Running head: DELEGATION PAPER 1

Delegation Paper
Kathy Le
California State University, Stanislaus

Delegation Paper
There is more nursing to do than there are nurses to do it, says the American Nurses

Association (ANA) and the National Council of State Boards of Nursing (NCSBN) (ANA &

NCSBN, n.d.). The shortages of nurses in hospitals, facilities, and the community are certainly a

problem. With the increasing need on healthcare, grows the demand for certificated nursing

assistants (CNAs), licensed vocational nurse (LVNs), and registered nurses (RNs). The RN

needs to delegate effectively to the CNAs and LVNs in order to provide the best patient care.

The ANA and the NCSBN quote sums up the importance for learning delegation, if RNs dont

learn the overview of delegation and practice a case study, their practice will eventually become

tiresome.
Overview of Delegation
Delegation and assignments are often confused as being the same thing. However, they

could not be anymore different. Delegation is defined as, the process for a nurse to direct
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another person to perform nursing task and activities (ANA & NCSBN, n.d.). While

assignment is defined as, where an RN directs another individual to do something that the

person is already authorized to do (Weiss & Tappen, 2015, p.104). RNs need to be familiar

with LVNs and CNAs the scope of practice at their place of work. Different work sites allow

LVNs and CNAs to do specific skills. For example, a CNA in a hospital would be allowed to

hook up an electrocardiogram (EKG) while a CNA in a nursing home would not. RNs also need

to assess whether or not the worker is competent in perform the skill. For instance, a new CNA

who has no experience hooking up a EKG, would not be who the RN delegates that task to. In

that situation, the RN would either give the task to a more experienced CNA or teach the new

CNA how to do the task. The RN is responsible for delegating the right task to competent

employees, and making sure that task gets done correctly. Using the Five Rights of Delegation

will help RNs in remember how to delegate properly. The Five Rights of Delegation includes,

right task, right circumstances, right person, right direction and communication, and right

supervision and evaluation (Weiss & Tappen, 2015, p. 105). This a great tool to apply

whenever RNs are thinking about delegating a task to another worker. The RNs will just think

about the five rights, and mentally check them off to see if they should permit the task to another

worker.
Case Study
Description
The author works as a CNA in a small, privately owned nursing home. There is a lot of

delegation that takes place between the LVNs and the CNAs. Most of the time, it is poor

delegation. One major example of poor delegation happened between the author and a LVN

during the night shift. It was getting late on the shift, everyone was getting tired and itching to

go home. The LVN was particularity feeling very worn out. She was pregnant during the time

and her ankles were so swollen from standing up all shift. Her mood and physical exhaustion
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definitely influenced her poor delegation skills. The LVN had told the author to go turn off the

nebulizer and retrieve the portable portion of the machine from a residents room. The LVNs

reasoning to delegate was because she was too tired to walk all the way to the residents room.

The native author felt bad for the LVN and her swollen ankles, so she said yes to the delegated

task. The author quickly learned upon entering the room that she had made a mistake by saying

yes. The author fumbled around the room trying to find the nebulizer and ended up waking up

the resident. The resident woke up in confusion and started speaking Spanish to the author. The

author tried to explain by pointing at the nebulizer but could not communicate clearly to her.

The author then went back to the LVN, and told her she could not complete the task. The LVN

then went to the room and completed the task by herself. It was a lot of unnecessary confusion

that could have been prevented.

Analysis
The delegator did not explain what to do. The LVN simply told the CNA to go turn off

the nebulizer and take back portable part of the machine because she didnt feel like walking all

the way to the residents room. The author did not receive enough information about the task.

The author did not even know what kind of nebulizer it was or where it was in the room. The

Five Rights of Delegation were not met. It was not the right task, right circumstance, right

direction and communication, nor right supervision and evaluation. The outcome of the task was

unsuccessful. The CNA did not finish the task and the LVN had to end up walking to the room

to do the task herself.

The author recommends that there be a training day for LVNs to learn about delegation

and the Five Rights of Delegation. The training can be one hour in duration and will educate the

LVNs about the proper way to delegate and utilize the Five Rights. Once the training takes

place, the author recommends that the LVN not delegate the task to the CNA. However, if the

LVN wanted to delegate the task for the future, she should fully explain what to do. The LVN
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should also go to the room to teach and supervise the CNA. Afterwards, the CNA would be

competent for delegating the task to.

Learning the importance of delegation and how to apply it is essential to nursing.

Knowing the difference between delegations and assignments are key terms to differentiate while

practicing as a nurse. There will be many cases of poor delegation and good delegation when

working in the nursing field. RNs should be able to delegate tasks correctly in order to increase

productivity. It up to educated nurses to apply the Five Rights, so their patients can receive the

best care.

References
American Nurses Association (ANA) and National Council of State Boards of Nursing

(NCSBN). (n.d) Joint statement of delegation. Retrieved September 7, 2016 from:

https://www.ncsbn.org/Delegation_joint_statement_NCSBN-ANA.pdf
Weiss, S and Tappen, R. M. (2015) Essentials of nursing leadership and management (6th

Edition). (pp. 104-105) F.A. Davis Company, Philadelphia

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