Question

Describe how delegation is currently used in the acute care settings. Focus on the role of the staff nurse as the delegator.  

Answer 1

Delegation is defined as transferring of responsibility to subordinates or staffs on behalf of the manager. It is an act through which a manager gives authority to their subordinates and others to attain certain tasks.

Delegation simply means transferring of responsibility from one person to another

Delegation currently used in acute care settings;

Salient Features:

· Not to delegate total authority

· Not to delegate authority which person does not possess

· Should be only for organizational purpose and not for personal purpose

· It does not imply reduction in power

In any setting Delegation will be followed as per below characteristics;

· Delegation of authority which can be exercised by higher authority

· Delegation can be of any kind

· Delegation does not mean transfer of final authority

· Does not involve surrender of power

5 Rights to delegation

National Council of State Board of Nursing in the US presented 5 rights to delegation from the perspectives of both nursing service administrator and staff nurse. They are,

1. Right task

2. Right circumstance

3. Right person

4. Right direction/communication

5. Right supervision/evaluation

Based on the needs of patient care, all below mentioned types of delegation works in acute care settings.

· With the restructuring of care delivery models registered nurse at all levels are expected to make assignments for and supervise the work of different levels of employees.

· Registered nurses perform role of supervisor and delegator need preparation to assume these leadership tasks.

· Nursing schools and health care organizations prepares professionals for the delegator role.

· This includes basic principles of delegation, right person, at a right time for the right reason, and an action must be undertaken when work is delegated in appropriate manner.

· Delegation provides a means for increasing productivities.

· It is a managerial tool for subordinate accomplishment and enrichment.

There are different types/kinds of delegation used, they are;

1. Full delegation – Providing full authority to perform all the functions of department. Ex: In the absence of head nurse, the junior nurse will handle the responsibilities like reporting and interdisciplinary communications.

2. Partial delegation - Providing authority to perform specific functions of department. Ex: There are certain tasks which will be allocated to junior nurse like medication inventory

3. Conditional delegation – Legislature makes a law and is done by executive authority. Ex: This is set as per the institutional rules.

4. Formal delegation – Providing authority as per the organizational structure. The delegation of responsibility happens as per organizational rules. But internally in emergency nurse care provider roles might be delegated but not the job described roles.

5. Informal delegation – Authority is nor entrusted to work neither given authority formally. Which is individual based. Ex: Nurse in charge will grants certain responsibilities within the unit for the best functioning thus helping the patient care.

Staff nurse is responsible for;

· Assessing client

· Delegating appropriately

· Communicate clearly

· Providing monitoring

· Supervision.

Delegation happens in 4 phases

1. First Phase: Analyze tasks and direct Instruction. Explaining the job roles and informing what exactly has to be done.

2. Second Phase: Investigate, select and Propose. Responsibility of a person on delegation of tasks who will identify the exact need for delegation and identifying the strength and weakness of staffs who is responsible for the job and select with the right skillset to right job.

3. Third Phase: Provide support and report. Making sure that the delegated tasks has been taken care and is running smoothly without hassle. And reporting the results to the higher authority.

4. Fourth Phase: Review and feedback. To simply check if the delegated tasks are performed and desired goal is reached. Periodic feedback will be given on the completed tasks and monitor for progress.

Role of the staff nurse as the delegator

· Plan ahead

· Identify necessary skill and levels

· Select most capable person

· Communicate goal clearly

· Empower the delegate

· Set deadlines and monitor progress

· Model the role: provide guidance

· Evaluate performance

· Reward accomplishment

· Identify the symptoms of poor delegation

o Dissatisfied subordinates

o Disorganized effort

o Person always busy

o Work never completed in time

o Constant time pressure

o Pending activities

· Avoid under or over delegation of tasks, thus delegating right responsibility to right person.