24-26.
J. P. (2001). UAP delegation: A step-by-step process. Nursing
acknowledge the assistance of, Dr. Sonya Hardin/Dr. Bettie Gleen/Dr. Virginia
the submission of this article.
with the submission of this article.
Sonya Hardin/Dr. Bettie Gleen/Dr. Virginia Adams
in Nursing Leadership Instructors
Distance Education Program
of North Carolina at Charlotte
University City Boulevard
Copyright© by The University of Arizona College of Nursing; All rights reserved.