Running Head: DELEGATION

Inappropriate Delegation
Tayler Lamagna
California State University, Stanislaus

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Inappropriate Delegation

As a nurse, delegation becomes a necessary responsibility in order to provide total

patient care. When delegating tasks, it is important to determine if the individual is
capable of completing that task. Using the five rights of delegation, the nurse can
determine if the task is indeed appropriate (NCSBN 1995). The first right to assess is
right task. Is the task safe to assign to this person? The second right is right
circumstance. Is the clients condition appropriate for the delegated individual to
complete this task? The third right is right person. Is this in their scope of practice? The
fourth right is right direction and communication. Did the nurse give clear, concise
directions on how to complete this task? The fifth and last right for the nurse to assess
before delegating a task is right supervision (NCSBN 1995). Did the nurse follow up
with the delegated individual to assess if they completed the task correctly?
Delegation is the transfer of responsibility for the performance of an activity
from one individual to another while retaining accountability for the outcome (ANA,
1996). My first day in the Emergency Department (ED) as a Student Nurse (SN), I was
assigned to shadow a Registered Nurse (RN). Since this was my first day in this
department, I was unaware of where they kept all their equipment, supplies, and how
patient care was achieved in this department specifically (as all departments are all a little
different). The day started out slow, but the RN quickly began to get overwhelmed with
patients and tasks. He then told me it, in order to help him out, it was my job to be the
first to talk and assess a specific patient when he were first brought into the room and to
report back to him what my findings were. I was nervous to have such a big job as a SN,
and being unaware of how the equipment worked, I was unsure if I could achieve this

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task. I began assessing and wrote my findings up on the whiteboard in the room for the
RN to refer back to. At the end of my assessment on this patient, I came to him to discuss
what I had done. After getting report from me, he then asked what the other three
patients had going on. I was unaware that he wanted me to assess all of his patients for
him and only got the message that he wanted me to assess this one patient. The RN then
yelled at me in front of a patient and made me feel very uncomfortable.
Using the five rights of delegation, we can assess if this delegated task was
appropriate for an RN to assign to a SN. The first right to assess is right task. According
to ANA Standards of Care, RNs cannot delegate an initial assessment. The second right
is right circumstance. One of the patients was having trouble breathing, and another was
a possible stroke patient. It was not appropriate for the RN to assign me these patients
alone because they require nursing judgment. The third right is right person. An
assessment is in my scope of practice as a SN, but not an initial assessment of one that
requires nursing judgment. The fourth right is right direction and communication. The
RN did not give clear, concise directions on how to complete this task. The fifth right is
right supervision. The RN did not follow through to see if the task was being performed
accurately. He did not see me assess the patients or even go in the room to assess for
himself.
The outcome of this delegated task did not go well but I did learn a lot from it.
Next time, I think I should report what I think is expected of me back to the delegator
before I start the delegated task. It is important for me to make sure I fully understand
what is asked of me before I begin. Also, as a delegatee, it is my responsibility to give
feedback to the delegator on the effectiveness of the delegation process (ANA, 1996). I

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should have told him I didnt understand what he wanted me to do and what he could do
differently next time.
Delegation is a necessary skill for RNs to have in order to keep up with
demanding schedules in the hospital. Both appropriate and inappropriate delegation
happens daily. It is our job as RNs to delegate correctly by using the five rights. From
my situation, I have learned the correct way to delegate. Most importantly, I will
periodically check in with the delegatee to make sure the task is being done correctly. If
done correctly, delegating is beneficial and necessary in order to provide total patient
care. It is important for us to remember that the patient is the one who ultimately will
suffer when delegating inappropriately. As future RNs, it is our job to delegate correctly,
and to provide the patient with the best care possible.

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References

National Council of State Boards of Nursing. (1995). Concepts and Decision-Making

Process National Council Position Paper. Retrieved from
http://www.ncsbn.org/public/resources/ncsbn_Delegation.htm.
American Nurses Association. (2003). Principles of Delegation. Retrieved from
http://www.indiananurses.org/education/principles_for_delegation.pdf
American Nurses Association. (1995). The ANA Basic Guide to Safe
Delegation. Washington, DC: American Nurses Publishing.