Nursing Delegation Strategies for Effective Patient Care

Introduction to Delegation in Nursing Practice

According to the Joint Statement on Delegation produced by the American Nurses Association (ANA) and the National Council of State Boards of Nursing (NCSBN), "the RN assigns or delegates tasks based on the needs and condition of the patient, potential for harm, stability of the patient's condition, complexity of the task, predictability of the outcomes, abilities of the staff to whom the task is delegated, and the context of other patient needs" (Joint Statement). These criteria form the professional foundation upon which sound nursing delegation must be built, guiding registered nurses in determining what tasks can be appropriately transferred to other members of the care team.

In this particular case, it is relatively straightforward to identify the frustrating aspects affecting Ms. W., and it can also be a relatively simple matter to correct the situation in order to ensure effective care for Ms. R. The nursing supervisor in this case would sit down with Ms. W. and map out a strategy for the patient's care, remembering that the key to successful delegation "depends on the quality of RN and NAP working relationships, timely ongoing communication, initiative and a willingness to collaborate" (Potter, Deshields, & Kuhrik, 2010, p. 157).

The Role of the Nursing Supervisor

It is at this point that the nursing supervisor can be most effective — by determining the underlying problem and taking the necessary actions to help the nurses under his or her charge become more effective in their duties. As Potter et al. determined, "nurse managers play a key role in the facilitation of delegation practices" (p. 157).

Ensuring that Ms. W. is open to collaboration is central to the supervisor's approach. The nursing supervisor can assess her attitude by first alleviating any fears of inadequacy that Ms. W. might be feeling. Oftentimes, new — and sometimes even experienced — nurses can feel overwhelmed by circumstances, especially when a patient is not cooperating or does not seem to understand the importance of maintaining treatments or their own health.

Building Collaboration and Alleviating Nurse Concerns

After alleviating Ms. W.'s concerns, the nursing supervisor can then explain how Ms. W. can facilitate care for the patient without being overwhelmed by the many aspects of that facilitation. The nursing supervisor can use the example of Ms. R. as a productive starting point, pointing out that being an effective nurse does not mean handling all of a client's needs alone — that she is part of a professional healthcare team, with each teammate capable of handling certain aspects of the client's treatment.

The nursing supervisor can also explain that it is sometimes necessary to go outside the immediate team and bring in additional assistance. Depending on the client's needs, it may even be necessary to delegate the client to another facility, such as a hospital.