Understanding Delegation and Why It Matters

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From the moment our shift starts, we find ourselves working to provide the best care for our patients.

From the moment our shift starts, we find ourselves working to provide the best care for our patients. However, it seems that this task has become increasingly challenging due to limited staffing resources, back-ordered supplies and organizational budget limitations. This situation is when we rely on our teammates the most, and one of the best tools we have is the act of delegation. It is necessary to have a foundational understanding of delegation, so let’s explore it further.

Big 6 of Nursing Delegation

The big 6 of nursing delegation is the what, why, who, where, when and how.

What

What is delegation?

Merriam-Webster defines delegation as “the act of empowering to act for another” and the verb to delegate as “to entrust to another… to assign responsibility.” These definitions include two very important words: empower and entrust. They imply a sense of growth, confidence and teamwork that is necessary in our profession.
Delegation is the act of requesting help, asking someone to complete an activity or task for us, outside of their assignment or usual role but within their scope of practice and training to do so.

What does an act of delegation look like?

A licensed nurse must first determine what they are specifically asking for and from whom.
As the delegator, they are responsible for communicating it clearly to the correct person, who has received the necessary education to complete the task.
The delegatee follows through with the request, asking questions and reporting back to the delegator when finished.
The delegator provides feedback and appreciation at the conclusion of this interaction.

Why

Why is delegation necessary?

First, it helps nurses manage their workload and ultimately benefits patients and improves safety.
Appropriate delegation promotes good teamwork while increasing opportunities for inclusion, professional development and skill development.
Delegation also builds confidence in the delegator’s ability to ask for help and the delegatee’s skills.

Who

Who are the key players in an act of delegation?

The delegator is the person asking for assistance with a task or activity. In the context of nursing delegation, this person is a licensed nurse, whether an APRN, RN or LPN/LVN.
The delegatee receives the request and is responsible for completing it. This person can be another licensed nurse, an unlicensed assistive personnel (UAP) or a nursing student.
Ultimately, these individuals are regulated by the Nurse Practice Act (NPA), the laws in the state where they work and the policies of their employer.

Where

Where does delegation happen?

Delegation happens across practice settings, from outpatient to inpatient areas, from procedure areas to the patient’s bedside.

When

When does delegation occur?

The delegator must decide when it is the correct time and what activity to delegate. They must consider many things, including patient stability, the need for assessment and the need for additional decisions.
The delegator cannot delegate critical decision-making, clinical judgment or clinical reasoning. Therefore, not everything can be delegated.
The delegator cannot ask the delegatee to practice outside their scope of practice or training.

How

How do nurses know what to delegate?

Nurses aren’t always great about asking for help and unless we’re taught, we’re not always great at delegation. Education and practice help develop the confidence and competence to delegate.
Nurses should be coached to perform delegation safely, which starts with teaching new graduate nurses.
Each organization should have delegation policies based on their state’s NPA.
Know your teammates and what they are capable of accomplishing. This knowledge will help you decide what tasks can be delegated and who they should be delegated to.

We know that our shift will only be as good as the people working with us. Nursing delegation helps us complete our work while supporting our co-workers, bringing teams together and providing the tools necessary for great patient care. It also is a matter of safety for our patients and it’s state law to ensure that delegation is accomplished correctly. Consult your organization’s protocols, policies and procedures, as well as state guidelines on delegation.