Introduction
With the advent of new technologies, advancement in medicine, economic constraints, and the increased population, there is a need to reconstruct our medical and healthcare delivery system. According to the National Council of State Board of Nursing, the demand for nurses is increasing every day due to an increase in chronic diseases, the average age of humans, and limited facilities of healthcare. With the advancements in the healthcare industry, the concept of delegation has emerged in which Unlicensed Healthcare Workers (UHCWs) are delegated some duties by the nurses. The delegation concept in nursing was introduced in 1859 by Florence Nightingale, and this idea has evolved ever since.
According to the definition provided by Joyce V. Winsted:
“Delegation is a process of decision making in which a nurse, based on her best knowledge and judgment, transfers her responsibility fully or partially to another nurse.”
In the Delegation process, nurses hire some unlicensed workers to provide service to patients whenever there is a shortage of available nurses or when the patients are in critical condition, and there is no time to wait for an expert nurse to provide services. The use of delegates is, however, not special for the time of need; delegates are also used as a regular practice to ensure there is no risk to the patient’s health. The nursing decisions related to the delegation of tasks and training of UHCWs must be made with extreme care and in the best interest of the public, as the outcomes of efficient healthcare and quality medical treatment are dependent on effective methods of delegation.
Discussion
Registered nurses sometimes provide themselves as delegates as they are trained and experts in their field, but there are some factors that are critical when assigning a registered nurse as a delegate. Delegates should have knowledge and skills in the field before they start their duty. As professional knowledge and skills are a must for a delegate, the healthcare professional sometimes assigns registered nurses for delegation services. The registered nurses then need to be careful in their service and must have full knowledge about the healthcare of patients and procedures devised by nurses, must learn to work under stress and have decision power in times when someone’s life is based on the critical decision. Registered nurses are advised to take procedures defined by nurses seriously and perform according to the plan strictly in case of urgency to avoid any mishaps. A conflict may sometimes arise when registered nurses try to use their own experience in the nursing field and ignore the strict advice of nurses in case of emergency; this conflict may result in wrong decisions and cost a patient his life. This issue is critical, and every registered nurse should follow the advice of experienced nurses in every decision, as someone’s life depends on it.
While delegating a registered nurse to a specific task, there are some points that I have to consider to provide the best healthcare to patients. The first step is to select the right person for a delegation task. Not everyone in the hospital has the same skills; for example, a nurse who has been serving in the Intensive Care Unit for the past five years is more experienced in CPR rather than one who has experience in the orthopedic department, so selecting a suitable person for the task is necessary. The next important thing is the task assignment. As a healthcare professional, I must ensure that the task I am assigning to a person falls within the expertise of that person. The daily routine tasks can be delegated easily, but for the complex tasks, only the experts of the field should be trusted and used. Communication is key in the delegation process; whenever a person is selected for delegation, the assigner should communicate the whole process clearly and also provide the critical outcomes that may arise in the procedure. Miscommunication in delegation can lead to severe outcomes. A healthcare professional needs to be aware of the current situation of the patient and whether or not he can be assigned to a delegate. Patients with critical conditions should not be delegated to any other nurse, even if the nurse assigned has full expertise in the field. Lastly, it is my responsibility to supervise and evaluate my appointed nurse, provide guidance when necessary and make sure they are performing efficiently and carefully while performing critical tasks on patients.
Delegation is nursing important, and it must be done efficiently and effectively because of many reasons. There come scenarios in hospitals when there is a shortage of nurses, the physicians are then left with no choice but to delegate some tasks and provide services where they are needed more. In case of natural disasters and catastrophes, there is a shortage of nurses and nursing staff; in these scenarios, if nurses devote themselves to a single patient, a lot more will suffer who also deserve medical attention. In these scenarios, nurses need to delegate some tasks to make themselves available for others where their expertise and specialized care are required more. The delegation of the task is essential so that the assigned nurse can plan, reason, and critically analyze healthcare given to patients. Not all nurses have the same critical analysis ability, and some have better knowledge than others. Therefore, some nurses have to delegate their tasks to someone who has more experience and technical expertise related to the present situation. In this scenario, the nurse who delegates tasks has to carefully supervise and observe the procedure as she shares the responsibility and cannot just walk off the case if she delegates the task. Nowadays, therapies have become more complex, and processes are becoming more technical. Due to this reason, there can be no one who fully understands every critical detail of all equipment; here is where delegation is needed to ensure that the equipment that is used in the process is used properly and the readings are made accurately. Nurses need help from other nurses who have better knowledge and understanding of the equipment and operate it with care and accuracy.
Conclusion
In short, the delegation of tasks in nursing practice is an essential requirement. It has many benefits in healthcare; it helps nurses in performing their duties well and provides efficient care to patients. However, possessing essential leadership and management skills while delegating a task is a must. Effective delegation can only be done if the nurse has enough confidence in her colleague and the delegates have enough expertise in the task assigned. It is the sole responsibility of the nurse to train the UHCWs and make sure that they have enough knowledge and skills before they are delegated to a task so that in case of an allegation of insufficient healthcare, the nurse or the delegate is not held responsible. The nurses should also carefully analyze the performance of delegates, detect any flaws and mistakes in the service and correct them immediately. It is also the nurse’s responsibility to check if the delegate should or should not be assigned to a specific task. The delegation process is of utmost importance because, as healthcare providers, we need to consider the needs and care of the patients as a priority, as making critical decisions in healthcare could affect a patient’s treatment and, in the worst case, his life.
References
Drummond, A. (2014). Working with Aboriginal and Torres Strait Islander health workers and health practitioners. Yatdjuligin, 163.
https://www.ncbon.com/vdownloads/course-bulletin-offerings-articles/bulletin-article-winter-2013-delegation.pdf
Joyce V. Winstead. (2013). Delegation: What are the Nurse’s Responsibilities? (2018). Ncbon.com. Retrieved 13 February 2018, from
Kim, E. J., & Gu, M. O. (2015). “Recognition of nursing competency importance, nursing competency level, and their influencing factors of nurses in the long-term care hospitals.” Journal of the Korea Academia-Industrial Cooperation Society, 16(3), 1989-2001.
Lichtenstein, B. J., Reuben, D. B., Karlamangla, A. S., Han, W., Roth, C. P., & Wenger, N. S. (2015). Effect of physician delegation to other healthcare providers on the quality of care for geriatric conditions. Journal of the American Geriatrics Society, 63(10), 2164-2170.
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