When we ask new graduate nurses what they find to be most difficult as they are transitioning from student nurse to professional nurse, the majority say that it is delegation. This is because the artful skill of nursing delegation is one that can take years of experience to master. It involves transferring responsibility from one individual to another, while retaining accountability for the outcomes. This is a completely different role for the new grad nurse to get used to, especially since the opportunities to practice delegation are very limited during nursing school.
Since new graduate nurses are often hesitant in giving the responsibility of carrying out patient care tasks to others, this brings on additional stress to the transitioning nurse, which can result in poor time management and overwhelming workloads.
Let’s face it – nursing is not a one person show. It takes a team to safely and effectively care for patients. Since nursing is a team effort, it is vial that the new nurse master strategies for safe and effective delegation. To help new grad nurses better manage their roles and responsibilities, we’re dropping gems on strategies for safe and effective delegation below.
Decide when delegation is appropriate
Okay new nurses, here’s the scoop – You should NEVER delegate what you can E.A.T. The nurse is responsible for Evaluating, Assessing and Teaching. These are specific responsibilities of the Registered Nurse and should always be carried out by the RN. Delegation can begin after the RN has assessed the patient, and the condition and needs of the patient have been considered. The RN will prioritize the patient’s needs based on their condition, and differentiate between nursing and non-nursing tasks. Let’s not forget that initial assessment (including vital signs) are to be done by the RN, and therefore should not be delegated to the nursing assistant. Once you have assessed your patients and have considered their needs, now you can begin to think about whom you may delegate to.
Determine adequate skill levels
It’s up to the RN to choose the appropriate person for the task. It is essential to know the skill level of each team member to match the task assignment appropriately. One easy way to accomplish his task is by getting to know your co-workers. Here are some questions you may want to ask to help you feel more confident about your decision in choosing:
Is this person licensed or unlicensed?
How long has this person worked within their role?
Has this person been validated for competence in performing the task?
Does the person feel confident that they can safely and effectively perform the task?
Does the person need additional training or instruction to complete the task independently?
Once you have asked yourself these questions, you will be able to move into the next phase of safely and effectively delegating.
Use clear communication when delegating tasks
In order for any task to be effectively delegated, nurses must give clear, concise and detailed instructions. This includes the purpose, any identified limits, and expected outcomes of the task. Also, the nurse must ensure that the person to assume the task can complete it within the expected time frame established. Nurses should consider that the person you are delegating to will be working with several other patients, so be mindful and set realistic, attainable goals. Finally, the nurse must always ask if there are any questions or concerns which promotes clarification and opportunity for the supportive personnel to disclose concerns related to the tasks.
Supervise the delegated work and provide feedback
To ensure the delegated work has been completed appropriately, nurses must offer direct supervision and feedback as needed. They must also be available in case an unexpected outcome occurs. You should never assume that the task was completed without validating it by checking that all components of the task have been accurately carried out. Be sure to build strong relationships with your nursing support staff by identifying areas of success and offering suggestions for improvement. And don’t forget to say “thank you”—it goes a long way!
Evaluate task outcomes
To ensure that the patient received the care needed and that the team worked together efficiently, RNs must evaluate the delegation process upon task completion. If an unexpected outcome occurs, it is essential that RNs develop a plan to correct the deficiencies if possible.
As you hit the floor running, please remember that learning to delegate effectively takes time and practice. Reflecting on the process of delegation and identifying areas for improvement will help you develop this important skill. Good luck —we know you got this!
If you have any further tips or suggestions to promote safe and effective delegation, please share your thoughts in the comments section!