Registered nurses (RNs) possess adequate skills that guide them when providing personalized and timely medical services to their patients. Due to the complexity of the profession, such experts are allowed to delegate various nontechnical activities to unlicensed assistive personnel (UAP). In my state, the relevant board of nursing has a framework outlining the duties and activities that should or should not be delegated to such UAPs. This paper begins by describing the roles of UAPs and RNs in the nursing environment and their relation to delegation. It goes further to discuss how the ICU environment differs from a general medical-surgical unit when it comes to the roles RNs can assign to UAPs.
Roles of UAPs and RNs in Delegation
The State Board of Nursing offers guidelines and control mechanisms intended to safeguard the process and help meet the changing needs of the targeted patients. UAPs are identified as paraprofessionals included in the care delivery field to help individuals to record improved medical outcomes. According to the board, such workers are expected to undertake various simple tasks. Some of these roles include observing patients, capturing and entering personal details, and reporting clinical occurrences. They can monitor the behavior and emotional well-being of an assigned patient. Additional tasks these individuals perform include reading body temperature, weight, and pressure (Weiss & Tappen, 2014). The State Board of Nursing identifies UAPs as helpers who can perform various duties RNs delegate to offer proper care to patients depending on their personal health demands.
The identifiable RN roles include observing and recording patients’ behaviors, performing necessary medical tests and examinations, providing counseling, and administering the right medication. These professionals need to complete clinical duties within their scope of practice. Under certain circumstances, RNs will delegate various tasks to UAPs following the formulated state code (Weiss & Tappen, 2014). Such RNs will assess the overall risk of the patient and the ability of the UAP to complete the intended task professionally. Additionally, RNs need to create desirable environments for a proper care plan. These initiatives will increase the chances of improved care delivery in the specific setting or medical unit.
The RN needs to remain accountable for the entire process of delegation. Specifically, the professional will have to assess and monitor the assigned tasks to ensure that they amount to effective nursing care. Before delegating the intended activities, it is appropriate that the professional assess the complexities and abilities of the specific UAPs. Such an approach required proper critical thinking skills while being aware of any possible harm (Weiss & Tappen, 2014). The practice setting should be favorable following the patient’s expectations (American Psychological Association, 2020). The RN needs to provide adequate training and education to the selected UAP based on such observations. The professional will document the UAP’s skill sets. RNs will provide a detailed evaluation plan for completing the delegated processes or procedures. Additionally, continuous evaluation of the delegated tasks is usually mandatory to reduce the chances of sentinel events in nursing care.
ICU Environment, General Medical-Surgical Unit, and UAP
Throughout the delegation process, professional nurses should be willing to balance patients’ health expectations and the competencies of the available UAPs. In the medical-surgical ward, the affected patient tends to have predictable medical needs. On the other hand, the beneficiary in an intensive care unit (ICU) environment would require high-level, personalized, and professional competencies (Weiss & Tappen, 2014). Under this circumstance, RNs would be discouraged from delegating tasks in ICU settings since specialized knowledge, abilities, and judgments are critical. The professional would acknowledge that the duties of evaluation of medical services and continuous assessment cannot be delegated in the ICU environment. The ultimate aim is to monitor the changing health status of the targeted patient.
On the other hand, the medical-surgical environment is characterized by patients whose needs are predictable and understandable. RNs could rely on this understanding to delegate a wide range of tasks since they do not professional skills and timely judgment. Some of the activities that RNs can assign to UAPs include bathing, measuring height and other vital signs, and dressing (Bakr, 2021). The UAPs will collaborate with RNs for the overall well-being of the patient and respond to the available medical care in the medical-surgical unit. This analysis reveals that RNs should avoid delegating tasks in ICU environments due to the uncertain status of the patients involved.
The concept of delegation is evidence-based and capable of allowing RNs to coordinate with skilled UAPs in care delivery. Throughout such a process, the RN should remain committed and monitor the process of care. Some key responsibilities of RNs throughout the delegation process include the development of proper plans, continuous evaluation, and supervision. These activities are practical and appropriate for patients in medical-surgical units whose healthcare needs remain predictable. The process would be ineffective in ICU settings whereby the involved patients require care delivery tasks associated with specialized medical skills.
American Psychological Association. (2020). Publication manual of the American Psychological Association (7th ed.). American Psychological Association.
Bakr, M. M. (2021). An exploration to the relationship between unlicensed assistive personnel role and patient safety. American Journal of Nursing and Health Sciences, 2(4), 105-112. Web.
Weiss, S. A., & Tappen, R. M. (2014). Essentials of nursing leadership and management (6th ed.). F. A. Davis Company.