Running head: DELEGATION

Task Delegation: First Experience as a Student Nurse

Tuyet Nguyen
California State University, Stanislaus
October 8, 2014

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Task Delegation: First Experience as a Student Nurse

Delegation is an important nursing skill that requires knowledge and practice. With a
growing demand on healthcare and high workloads for registered nurses (RNs), effective
delegation has become more and more pressing in order for RNs to be able to concentrate on
their professional nursing activities (Krnested & Bragadttir, 2012, p. 10). Effective
delegation helps gain work efficiency which can only be achieved when RNs and nursing
assistive personnel (NAP) work together in partnership to manage the changing priorities of
patient care (Potter, Deshields, & Kuhrik, 2010). When the tasks are incorrectly delegated, there
is the potential for compromised patient care. As a student nurse, I have had many opportunities
to perform delegated tasks during clinical rotations. However, I have never forgotten the first
delegated task I performed on the first day of clinical during the second semester.
Delegation is defined as the process of transferring responsibility for the performance of
a task from one individual to another while the delegator still retains the accountability for the
outcome (Potter, Deshields, & Kuhrik, 2010). RNs can gain effective delegation skill by
following the five rights of delegation. They are right task, right circumstances, right person,
right direction and communication, and right supervision and evaluation (National Council of
State Boards of Nursing, 2005). In other words, these five rights emphasize the importance of
RNs being responsible for assessing the NAPs competency based on patients health status,
giving NAPs clear direction and communication before performing the delegated tasks, and
providing NAPs sufficient supervision and evaluation during and after performing the tasks
(National Council of State Boards of Nursing, 2005). Failure to follow these rights when
delegating tasks can result in conflict and threaten patient safety.
During the medical and surgical rotation in second semester, I was excited and nervous.
On the first day being in the hospital setting, I was eager to ask the assigned nurse if I could help

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with anything. I was delegated the task of feeding the patient. I thought that should be simple
for me to complete that delegated task. I brought the breakfast tray, proceeded to the patients
room, and introduced myself. My patient was an elderly female with a history of stroke,
hypertension, diabetes, and dementia. Her admitting diagnosis was pneumonia. As I was
feeding the patient with the first bite of smashed potatoes, I noticed her face grimacing and
gagging. I offered the patient a drink, but she still struggled with swallowing the food. I stopped
feeding the patient and notified the nurse. The nurse forgot to tell me that the patient had a
problem with swallowing after the stroke. The nurse then notified the physician and a
nasogastric tube placement was ordered.
Considering the five rights of delegation in my experience, the nurse did not follow all
five rights when delegating the task. She delegated the right task because feeding the patient is
considered a non-invasive task. Repetitive interventions and non-invasive procedures are often
acceptable for delegation (Potter & Perry, 2009). However, the nurse did not delegate the task
under the right circumstance because the patient was not stable for me to carry out the task. The
nurse delegated the task to the right person because I have had previous training as a student
nurse. But, she did not provide me the right direction and communication. She did not notify
me about the patients swallowing problem due to the previous stroke. I thought the nurse
wanted me to feed the patient because the patient was confused and weak. If the task was
delegated to another NAP who was busy with other assigned patients, that NAP might rush the
feeding and the patient might get choked. At the core of delegation is effective communication.
Good delegation requires clear, concise and complete communication (Potter, Deshields, &
Kuhrik, 2010, p. 159). Failure to communicate the important information regarding the patients
health status when delegating any task can seriously threaten patient safety. Furthermore, the
nurse failed to provide me the right supervision and evaluation. She did not go into the patients

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room to check how the feeding was going. When I notified the nurse about the patients
swallowing problem, she did not evaluate the patient by herself. My first working experience
with the nurse in the hospital setting was not as ideal as I had imagined.
The first thing I would have done differently is ask the nurse the rationale behind the
reason she delegated the feeding task to me. By doing that, the nurse should remember the
swallowing problem and give me the specific instructions of how to perform the task safely and
when to stop the feeding. The second thing I would have done differently is ask the nurse to go
into the patients room to reassess the patients swallowing status instead of just listening to my
observation. By doing that, the patients status can be evaluated accurately and I can also learn
from her assessment skill.
Performing a simple delegated task with lack of important information about the patients
health status can seriously threaten patient safety. If I were the nurse, I would have delegated
differently by assessing the competency of the person performing the task, giving clear and
specific instructions about limits and expectations, and providing sufficient supervision and
evaluation during and after performing the task. By evaluating the experience, I learn more
about the importance of following the five rights of delegation and have a better understanding
on how to initiate effective delegations.

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References

Krnested, B., & Bragadttir, H. (2012). Delegation of registered nurses revisited: attitudes
towards delegation and preparedness to delegate effectively. Nordic Journal of Nursing
Research & Clinical Studies / Vrd I Norden, 32(1), 10-15.
National Council of State Boards of Nursing. (2005). Joint Statement on Delegation - American
Nurses Association (ANA) and the National Council of State Boards of Nursing
(NCSBN). Retrieved October 8, 2014 from
https://www.ncsbn.org/Delegation_joint_statement_NCSBN-ANA.pdf
Potter, P., Deshields, T., & Kuhrik, M. (2010). Delegation practices between registered nurses
and nursing assistive personnel. Journal of Nursing Management, 18(2), 157-165.
doi:10.1111/j.1365-2834.2010.01062.x
Potter, P.A., & Perry, A.G. (2009). Fundamentals of nursing. (7th ed.). St. Louis, MO: Mosby
Elsevier.