The process of registered nurses (RNs) delegating roles to unregistered assistant personnel (UAPs) is complex guided by strict rules and regulations. The American Nurses Association (2022) acknowledge that the challenging requirements of contemporary nursing environment require RNs to delegate some duties to UAPs. The state laws, decision tree for delegating UAP, institutional policies, and Nursing Practice Act are some guiding principles that RNs should adhere to when delegating duties. According to Barrow and Sharma (2023), the responsibility of performing assigned tasks lies with the UAP, but the accountancy of the job is reserved for the RN. Due to the delicate nature of nursing practice, RNs are usually uncomfortable to delegate duties without observing the rules to the latter.
While analyzing nursing delegation practices, Barrow and Sharma (2023) highlighted the “five rights” that should be observed: right task, right circumstance, right person, right supervision, and right communication. The right task states that UAPs should be assigned tasks that they are familiar with and which are within the organizations’ guidelines. Secondly, the right circumstance means that UAPs should have the right resources, equipment, and environment to undertake the assigned job. Thirdly, the right person states that the potential UAP must have the requisite skills to perform the assignments. Furthermore, the right supervision means that the assigned nurse be given proper direction and oversight from a proficient nurse. Lastly, right communication dictates that delegators explain the performance expectations to the UAP to determine the assignment’s dos and don’ts.
According to the American Nurses Association (2022), a clear guideline should be observed when assigning duties to UAPs-decision tree for delegation of duties. The flow charts contain various guidelines that help RNs make critical decisions about whether to assign tasks to their unqualified subordinates. For instance, the first decision box examines if the RN has conducted an assessment before appointing a junior staff. The decision flow dictates that the nurse can proceed to the next step if an assessment has been undertaken. However, the RN should not consider delegating such cases if the assessment has not been done. The second decision box evaluates if the task falls under the jurisdiction of the UAP. If it does, the RN can consider moving to the next stage. However, if it does not, the nurse should abolish the process. The decision flow chart moves forward a couple of other steps until the last one, which confirms if the unqualified nurse has ample supervision. Notably, RNs may choose not to delegate a job because it does not meet the last requirement: the availability of supervision mechanisms.
Indeed, the existing rules and regulations governing the delegation of duties in nursing practice make it hard for RNs to assign UAP tasks carelessly. Furthermore, the consequences of performing a healthcare error due to negligence or wrong decision-making motivate qualified nurses to carefully follow the underlined procedures while delegating duties, essentially to UAPs. In some cases, RNs prefer to perform the crucial tasks that they feel may pose a challenge to a UAP to guarantee the safety and well-being of patients.
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