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The Importance of Delegation in Nursing
Introduction
Delegation of authority should be understood as the transfer of a certain part of the responsibilities by the leader to other team members to achieve the goals of the organization. This practice allows to facilitate the functional duties of the leader and increases the responsibility of employees, as well as the level of efficiency of the organizations response to external factors. Thus, the concept of delegation of authority is part of the changes taking place in all industries today especially healthcare, which is characterized by high workload and responsibility. With delegation, hierarchical levels of control are being replaced by a decentralized network structure that is more flexible and adaptive to changes. The focus on high volumes and low cost is increasingly being replaced by a focus on quality, speed, and innovation. There is a shift in the paradigm of working in collaboration: from error-free work to measurable improvements in the organization of activities. Despite the constant development of new technologies, in modern healthcare, the only stable competitive advantage remains with people or rather their knowledge. Thus, delegation becomes increasingly important for the functioning of healthcare organizations and facilities.
Discussion
In nursing, delegation refers mainly to the process of a leading nurse directing others to perform nursing tasks and responsibilities. Barrow and Sharma (2021) define the five rights of delegation in nursing: right task, right circumstance, right person, right supervision, and right direction and communication. The right task concept states that the activities must be legally appropriate to delegate, and the delegator must consult the organizations policy before delegating them. Right circumstance outlines what the delegator must consider before transferring responsibilities, such as the availability of equipment and resources necessary for performing them, the presence of supervision over the delegate, and the state of the working environment. The right person aspect determines whether the person to which the tasks are to be delegated is competent enough to carry them out safely. Within the right supervision point, an experienced and skilled nurse must be always available to look over the delegatees performance. Finally, right direction and communication emphasizes that the delegate must be given clear, accurate, and concrete instructions before and during their performance. All of these aspects should be used to guide the delegation process to ensure the best quality care and patient safety.
High-risk delegation occurs when the tasks that are up for delegation might result in harmful actions toward patients if performed incorrectly. The main risk factors there is the lack of proper consideration before the responsibility is transferred, inadequate skill of the delegate, unclear directions, and unsupervised actions. With high-risk delegation, the nurse responsible for it and the delegate themselves might be exposed to liability lawsuits, especially in case of negative consequences for patient care.
Supervision refers to the monitoring of the delegated task without interfering with the work in progress. It involves tracking events at certain intervals and comparing what is planned and what is happening, determining the differences between predicted and actual results. With supervision, if an employee asks what steps should be taken in the performance of one or another aspect of the assigned case, the manager should ask them how they see the further development. As a rule, in supervision, the employee already has a reasonable option they only lack the confidence or authority to apply it in practice. Redirecting the question helps to get rid of unnecessary dependency.
By imperceptibly supervising the process and observing the activities of the employee, the nurse can determine if they are competent to be delegated new tasks. According to Zaccagnini and Pechacek (2021), the nurse might act as a regulatory force, enacting controls to restore stability (p. 18). A good example of supervision in a nursing clinical setting could be observed during my time as a trainee at the hospital. I was allowed to work as part of a multidisciplinary team under the supervision of a nurse leader and performed certain tasks that I have had competency in. Throughout my work, I have been in close contact with my mentor who provided me with feedback on my performance and guided me through different processes occurring at the clinic.
Meanwhile, the delegation of authority is the process of granting the right to make decisions regarding the employees official duties without the need to obtain additional approval. As opposed to supervision, it stimulates initiative and improvement of daily work and relationships between employees. Moreover, the delegation also facilitates innovation, as workers try new approaches and make decisions that are directed towards developing new ways of doing things. It stimulates responsible behavior towards each other and the coordinated achievement of goals in the team.
Conclusion
To conclude, delegation as a whole turns the organization into a learning system that is ahead of and anticipates changes. It leads to a rethinking of the experience of the organization and training of staff through transferring responsibilities. My experience with delegation occurred during my first year of practice as a registered nurse. During this time, I was tasked with everyday patient observation, administration of medicine, and provision of services such as bandage changes, injections, and physical examination of incoming patients. I was not directly supervised during my duties and was only required to report twice a week as part of my nursing activities.
References
Barrow, J. M., & Sharma, S. (2021). Five rights of nursing delegation. StatPearls Publishing.
Zaccagnini, M. E., & Pechacek, J. M. (2021). The doctor of nursing practice essentials: a new model for advanced practice nursing. Jones & Bartlett Learning.
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