SchoolNurse.com: School Nurses and Delegation

School Nurses and Delegation

Delegation means transferring the execution of a task while retaining accountability for the outcome. This article outlines a framework and important habits for the registered nurse in any setting. It cites four "rights" of delegation: the right task, the right person to do the job, the right communication, and the right feedback for the worker. The author recomends that unlicensed staff be assigned directly to an RN, not to a group of clients.

Formal training is cited as critical to assure competency and to document inability to perform. As well, assistants need more than basic care skills:
1) communication skills - particularly listening;
2) decision-making skills, (recognizing when to call the RN); and

3) critical thinking, (recognizing hazards or potential harm). RNs need to be directly involved in development of the job descriptions, training, and evaluation of unlicensed staff who work under their licenses.

Other critical components of safe delegation include: determining the patient’s status and type of care needed; communicating clearly and listening carefully to the unlicensed assistant to confirm that s/he knows the purpose of the tasks; and evaluating both the worker’s performance and the client’s status.

Skillful delegation and consistent documentation of training and performance of unlicensed staff as well as the client’s condition are considered "good malpractice insurance."

( Parkman C. Am J Nurs. 1996; 96 (9): 43-47)

COMMENT: Delegation principles and practices are pertinent in school settings even if the relationship is non-supervisory. The RN must determine and clearly indictate the circumstances requiring that s/he be called. The registered nurse will be held increasingly accountable for directions given to secretaries and teacher assistants in the event their actions result in harm. - J.O.

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