Delegation in Nursing

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A Discussion of Various Perspectives on Delegation in Nursing Jessica Abbott
University of Central Florida

ABSTRACT: Delegation refers to the practice of a registered nurse assigning certain tasks and activities to other people while still maintaining responsibility for the actions of the others to whom responsibility has been delegated. The act of delegating assumes that the delegator has a certain amount of trust in the person to whom they delegate. Additionally, quality communication is paramount in maintaining superior patient care when delegating tasks to others. One signifigant obstacle to delegation is ensuring that the proper tasks are delegated to the appropriate individuals. The organizational structure and leadership of the unit should prevent delegation to unqualified personel by having clear scope of practice guidelines. The economic implications on the nursing profession and healthcare in general, also affect the act of delegation.

Key words: delegation, leadership, organizational structure, responsibility

A Discussion of Various Perspectives on Delegation in Nursing In general, "delegation" in the nursing profession refers to the practice of a registered nurse assigning certain tasks and activities to other people while still maintaining responsibility for the actions of the others to whom responsibility has been delegated. As Cipriano (2010) puts it, "Delegation is a universal nursing skill. With the looming world-wide nursing shortage, any change in skill mix will undoubtedly lead to an increase in the amount of delegation of certain aspects of care". Delegation is thus an integral component of the general organizational structure of nursing practice, and it can only be expected to become even more prominent in coming times. The issue of delegation is extremely important for the nursing profession because it has strong implications for the nature of effective leadership; and consequently, it also has political implications. Statement and Review of the Subject

In her article, Weydt (2010), paraphrasing the ANA Code of Ethics, states that "delegation is based on the RN's judgment concerning a patient's condition, the competence of all members of the nursing team, and the degree of supervision required". Weydt (2010) effectively creates a small compendium of the most important skills and characteristics with respect to the practice of delegation: for example, these include responsibility, accountability and authority. One important feature of this article which is worth noting is Weydt's assertion that "[t]rust is an important element of developing healthy teams" and consequently an important component of successful delegation. This implies that delegation presupposes a leadership structure in which trust, as opposed to more coercive forms of power, constitutes the "glue" which binds the unit or team together.

Further, Anthony and Vidal (2010) emphasis the epistemological dimension of delegation, that is, the dimension pertaining to the objective communication of information: the article draws a correlation between the quality of communication present during the delegation process and the quality of care delivered to the patient. The authors develop the concept of "mindful communication" in order to describe the form of attention which they believe to be essential for the successful communication of information when delegating: When mindful communication is utilized, it involves not only understanding the importance of the patient care facts but also, how they relate to the unique patient at hand. (Anthony & Vidal, 2010). This, too, has political implications for the organizational and leadership structures of nursing units.

A somewhat more reserved perspective on delegation is expressed by Resha (2010), who questions the parameters of the context in which delegation occurs. Addressing nursing in schools, she writes, school health nurses face the challenge of safe and effective...
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