Delegation in Nursing: Steps, Skills, and Solutions for Creating Balance at Work
Learn how to implement the Five Rights of Delegation to make life easier and avoid nurse burnout.
Image via Unsplash.com/Marten Bjork
As a nurse, you may often feel as if you’re expected to handle everything that comes your way. But as much as you may want to, it’s just not realistic. There’s only so much you can do in a day, and trying to take on too much too often can quickly lead to fatigue and burnout. That’s why it’s crucial that you to learn how to delegate tasks early on in your nursing career.
What Is Delegation in Nursing?
Let’s say that “Nurse Sydney” is swamped with six patients to check in on, charts to fill out, and medications to order. She has two hours left in her shift and needs some qualified, helping hands to complete everything effectively and on time. She needs to delegate.
Simply put, delegation is a tool that lets you shift some of your responsibilities to another person. In nursing, this means that a nurse is assigning a responsibility, skill, or procedure to a fellow staff member (licensed nurses as well as unlicensed assistive personnel). But, it’s important to note that the person getting the new assignment is usually being asked to do something beyond their traditional role—and thus rules, approvals, and procedures should be put in place.
Who Can Delegate Tasks?
All nurses can delegate, but it’s important to understand how delegation laws work in your state. Different areas have different regulations, so you should always know which rules apply to your role as a nurse, and make sure your supervisor is supportive and feels your team can handle the work.
What’s the Difference Between “Delegating” and “Assigning”?
Think of it this way: “Assigning” is the act of handing over a patient to someone else, while “delegating” is the act of handing over a task. When “delegating,” you’re still in charge of the patient’s care and ultimately responsible for your teammate’s work. When “assigning,” you’re giving the responsibility to someone else.
Why Is Delegating Important in Nursing?
A 2012 study conducted by the Nursing Quality and Care Forum discovered that many nurses took on work that other teammates (i.e., LPNs or health aides) were qualified to do. Because these nurses were distracted by extra tasks, they ultimately didn’t get as much done as they could have. As a result, they ended up feeling tired and overworked.
What does this mean for you? At the end of the day, if you’re able to lift part of your massive workload off your shoulders, you’ll be in a much better position to make good decisions and deliver quality care to your patients.
What Are the “Five Rights” of Delegation?
There are five important tenets of delegation in nursing, better known as the Five Rights of Delegation. When you delegate a task, you must:
1) Delegate the Right Task
Make sure that you delegate tasks that would both save you time and can be done just as effectively by another nurse or team member.
2) Under the Right Circumstances
Look for the right timing. If someone’s slammed during their shift, they won’t be the right candidate to whom yiou should delegate your project. Or if you have a critical care patient, you may want to delegate other patients to someone else and care for the more complex case yourself.
3) To the Right Person
Make sure you’re only delegating tasks to nurses, teammates, or patient care associates who are qualified to handle them.
4) With the Right Directions and Communication
Make sure you provide your teammate all the necessary information they need to know about a patient so that they can perform the task properly. Specify your expectations, clarify the work you want done, and offer any guidance your teammate might need along the way.
5) Under the Right Supervision and Evaluation
The ultimate responsibility for the patient lies with you, so be vigilant about checking in with your teammate to make sure that they understand the task and feel comfortable doing it. If they need guidance, delegate supervision to another nurse or supervise the person yourself. Follow up with the patient and the staff member to see how it went. And remember to always have colleagues report any issues or concerns immediately.
Skills You’ll Need to Delegate Effectively
Delegation in nursing isn’t just about getting work off your plate; it’s also about training other team members so that they know how to do their jobs properly. All in all, good delegation requires a number of skills, including:
- Effective Planning: Start the day by planning which tasks to delegate (and to whom) so you can keep everyone on the same schedule.
- Good Communication: Know how to explain to teammates what needs to be done in a clear and efficient way.
- Follow-Through: Never just delegate a task and forget about it. Always follow up with both the patient and teammate to see how things are going.
- Understanding Your Coworkers: You need to know your teammates’ strengths or you might misuse their talents. Familiarize yourself with each person’s skills and weaknesses and delegate accordingly.
- Fearlessness: Don’t be afraid to delegate. It’s part of your job, and it will help ensure that you can make better use of your nursing talents.
- Leadership: You can’t delegate if you aren’t a good leader. You need to be comfortable with making quick decisions, and be ready to delegate various tasks to your teammates at a moment’s notice.
- Trust: To delegate effectively, you need to be able to trust that the other person can get the job done—and properly. If you keep checking up on your teammate because you don’t think they can handle it, you run the risk of wasting both their time and yours. ___
Effective Delegation in Nursing: A Real-World Example
Knowing the Five Rights of Delegation and actually understanding how to implement them are two different things. Here’s an example of what the delegation process could look like in a real-world scenario.
