Five Rights of Nursing Delegation

by Samantha Rhea, MSN, RN

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    00:01 So, let's remember the registered nurse at the top of that pyramid.

    00:04 They're gonna be able to delegate to the LPN and the nursing assistant personnel.

    00:09 So, let's look at the five rights of delegation and we'll go through each one of those.

    00:15 So, as a registered nurse, when I delegate, I need to make sure I'm giving them the right task.

    00:20 So, here's an example. I need to make sure if I delegate vital signs, that's within the scope of practice of that nursing assistant personnel.

    00:29 I cannot ask that nursing assistant personnel to maybe go do a head-to-toe assessment to monitor the patient.

    00:37 Who would that be more appropriate for? That's right, the LPN. So, again, the nursing assistant personnel may do something like vital signs or blood glucose.

    00:48 The LPN would monitor the patient. So, then, let's talk about the right circumstance.

    00:55 This one's a little bit tricky and where the skill level of the RN comes in.

    01:00 So, it's okay to delegate maybe vital signs to a nursing assistant but I would not wanna do that if the patient's condition is not stable.

    01:09 So, if the patient doesn't look good, maybe they look lethargic and tired or they're not arousing very well.

    01:16 Or maybe they're just not doing well overall, I do not want the nursing assistant to delegate to do those vital signs.

    01:23 I need to do that as a nurse.

    01:25 That takes a different level assessment that is within my scope of practice as a registered nurse.

    01:31 And next, remember to do the right person.

    01:35 Again, this goes back to what's that person's scope of practice? What's the most appropriate for that individual when we give them a task? And don't forget direction.

    01:47 Now, it seems to be a silly thing to talk about but unless I give my LPN or nursing assistant personnel the right instructions and clear, if I just say, "Hey, go take vital signs on that guy." Who is that? Which guy? What patient? Which vital signs? How much? Do you want a pulse ox with it? What else do you want with that? So, be clear.

    02:10 So, make sure you say maybe, "I need you to take a blood pressure and a heart rate on Mr. Jones in 956, please." Again, notice that please after.

    02:21 That's always nice when you delegate. And lastly, don't forget about the right supervision.

    02:27 So, this is what's a little bit difficult for us as registered nurses and something we definitely got to remember.

    02:33 Anything that I delegate to the LPN or the nursing assistant personnel, I am ultimately responsible for the supervision and the outcome of that patient.

    02:45 Okay, that's important, so, I'm gonna say it again.

    02:47 If I as a registered nurse delegate something to someone else, I am responsible for that action.

    02:54 Here's a great example. I used to work on the stroke floor and I would delegate a manual blood pressure with a cuff, a lot of the times, what you guys see at the doctor's office to my nursing assistant.

    03:05 So, maybe my nursing assistant brings back a blood pressure and I look at, "This doesn't look like what that patient's been running on their blood pressure." So, if I just take it as is, I am responsible for any medication that I give.

    03:19 So, therefore, I need to make sure that this is correct and accurate and I'm responsible for this blood pressure.

    03:27 So, if there's any questions, sometimes as a registered nurse, we may just need to go do it for ourselves.

    03:32 So, make sure whatever you delegate, know that you are responsible for as a registered nurse.

    About the Lecture

    The lecture Five Rights of Nursing Delegation by Samantha Rhea, MSN, RN is from the course Management of Care (Nursing).

    Included Quiz Questions

    1. The registered nurse asks the nursing assistant to record the output in a Foley catheter bag.
    2. The registered nurse asks the licensed practical nurse to care for a stable client on the medical floor.
    3. The registered nurse asks the licensed practical nurse to assess the pain level of a client who received Tylenol not long ago.
    4. The registered nurse asks a licensed practical nurse to assess a client who is on an intravenous titratable cardiac drip.
    5. The registered nurse bases care on a glucose result that the nursing assistant took that didn't correlate with the client's trends.
    1. Right supervision
    2. Right person
    3. Right circumstance
    4. Right task

    Author of lecture Five Rights of Nursing Delegation

     Samantha Rhea, MSN, RN

    Samantha Rhea, MSN, RN

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