Chapter 4: "Delegation" (pp. 32-38)

Chapter 4: Delegation

​(pp. 32-38)

NAs function under supervision of licensed nurses:

• APRN

• RN

• LPNs/LVNs​

​

​Know the specific terms used in the state where you seek/gain employment

​

< ------------------ Review definitions!

Introduction to Delegation

​(p. 32

You will learn how to perform routine nursing tasks. Examples include:

• ​Moving & transfer procedures

• Hygiene & grooming measures

• Height & weight

• VS

​

​Delegated Nursing Tasks

​-> only allowed in certain states, these are tasks that are NOT routinely done by NAs

• Urinary catheter​ insertion [Ch. 28]

• Giving tube feedings [Ch. 32]​

​

(pp. 32-33)

APRN (advanced practice registered nurse)

• Delegates to RNs, LPNs/LVNs, & NAs

• APRNs include NPs, ​clinical nurse specialists, CRNAs, & nurse midwives

​RN (registered nurse)

• Delegates to LPNs/LVNs & NAs

​LPN/LVN (licensed practical/vocational nurse)

• Delegates to NAs (if allowed by state's nurse practice act)​

NA (​nursing assistant)

• Cannot delegate, re-assign, or re-delegate!​

(p. 33)

​Who Can Delegate?​

Multiple Choice

TRUE or FALSE:

Accountable means to be responsible for one’s actions and the actions of others who performed the delegated task.

• TRUE

• FALSE

For safe delegation, the _____, the _____, and the _____ must fit!

• person's needs

• nursing task

• ​staff member performing the task

​

​Delegation decisions must result in the best care for the person.

• To make delegation decisions, the nurse follows a process

  • See Fig. 4-2 (next slide --->)​

​(p. 33)

​Delegation Process

​Delegation Process; (p. 34)

Multiple Choice

You have been delegated several tasks. What should you do?

• Refuse the tasks that you do not have time to complete.

• Ask the RN to help you prioritize the tasks.

• Delegate the tasks you do not have time for to another nursing assistant.

• Complete the tasks in order of "easiest" (first) to "hardest" (last).

Multiple Choice

TRUE or FALSE:

Nursing assistants cannot delegate.

• TRUE

• FALSE

Multiple Choice

TRUE or FALSE:

LPNs/LVNs cannot delegate to nursing assistants.

• TRUE

• FALSE

The RN must understand the person's needs

• In order to assess person's needs, the RN answers these​ questions

  • See image [top-left]

​​

The RN must know your knowledge, skills, and job descriptions

• In order to assess your knowledge and skills, the RN answers these questions

  • See image [bottom-left]​

​

​

​(p. 34)

Assessment of Needs​

The RN asks questions to assess your understanding:

​

• S/he may ask you to explain what you will do

• Do not be insulted​

  • Intent is to protect person + you!

​

​

(pp. 34-35)

​Communication

​Following the completion of a task, the NA will __________.

• Report & record care given

• ​Report & record observations

  • Will be covered in chapter 8​

​

​

​(p. 35)

Multiple Choice

The nurse is delegating a task to you. Which of the following involves the communication step?

• The RN observes the care you give.

• The RN discusses the steps of the task.

• The RN thanks you for a job well done.

• The RN assesses the person's needs.

The RN follows up on concerns & takes action if:

• Task is not done in timely manner

• Task does not meet expectations

• Change in person's condition

​With NA's help, nurse can act before person's condition changes ("declines")

​

After task ---> RN may review/discuss with you:

• ​Helps NA learn

• NA develops ideas for adjustment(s) in similar situations​

(p. 35)

Guidance & Assistance

Follow up -> to review & take action

Feedback -> to respond

​​

• When deciding if delegation was successful, the RN answers these questions

  • See image [left]​

(p. 36)

​Follow Up & Feedback

Multiple Choice

The nurse provides corrective feedback on a task that you did not complete well. Which of the following responses is the most appropriate?

• Tell the nurse that you were too busy at the time.

• Inform the nurse that you were not taught the correct steps.

• Suggest ways in which your performance can improve.

• Remind the nurse of your education and knowledge.

Multiple Choice

TRUE or FALSE:

The delegating nurse must make sure that the task was completed safely and correctly.

• TRUE

• FALSE

The NA must protect the person from harm!

• When delegated a task, NA has 2 choices:

  • Accept task

  • Refuse task

• NA must use the Five Rights of Delegation when choosing to accept/refuse each task

  • See Box 4-1 [right]​

​

​(p. 36)

​Your Role in Delegation

Multiple Choice

Which of the following is a task that can be delegated to you?

• Administer medications

• Insert an IV catheter

• Turn and re-position a person in bed

• Supervise others

Multiple Choice

The nurse delegates a task to you. Why might the nurse observe you?

• S/he does not trust you to complete the task.

• S/he wants to make sure that you complete the task correctly.

• S/he wants to test your skills and abilities.

• The RN must, by law, observe every task s/he delegates to a CNA.

Use common sense

• Is this safe for the person?

• Share concerns with RN

​

NEVER ignore an order/request to do something​

• If task is within SOP, RN can ________ to increase your comfort.

  • answer questions

  • demonstrate

  • help/observe prn​

​

(pp. 36-37)

​Refusing a Task

Unacceptable reasons to refuse a task within SOP:

• I don't like that task.

• I don't want to do that task.

​

​

The NA must have sound reasoning for refusing a task​. Otherwise....

• May place person at risk for harm​

• Could lose your job​

(pp. 36-37)

Multiple Choice

TRUE or FALSE:

You can refuse a task because you don't want to do it.

• TRUE

• FALSE

​(p. 38)

We will be having a quiz over the first section of vocabulary words upon your return to class on Monday, 08/29/2022!

Ch. 5: Ethics & Laws (pp. 39-56)

Chapter 4 Review Questions will now be posted; they are due on Friday (8/27/22) by 2359 via Google Classroom!

​Ch. 4: Delegation (pp. 32-38)

Upcoming Homework Due Date(s)

HAPPY STUDYING!