Take, for instance, an 89-year-old patient who just had a hip replacement. As the nurse on this case, you’ll be responsible for performing aftercare, monitoring the patient’s wound for complications, helping with mobility, giving them a bath, and generally seeing to their comfort. Of course, this is in addition to caring for your other patients — meaning you’ll have a full plate during your shift.
Step 1: Choose the right tasks to delegate.
If you need more time in your day, identify some of the major time sucks on your to-do list, such as bathing. Because the patient is still under your care, you’ll need to check for signs of infection daily. However, another nurse can help bathe the patient. You might also consider delegating activities like bathroom visits, bedpan duty, or other nonessential care.
Step 2: Choose the right circumstances.
Timing is everything, so you’ll need to make sure that you’re paying attention to the circumstances under which you’re delegating a task to someone else. In this scenario, you’ll need to choose someone who has a light patient load and can handle the addition of another task. However, if the patient’s condition begins to deteriorate, know that it’s no longer the right circumstance for delegation and that you’ll need to step back in to take over.
Step 3: Choose the right teammate.
Choose someone with experience caring for geriatric patients, as well as someone who’s worked on patients with hip replacements and understands how to bathe someone in that kind of condition. You should also make sure that you’re conforming to your state’s laws regarding the kinds of activities different team members can and cannot do. When the teammate has completed the task, always check into make sure that they performed the job properly.
Step 4:Choose the right directions to give.
Explain exactly how you want the teammate to perform their new duties. For example, with bathing, make sure that they know to avoid submerging the wound. If they’re helping the patient walk, make sure that they bring along a walker. Be as precise as possible to avoid any mishaps.
Step 5: Follow up with supervision.
Check back in throughout your shift, both with the patient and the teammate. Ask the patient how things are going, and double-check the wound to make sure that everything looks good. Ask the teammate if they performed their duties properly or noticed any issues. If all went well, compliment their work and thank them for their help. If they made a mistake, discuss it with them and talk through any alternate steps they could’ve taken instead.
The Benefits of Proper Delegation in Nursing
So, what benefits can come from delegating nursing tasks effectively? Take a look:
- Better Workload Balance: Everyone on your team will be contributing evenly and working together to provide quality care to patients. Both nurses and other teammates will have balanced loads during their shifts.
- Decreased Risk of Burnout: With less work on everyone’s plate, you can help prevent your teammates from burning out. In turn, you’re all be much more likely to provide your patients with the quality care they deserve.
- Enhanced Team Dynamics: When you see just how great other teammates are performing, you’ll discover their specialties and feel more comfortable relying on them when you need their help. Delegation also gives you the chance to teach others who might not be as experienced as you are. They can take on new tasks after you show them what to do.
- More Time for Your Patients: Not sure what’s wrong with a patient? When you don’t have to worry about tending to busywork, you can spend more time studying their troubling symptoms.
- More Time for Yourself: Now that you don’t have to run around the halls your whole shift, you can take time to breathe and tend to any needs you’ve been putting off. ___
3 Common Concerns Nurses Have About Delegation
Asking for help isn’t always an easy thing to do. But in order to be the very best nurse you can be, you’ll need to become comfortable with it. Here’s how to get over three of the most common hangups nurses have about delegating.
Concern #1: You don’t feel like you can give another person work.
Don’t think this way, even for a second. As a nurse, you’ve made it through years of school and are in charge of saving people’s lives every day, so you have what it takes to delegate.
However, you may also be working on a team or at a facility that doesn’t encourage this kind of collaboration. If that’s the case but you’re feeling as if you’re stretched too thin, you need to raise this issue immediately. Sit your manager down and explain your situation; they don’t want you to burn out either, so chances are good that your manager will want to work with you to solve the problem. And if you still get resistance to the idea of delegating tasks, you may want to consider moving to another team or facility.
Concern #2: You’re afraid that delegating a task to a teammate will make them feel angry or resentful.
Nurses are “do it all” kind of people and typically come into the workplace expecting to have tasks delegated to them, not the other way around. Now you get to hand off bedpan duty? Amazing!
That said, it’s always a good idea to switch up the kinds of tasks you delegate, as well as to whom you’re delegating them. And, as always, make sure to follow up with compliments and gratitude so those to whom you delegate know that you appreciate their help.
Concern #3: You’re not sure how qualified the staff member is to do the task you’re delegating.
This is a very valid concern that you shouldn’t take lightly. If the issue is that you simply don’t know whether a staff member has handled a certain task before, just ask. If they say “no” or can’t give you correct answers to clarifying questions, move on to someone else.
If you’re not confident that the person can perform the given task properly, simply don’t give it to them. Find a teammate who you know has done the task before AND has done it correctly.
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