III. Background Information for the post
Delegation and Prioritization
Delegation and prioritization – two very important skills for the BSN!
Delegation – the process of transferring the authority and responsibility to another team member to complete a task while maintaining the accountability.
Most often, nursing practice is provided using somewhat of a team method. This team may involve members that hold an advanced practice license, those with a nursing license, and those that are not licensed. In the hospital setting, where most nurses hold their first professional role, often it is the RN that is the team leader. Certainly, many tasks are required to provide care. Some of the tasks MUST be completed by the RN – this is required legally. For example, assessment. Assessment is not a task that can be delegated to one without a license. Taking Vital Signs – this can be delegated!
Things to consider:
What are the tasks that can be delegated?
What tasks should be delegated to whom?
What is the check-back timeframe?
How does the RN make the decisions? What factors should be reviewed?
What if the person you assign a task to delegates to someone else?
Is the RN still ACCOUNTABLE for the task? (YES!)
The 5 rights are key – right task, right circumstance, right person, right communication, right supervision!
In April, 2019, the NCSBN and the ANA issued a joint statement on Delegation. (see reading for this module).
Delegation is an important consideration for liability – remember, even with appropriate delegation, the accountability remains with YOU (the the one delegating). Scope of practice knowledge is required to make the best decisions regarding delegation. Each nurse needs to know the Nurse Practice Act as there are some differences state to state. In addition to knowing your own scope, you need to have knowledge of the scope of practice of your team in order to delegate effectively.
Hewertson (via ‘Management and Leadership for Nurse Administrators’ 8th ed) says delegation should be planned and well-managed. This is important – delegation on-the-fly is simply not effective and often not appropriate. She defines the principles of delegation as:
• Right person
• Consider learning styles
• Delegate good AND new work
• Take your time
• Delegate gradually and monitor progress carefully
• Match authority with responsibility
• Delegate the whole (when possible)
• Delegate for specific results
• Avoid gaps and overlaps
• Trust the successful delegate
Each of the above bullets is a learning for new nurse leader!
Prioritization – deciding which needs of problems require immediate action and which ones could tolerate a delay …
Setting priorities is important for high quality outcomes. Tasks for the day can be listed by order of importance and often we are faced with emergencies that require us to ‘reprioritize’! This begins with shift report – we are assessing the information received during report, make immediate rounds to assess the patient (not relying on report only!), and then we start the process of prioritization. This includes basic tasks, required interventions, timed procedures, and ones that are unexpected emergencies – therefore it shifts many times during the day.
When deciding on priority for the tasks at hand, the nurse needs to ask themselves a series of questions: is this life threatening; is there danger to patient or others; is this essential to patient? All of these answers lead to ordering the tasks.
Sample Solution
