DELEGATIONPrepared by: Paul John Bautista RN / NBP2012
General objective: At the end of 1 hour lecture discussion BSN IV students will be able to have an increased understanding on the concept of Delegation
Specific Objectives: Define the meaning of Delegation Compare Direct and Indirect Delegation State the Five Rights of Delegation Determine the Reason for Delegation Describe the common Delegating Errors Differentiate LPN and UAP Analyze the Delegation Decision –Making Grid Identify the ways to deal with subordinates resistant to delegation Recognize the Barriers in Delegation Determine the Cultural Considerations in Delegation Enumerate the ways on how to delegate effectively Application of delegating skills
Delegation Process by which the manager assigns specific task to the workers with commensurate authority to perform the job Getting the work done through others or as directing the performance of one or more people to accomplish organizational goals
Supervision It is more direct and requires directly overseeing the work or performance of others. It includes checking with individuals throughout the day to see what activities have been completed
Direct Delegation Verbal direction by the RN regarding an activity or task in a specific nursing care situation
Indirect Delegation An approved listing of activities or tasks that have been established in policies and procedures of the health care institution or facility.
FIVE RIGHTS OF DELEGATION Right Tasks Right Circumstances Right Person Right Direction/ Communication Right Supervision/ Evaluation
Reason for Delegating Assigning routine tasks Save time on the part of the manager Problem solving Capability building Train and develop staff members for greater opportunities, making them more committed and satisfied in the job
JOB DESCRIPTIONA job description sets out the purpose of a job, where the job fits into the organization structure, the main accountabilities and responsibilities of the job and the key tasks to be performed.
Common Delegating Errors
UNDERDELEGATING Manager’s desire to complete the whole job personally due to lack of trust in the subordinates Fear that subordinates will resent having work delegated to them Myself Fallacy Lack of ability to direct They find it difficult to assume manager role
OVERDELEGATING Burdening their subordinates
IMPROPER DELEGATING Delegating at the wrong time, wrong person and wrong reason Delegating beyond the capability of the person Delegating decision making without providing adequate information
Licensed Practical Nurse(LPN) known as LPNs or LVNs, depending on the state in which they work provide basic nursing care work in many settings, including nursing homes and extended care facilities, hospitals, physicians offices, and private homes
Licensed practical and licensed vocational nurses must complete a state-approved educational program, which usually takes 1 year. They also must pass an exam and get a license before they can work. They perform duties that may include giving injections, taking vital signs, performing basic diagnostic tests, observing patients, dressing wounds, and administering medication
Unlicensed Assistive PersonnelUAP describe a job class of paraprofessionals who assist individuals with disabilities and provide bedside care all under the supervision of a Registered Nurse, Licensed Practical Nurse or other health care professional
UAPs, by definition, do not hold a license or other mandatory professional requirements for practice, though many hold various certifications
DELEGATION DECISIONMAKING GRID RN SKILLS UAP•Sophisticated •Feedingapplication of nursing •Hygieneprocess •Physical care•Initial Assessment •Patient•IV medications Transportation (•Teaching stable patients)• Assessment on new •Getting the suppliespatients •Cleaning up after•Physician ‘s Order procedures•Blood Administration•Clinical Judgment
Subordinate Resistance toDelegation Incapableof completing the delegated tasksI: Performance Coaching
Inherent resistance to authorityI: maintain an appropriate authority power gap
Tasks are overdelegated in terms of specificityI: mix routine and boring tasks with more challenging and rewarding assignmentsProvide constructive feedback- positive and negative to foster growth and self esteem
Barriers in DelegationDelegator: Insecurity Fear of being disliked Lack of confidence in his/her subordinates Refusal to allow mistakes
Delegatee: Lack of experience Lack of competence Avoidance of responsibility Overload of work Confusion in responsibilities and authority
Cultural Considerations inDelegation Communication Cultural diversity in the workforce because of dialect, use of touch, context of speech. Space Interpersonal space differs in cultures
Social Organization Family unit of primary importance in some cultures Time Past oriented Present oriented Future oriented
Environmental control Some cultures believe more stongly in in fate, luck or chance and this may affect how a person approaches and carries delegated tasks Biological considerations Susceptibility to diseases and physiological differences
Ways to Delegate Successfully Plan Ahead Identify Necessary Skills and Levels Select Most Capable Personnel Communicate Goal Clearly Empower the delegate
Set Deadline and Monitor Progress Model the Role and Provide Guidance Evaluate Performance Do not take back delegated tasks Reward Accomplishment
The RN, although well trained in the role of direct care provider, is often inadequately prepared for the role of delegator The mark of great leader is when he or she can recognize the excellent performance of someone else and allow others to shine for their accomplishment Responsibility is shared when tasks is delegated
Case Analysis: A 25 year-old client, unresponsive after a motor vehicle accident, is being transferred from the hospital to a long term care facility. To which staff member should the charge nurse assign the client? A) Unlicensed assistive personnel (UAP) B) Senior nursing student C) PN D) RN
The correct answer is D: RN The RN is responsible for teaching and assessment associated with discharge and these activities cannot be delegated to the others listed.
Case AnalysisA practical nurse (PN) from the pediatric unit is assigned to work in a critical care unit. Which client assignment would be appropriate? A) A client admitted with multiple trauma with a history of a newly implanted pacemaker B) A new admission with left-sided weakness from a stroke
C) A 53 year-old client diagnosed with cardiac arrest from a suspected myocardial infarctionD) A 35 year-old client in balancedtraction admitted 6 days ago after amotor vehicle accident
The correct answer is D: A 35 year-old client in balanced traction admitted 6 days ago after a motor vehicle accident This client is the most stable with a predictable outcome.
Case AnalysisA client has had a tracheostomy for 2 weeks after a motor vehicle accident. Which task could the RN safely delegate to unlicensed assistive personnel (UAP)? A) Teach the client how to cough up secretions B) Changes the tracheostomy trach ties C) Monitor if client has shortness of breath D) Perform routine tracheostomy dressing care
The correct answer is D: Perform routine tracheostomy dressing care Unlicensed assistive personnel should be able to perform routine tracheostomy care.
SYNTHESIS Delegation is not an option for the manger-it is a necessity Delegation should be used for assigning routine tasks and tasks for which the manager does not have time. It also is appropriate as a tool for problem solving and building capacity in subordinates
In delegation, managers must clearly communicate what they want to be done. It is important that the subordinate has an appropriate degree of autonomy in deciding how the work is to be accomplished Managers must delegate the authority and the responsibility necessary to complete the tasks
RNs who are asked to assume the role of supervisor and delegator need preparation to assume the leadership tasks Assuming the role of delegator and supervisor to the UAP increase the scope of liability for the RN The RN always bears the ultimate responsibility for ensuring that the nursing care provided by his or her team members meets or exceeds minimum safety standards.
When subordinates resists delegation, the delegator must ascertain why the delegated task was not accomplished and take appropriate action to remove restraining forces Transcultural sensitivity in delegation is needed to create a productive multicultural work team.