Many nurses are reluctant to assume a Charge Nurse role, since they are often asked to do this without any education or training. Yet charge nurses play a critical role in helping their Nurse Manager or leader achieve desired financial and clinical outcomes. Examples include: staffing, scheduling, assignments, patient placement and throughput.
One key competency that Charge Nurses struggle with is learning how to delegate. Many find it is difficult to delegate tasks to peers, since they rely on peers for assistance with patient care later when not in the Charge Nurse role. Staffing in some organizations require the Charge Nurses to take a patient assignment, while in other hospitals they do not. But delegation is still a key competency Charge Nurses need to exhibit to assure that units run efficiently.
Following a delegation framework will help assure that the right task(s) will be assigned to the right staff member, under the best circumstance, and begin to answer issues of communication, supervision, and evaluation needed. Delegation remains an underdeveloped skill among nurses, and one that is difficult to measure – but it can be planned for! The following outlines components of the
Rights of Delegation Model:
Assessment and Plan: As a Charge Nurse, am I giving the right tasks to the right nurse/staff member?
- What are needs of the patients?
- What is the predictability of the patient’s response to care?
- What cognitive abilities are needed to perform tasks? Which team member has the best competencies to perform?
Communication: Is the Charge Nurse providing communication that puts the unit on the right path?
- How will tasks get accomplished?
- What needs to be reported?
- What are communication expectations in emergency situations?
Supervision and Surveillance: Find the right amount of supervision for the unit
- What level of supervision should the Charge Nurse provide to be optimal?
- What is the frequency of monitoring and care observation?
- Can we document completion of care?
Observation and Feedback: Assess effectiveness of Charge Nurse Delegation
- Was delegation successful?
- Is there a better way to meet patient or unit needs?
- Were there any learning moments during the shift?
- Did the Charge Nurse provide good feedback?
Appropriate delegation assumes that prior to assignment of tasks, the Charge Nurse uses judgment and demonstrates critical thinking to assess the skill, competence, attitude, and experience of staff, as well as patient requirements and circumstances. Delegation paves the way for trust, effective communication, and mutual support which contribute to success of effective nursing teams. So help your Charge Nurses plan for delegation. Planning for delegation is planning for success!
-OIJN/ANA . “Delegation Dilemmas: Standards and Skills for Practice” Pamela Cipriano, PhD, RN, NEA-BC, FAAN
-Emerging RN Leader. “How to Delegate Care” Rose Sherman, EdD, RN, FAAN
-Nurse Leader. “Why nurses still must learn to delegate” R.I. Hansten