Moraine Valley Community College Delegation in Nursing Discussion

respond to two students discussion posts 

First student: Caring for a post operative patient is not an easy task. All members of the healthcare team must work together in order to make sure the patient recovers with out any complications. It is crucial that the nurse, LPN, medication aid, and nursing assistant communicate with each other so that all tasks can be accomplished. Each member of the team will have their own responsibilities based on their scope of practice. When it comes to delegating tasks, it’s important to know the difference between delegation and assignment. An assignment is something that a nursing assistant can do without supervision from the nurse. The NCSBN states, “Delegation is allowing a delegatee to perform a specific nursing activity, skill, or procedure that is beyond the delegatee’s traditional role and not routinely performed” (pg 6, 2021). The delegatee must be educated and trained on the appropriate skill before performing the task. It is important to remember that the nurse still holds responsibility over the task being delegated. An article titled, Five Rights of Nursing Delegation, states, “The registered nurse is always accountable for the overall outcome of delegated tasks based on each state’s nurse practice act provisions” (Barrow, 2021).This is why it’s important for the nurse to consider the 5 five rights of delegation to ensure they are delegating appropriately. The five rights include task, circumstance, person direction/communication, and supervision/evaluation. There are some tasks that can be delegated when caring for a post operative patient. First, assessing the ability to drink clear liquids should be a task of the nurse or delegated to the LPN. This task is within the scope of an LPN so it would be an appropriate delegation. Determining the amount eaten by the patient can be delegated to a UAP. The UAP must report back to the nurse after the task is completed and the nurse must make sure that it was done correctly. Documenting the patient’s tolerance to clear liquids and documenting the patient’s tolerance for activity should be done by the nurse. Any documentation needs to be performed by the registered nurse. Assessing the patient’s tolerance for sitting at the bedside and assessing the patient’s tolerance for ambulating should be done by the nurse or LPN. Lastly, assessing the patients pain level could be delegated to the UAP because pain assessment is part of taking vitals which is within a UAP’s scope. None of these tasks can be delegated to a medication aid because there aren’t any medications involved. An appropriate outcome for assessing a patient’s pain level would be that their pain has decreased since their initial assessment. The UAP would assess the patient’s pain, report back to the nurse, and the nurse would provide the appropriate intervention for pain. The nurse could then evaluate the patient’s response to the intervention.

Second student: Assess the patient’s ability to drink clear liquids.

• Cannot Delegate 
• According to the in-class PowerPoint nurses cannot delegate assessments that identify needs or problems.  
• According to the article, “National Guidelines for Nursing Delegation states, “the license nurse cannot delegate nursing judgement or any activity that will involve nursing judgement or critical decision making”(National Council of State Board of Nursing, 2015, pg. 6). 
• Determine the amount eaten.
  • Can Delegate 
  • This task can be delegated to a CNA or LPN if available. Either of these roles can watch the patient eat, and report back to the nurse. This allows the nurse to focus on giving medications, and completing assessments. 
• Document the patient’s tolerance of clear liquids.
  • Can Delegate 
  • According to the Ohio Board of Nursing, LPNs can, “Document the patient’s response to the nursing plan of care or the medication or treatment”(Ohio Board of Nursing, 2019, pg.3). If the LPN was in a patient’s room giving them a PO medication they can document how the patient tolerated this intervention, and relay this information to the RN.
• Assess the patient’s tolerance for sitting at the side of the bed.
  • Cannot Delegate
  • Nurses cannot delegate any assessments that identify needs or problems. 
• Assess the patient’s tolerance for ambulating.
  • Cannot Delegate 
  • Nurses cannot delegate any assessments that identify patients needs or problems.
  • The nurse can ask for a CNA or LPN to help if assistance is needed. LPN can collaborate with the RN, but ultimately it is the RNs responsibility. 
• Document the patient’s tolerance for activity.
  • Can Delegate 
  • As I stated in a previous point, The Ohio Boards of Nursing states, “LPNs  can collect and documents objective and subjective data and observations about the
    patient(Ohio Board of Nursing, 2019, pg.3). 
• Assess the patient’s pain level.
  • Cannot Delegate
  • The medication aide can give pain meds to the patient 
  • A nurse needs to assess and identify any problems a patient may be having. A nurse could delegate to a LPN to give a PO pain medication.Depending on the state through my research LPNs are not allowed to give medications via IV push. 
• Provide education about activity levels.
  • Cannot Delegate
  • According to our class PowerPoint RNs, are not allowed to delegate health counseling, teaching, or referrals to other healthcare providers. 

Assess the patient’s pain level:

1. The patient will experience pain less than 3 out of a 1-10 scale during the day shift on 10-3-21. 
2. Patient uses pharmacological and nonpharmacological pain-relief strategies.
3. Patient shows improved vital sign baseline like BP, pulse, RR thorough out shift.