Delegating Deb — Delegation, Assignment & Scope of Practice
The five rights of delegation exist because the RN keeps accountability even after handing off the task
Deb is short-staffed with four admissions pending, and she has one RN, one LPN and one UAP to cover twelve clients. She has thirty seconds to decide who does what before the next crisis hits.
Deb is charge nurse on a busy medical floor and must decide which tasks go to the LPN/LVN, the unlicensed assistive personnel (UAP), and which she must keep for herself. Delegation only works when the right task goes to the right person under the right circumstances with the right direction and supervision — and the RN remains accountable for the outcome. Tasks that require nursing judgment, assessment, teaching or apply to unstable clients cannot be delegated to UAP. Getting this wrong risks client safety and licensure.
Read Delegating Deb's full story →The story arc
The setup
Deb's unit is short two nurses tonight, and she must assign tasks across an RN, an LPN and a UAP for twelve clients of varying acuity.
The turn
A new UAP offers to hang a unit of blood for a stable client 'to save time,' and the LPN asks to complete the initial admission assessment on a newly arrived client.
The crisis
Deb realizes she almost let the LPN take a client whose condition is unstable and rapidly changing, which would leave critical assessment findings uncaught.
The save
Deb keeps the unstable client and the blood administration for herself, delegates vital signs, hygiene and ambulation to the UAP with clear parameters for reporting abnormal findings, and assigns the LPN stable clients needing routine medications and reinforcement of teaching.
NCLEX study section — Delegation, Assignment & Scope of Practice
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Safety & Infection Control
Take this chapter into practice questions on the same topic.