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Delegation in Nursing: Steps, Skills, and Solutions for Creating Balance at Work

Learn how to actually implement the Five Rights of Delegation to make life easier and avoid nurse burnout.

Image - How to Delegate in Nursing Image via Unsplash.com/Marten Bjork

As a nurse, you may often feel like you’re expected to handle everything that comes your way. And as much as you may want to, it’s just not realistic. There’s only so much you can do in a day and trying to take on too much too often can quickly lead to fatigue and burnout. That’s why it’s crucial that you to learn how to delegate tasks early on in your nursing career.

What Is Delegation in Nursing?

Let’s say that “Nurse Sydney” is swamped with six patients, charts to fill out, and medications to order. She has two hours left in her shift and needs some qualified, helping hands to complete everything effectively and on time. She needs to delegate.

Simply put, delegation is a tool that lets you shift some of your responsibilities to another person. In nursing, this means that a nurse is assigning a responsibility, skill, or procedure to a fellow staff member (licensed nurses as well as unlicensed assistive personnel). But, it’s important to note that the person getting the new assignment is usually being asked to do something beyond her traditional role—and thus rules, approvals, and procedures should be put in place.

Who Can Delegate Tasks?

All nurses can delegate, but it’s important to understand how delegation laws work in your state. Different areas have different regulations, so you should always know which rules apply to your role as a nurse, and make sure your supervisor is supportive and feels your team can handle the work.

What’s the Difference Between ‘Delegating’ and ‘Assigning’?

Think of it this way: “Assigning” is the act of handing over a patient to someone else, while “delegating” is the act of handing over a task. When “delegating,” you’re still in charge of the patient’s care and you’re ultimately responsible for your teammate’s work. When “assigning,” you’re giving the responsibility to someone else.

Why Is Delegating Important in Nursing?

A 2012 study conducted by the Nursing Quality and Care Forum discovered that many nurses took on work that other teammates (i.e., LPNs or health aides) were qualified to do. Because these nurses were distracted by extra tasks, they ultimately didn’t get as much done as they could have. As a result, they ended up feeling tired and overworked.

What does this mean for you? At the end of the day, if you’re able to lift part of your massive workload off of your shoulders, you’ll be in a much better position to make good decisions and deliver quality care to your patients.

What Are the “Five Rights” of Delegation?

There are five important tenets of delegation in nursing, better known as the Five Rights of Delegation. When you delegate a task, you must:

  1. Delegate the Right Task
    Make sure that you delegate a task(s) that would both save you time and that can be done just as effectively by another nurse or team member.
  2. Under the Right Circumstances
    Look for the right timing. If someone’s day is slammed, they won’t be the right candidate for you to delegate your project to. Or, if you have a critical care patient, you may want to delegate other patients to someone else and care for the complex case yourself.
  3. To the Right Person
    Make sure you’re only delegating tasks to nurses, teammates, or patient care associates who are qualified to handle them.
  4. With the Right Directions and Communication Make sure you provide the delegatee with all the necessary information they need to know about a patient so that they can perform the task properly. Specify your expectations, clarify the work you want done, and offer any guidance they might need along the way.
  5. Under the Right Supervision and Evaluation
    The ultimate responsibility for the patient lies with you, so be vigilant about checking in with your teammate to make sure that they understand the task and feel comfortable doing it. If they need guidance, delegate supervision to another nurse or supervise them yourself. Follow up with the patient and the staff member to see how it went. And remember to always have colleagues report any issues or concerns immediately.

Skills You’ll Need to Have to Delegate Effectively

Delegation in nursing isn’t just about getting work off your plate; it’s also about training other team members so that they know how to do their jobs properly. All in all, good delegation requires a number of skills, including:

  • Effective Planning: Start the day by planning out which tasks to delegate (and to whom) so you can keep everyone on the same schedule.
  • Good Communication: Know how to explain to teammates what needs to be done in a clear and efficient way.
  • Follow-Through: Never just delegate a task and forget about it. Always follow up with both the patient and teammate to see how things are going.
  • Understanding Your Coworkers: You need to know your teammates’ strengths, otherwise you might misuse their talents. Familiarize yourself with each person’s skills and weaknesses and delegate accordingly.
  • Fearlessness: Don’t be afraid to delegate. It’s part of your job, and it will help you ensure that you can spread your nursing talents further.
  • Leadership: You can’t delegate if you aren’t a good leader. You need to be comfortable with making quick decisions, and be ready to delegate various tasks to your teammates at a moment’s notice.
  • Trust: To delegate effectively, you need to be able to trust that the other person can get the job done–and properly. If you keep checking up on them because you don’t think they can handle it, you run the risk of wasting their time and yours.

