N108: Transition to the Registered Professional Nurse

N108: Transition to the Registered Professional Nurse Role Study Guide • Level of interaction required with the patient • Capabilities of the nursing assistive personnel • Availability of professional staff to accomplish the unit workload Potential issues that can occur with delegation include: • Control: The nurse manager feels the need to control details personally • Fear of sounding bossy: The nurse manager fears damaging the relationship with staff • Lack of trust: The nurse manager does not believe workers are capable of completing work • Inadequate staff: This is a chronic problem; the nurse manager needs to work with administration to get staffing issues corrected • Roles are unclear: The nurse manager is unclear if her role is a manager or specialist role • Undesirable tasks are delegated unfairly: The nurse manager may give these tasks to someone who will not complain or to an employee who is unpopular • Be clear and concise when communicating tasks: Directions should be specific; as is true with medication administration, delegation also has “five rights” High risk delegation: • Delegating tasks that are highly invasive or have the potential to cause significant physical harm to the client • Delegating tasks that can only be performed by RN according to law, organizational policies, or professional standards of practice, such as admission assessments, care planning, or teaching • Delegating tasks that the person is not trained for or lacks the knowledge to complete safely • Delegating tasks when there is inadequate time to safely monitor or evaluate the practice of the person performing the tasks • Failing to adequately supervise • Failing to reassess the patient after the task is completed The five rights to remember of successful delegation involve: • Right task: One that is delegable for specific patient • Right circumstances: Appropriate patient setting, available resources, and other factors • Right person: And right patient • Right direction/communication: Clear, concise, description of the task, including objective(s), limits, and expectations • Right supervision and evaluation: Appropriate monitoring, evaluation, intervention as needed, and feedback

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