Nursing Delegation
Nursing delegation is the process by which a registered nurse (RN) assigns specific tasks or responsibilities to another qualified person, such as a licensed practical nurse (LPN) or unlicensed assistive personnel (UAP) within their scope of practice while retaining accountability for the overall outcome.
An RN assigns a UAP to assist a post-op patient with walking for the first time. The RN first ensures the patient is stable and the UAP is trained in ambulation support. The RN then provides instructions to call for help if the patient feels dizzy. The RN supervises the first walk and follows up with an assessment.
Five Rights of Delegation
Right Task
The task is appropriate to delegate and allowed by policy.
Example: Assisting a stable patient with ambulation.
Right Circumstance
The patient’s condition must be stable, and the environment safe.
Example: Don’t delegate tasks during emergencies or for unstable patients.
Right Person
The person must be competent and trained to perform the task.
Example: A UAP may take vital signs, but not administer medications.
Right Direction/Communication
Clear, specific instructions must be given, including expected results and when to report back.
Example: "Take Mr. Smith’s BP at 10 AM and notify me if it's over 140/90."
Right Supervision/Evaluation
The RN must monitor, evaluate, and follow up on the outcome.
Example: The RN checks the BP reading recorded by the UAP and documents the result.
What RNs Cannot Delegate
Nursing judgment
Patient assessment
Care planning
Teaching
Evaluating outcomes
Important Consideration’s
Always assess the patient’s condition before delegating.
Match the task to the skill level and scope of the delegated.
Provide feedback and be available for questions or unexpected issues.
Document delegated tasks and any follow-up appropriately.