Effective Delegation in Nursing: A Real-Life Example

Knowing the Five Rights of Delegation and actually understanding how to implement them are two different skills. Here’s an example of what the delegation process could look like in a real-life scenario.

Take, for instance, an 89-year-old patient who just had a hip replacement. As the nurse on this case, you’ll be responsible for performing aftercare, monitoring the patient’s wound for complications, helping them with mobility, giving them a bath, and generally seeing to their comfort. Of course, this is in addition to caring for your other patients–meaning you’ll have a full plate during your shift.

  • Step 1 - Choose the Right Tasks to Delegate: If you need more time in your day, identify some of the major time-sucks on your to-do list, such as bathing. Because the patient is still under your care, you’ll need to check for signs of infection daily. However, another nurse can help bathe the patient. You might also consider delegating activities like bathroom visits, bedpan duty, or other nonessential care.
  • Step 2 - Choose the Right Circumstances: Timing is everything, so you’ll need to make sure that you’re paying attention to the circumstances under which you’re delegating a task to someone else. In this scenario, you’ll need to choose someone who has a light patient load and can handle the addition of another task. However, if the patient’s condition begins to deteriorate, know that it’s no longer the right circumstance for delegation and that you’ll need to step back in to take over.
  • Step 3 - Choose the Right Teammate: Choose someone with experience caring for geriatric patients, as well as someone who’s worked on patients with hip replacements and understands how to bathe someone in that kind of condition. You should also make sure that you’re conforming to your state’s laws regarding the kinds of activities different team members can and cannot do. When they’ve completed the task, always check into make sure that they performed the job properly.
  • Step 4 - Choose the Right Directions to Give: Explain exactly how you want the teammate to perform their new duties. For example, with bathing, make sure that they know to avoid submerging the wound. If they’re helping the patient walk, make sure that they bring along a walker. Be as precise as possible to avoid any mishaps.
  • Step 5 - Follow Up With Supervision: Check back in throughout your shift, both with the patient and with the teammate. Ask the patient how things are going, and double-check the wound to make sure that everything looks good. Ask the teammate if they performed their duties properly or noticed any issues. If all went well, give them a compliment. If they made a mistake, reprimand them in a productive way that isn’t discouraging or demeaning.

The Benefits of Proper Delegation in Nursing

So, what benefits can come from delegating nursing tasks effectively? Take a look:

  • Better Workload Balance: Everyone on your team will be contributing evenly and working together to provide quality care to patients. Both nurses and other teammates will have balanced loads during their shifts.
  • Decreased Risk of Burnout: With less work on everyone’s plate, you can help prevent your teammates from burning out. In turn, you’re all be much more likely to provide your patients with the quality care they deserve.
  • Enhanced Team Dynamics: When you see just how great other teammates are performing, you’ll discover their specialties and feel more comfortable relying on them when you need their help. Delegation also gives you the chance to teach others who might not be as experienced as you are. They can take on new tasks after you show them what to do.
  • More Time for Your Patients: Not sure what’s wrong with a patient? When you don’t have to worry about tending to busywork, you can spend more time studying their troubling symptoms.
  • More Time for Yourself: Now that you don’t have to run around the halls your whole shift, you can take time to breathe and tend to any needs you’ve been putting off.

The views expressed in this article are those of the author and do not necessarily reflect those of Cinch™ or Berkshire Hathaway Specialty Insurance Company. This article (subject to change without notice) is for informational purposes only, and does not constitute professional advice. For our full disclaimer, click here.

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