What principles do you use when delegating to unlicensed personnel? Because the licensed nurse is … for care performed by an unlicensed person, how do you protect yourself and your patients?
Week 5 Discussion Topic NR 395
What principles do you use when delegating to unlicensed personnel? Because the licensed nurse
is liable for care performed by an unlicensed person, how do you protect yourself and your
patients?
In nursing school, we were taught the 5 Rights of Delegation, being “1. The right task 2. Under
the right circumstances 3. To the right person 4. With the right directions and communication;
and 5. Under the right supervision and evaluation” (NCSBN.org, pg. 2). Tasks that are delegated
to unlicensed personnel are based on the nurse’s judgement on whether or not the person is suited
to complete the job and if it is in their job description to do so. Nurses place their license at risk
when delegating inappropriately to unlicensed personnel. Huston expands on such tasks that
would fall under tasks to delegate, “the UAP may complete non-nursing functions such as
bathing the patient, taking vital signs, and measuring and recording intake and output, it is the
RN who must analyze that information using highly developed critical thinking skills and then
use the nursing process to see that desired patient outcomes are achieved” (Huston, pg. 100). Any
task that requires assessment of data, administration of medications, or evaluating patient’s status
are reserved to nurses, however tasks like acquiring vitals for a critical patient for the nurse to
assess are in the proper scope of practice.
I had worked for 3 years as a patient care assistant (unlicensed personnel) prior to achieving my
nursing license, so I had first hand experience of being delegated to and understand the role of
our patient care assistants on our floor. As a patient care assistant, we cleaned the patients, fed
patients, changed the bedding, took vital signs, checked glucose levels, and would collect stool
and urine samples for the nurses to send to lab. We were able to get blood from the lab for
transfusions as well. Patient care assistants are able to do actions while nurses supervise and
evaluate the results of the actions. Now being a nurse, if I feel that a task that I need to be done is
not a job for a patient care assistant, I ultimately do it myself to ensure that it gets done correctly.
In doing this, I do take more roles on that I should, but it is to make sure it is done and done right
the first time, or I can show the patient care assistant the task so that in the future, they
understand what I am asking for. Delegation is a form of trust and understanding of the task and
person with whom you give the task to.
-Karina
References:
National Council of State Boards of Nursing. (2019). Joint Statement on Delegation. Retrieved
from https://www.ncsbn.org/Delegation_joint_statement_NCSBN-ANA.pdf
Huston, C.J. (2017). Professional nursing: Challenges and opportunities (4th ed). Philadelphia,
PA: Wolters Kluwer
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