N108: Transition to the Registered Professional Nurse

N108: Transition to the Registered Professional Nurse Role Study Guide unlicensed, assistive personnel to perform those tasks that they can perform safely. The results of delegation can lead to cost cuts as the unlicensed assistive personnel command a much lower salary. Delegation can have a positive effect on team building spirit. It is critical to remember that although a nurse has asked someone else to carry out a nursing task, he or she is still accountable for the care that is given. Those of a lesser educational background can carry out certain aspects of care such as: • Taking vital signs • Assisting with ambulation • Assisting clients with transport • Performing basic procedures Certain tasks cannot be delegated such as any activity that requires knowledge and judgment that is unique to the function of the RN. Nurses may not delegate any responsibilities that call for professional judgment, skill, or decision-making ability to the unlicensed assistive personnel. An RN must complete all assessments of the clients and the client needs. The ability to complete a thorough assessment and to not overlook some critical need is part of the nursing judgment acquired through the nurse’s educational background. Nurses may not delegate roles that are limited to licensed individuals under the nursing licensure laws and can delegate only to a person who is competent to perform the task delegated. The scope for practice for RNs and LPNs is outlined in state practice acts and may vary from state to state. The nurse who is delegating tasks must know and understand the level of care that can be performed by the person to whom the task is being delegated. The tasks delegated to assistive personnel should not require nursing judgment while being carried out. When working with someone who is not licensed, the RN will want to be knowledgeable about the individual’s skill level, job description, specific competencies, and agency policies and protocols. It is important for the RN to be familiar with practice acts in the state they are employed. Delegation involves the transfer of responsibility for the performance of an activity to another individual while retaining accountability for the outcome, and is a critical competency and essential skill for a registered nurse. Often times nurses function as a team leader, which involves delegation of responsibilities involving the following duties: • Making assignments • Matching each patient’s needs with the staff member most likely to meet those needs • Communicating with physicians, taking of orders, and running the team conference • Ensuring that all patient care is completed Before delegating duties to other members of the healthcare team, the nurse needs to consider the following: • Patient’s condition • Complexity of the activity • Potential for harm • Degree of problem solving and innovation necessary

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