Nursing Field Notes / Nursing Core · Fundamentals of Nursing
Delegation ✋
The 5 Rights of Delegation
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Delegation transfers the task, never the responsibility. The RN is still accountable for choosing to delegate correctly and for supervising the outcome — which is exactly why assessment, evaluation, teaching, and any task requiring nursing judgment can never be delegated to a UAP.
✅ UAP CANStable vitals, ADLs, ambulation, positioning, I&O on a stable client.
❌ RN ONLYAssessment, evaluation, teaching, IV push — never delegated.
🛡️ Still accountableThe RN can be liable for negligent supervision — delegation ≠ off the hook.
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THE 5 RIGHTS
STEP 1 · BEFORE YOU DELEGATE
Every one of these five has to be true before a task leaves the RN's hands.
✋ The 5 Rights of Delegation
🧠 "TCP-DS" — Task · Circumstance · Person · Direction · Supervision. If any one of the five is missing, don't delegate the task.
📋 Right Task & Right Circumstance
Right Task — the task is stable, routine, standardized, and does not require nursing judgment.
Right Circumstance — the client's condition is stable and predictable for this task, right here, right now.
Do not delegate a task for an unstable client — even a normally-delegable task like vital signs becomes RN-only if the client is unstable.
🧠 Stable task + stable client = safe to hand off. Either one being unstable cancels the delegation.
🙋 Right Person
Only delegate tasks allowed by state Nurse Practice Act and workplace/facility policy, to someone whose knowledge, skill, and experience matches the task.
Assess the assistant's competency to perform the task safely before delegating.
"Right Person" applies at every level — RN → LPN/LVN, and RN/LPN → UAP/CNA.
🧠 Scope of practice isn't optional. "I thought they could do it" is not a defense — verify competency first.
🗣️ Right Direction & Communication
Give a clear, concise description of the task, the goal, the expected time frame, and exactly when to report back.
🧠 "Task + Time frame + Tell me." Every delegated order needs all three, or the AP doesn't know when something is wrong.
🔎 Right Supervision & Evaluation
Follow up, and evaluate the outcome of the delegated task. Always reassess tasks you have delegated — supervision doesn't end when you walk away.
🧠 Delegate, don't disappear. The RN checks the work and the outcome, every time.
🧩
WHO DOES WHAT
STEP 2 · SCOPE OF PRACTICE
Delegation flows downhill from RN → LPN/LVN → UAP/CNA — and the higher-judgment tasks stop at the top.
🔻 The delegation hierarchy
🧠 "Judgment doesn't roll downhill." The higher the level of clinical judgment a task requires, the closer it stays to the RN.
✅ CAN delegate to UAP/CNA — stable, routine, predictable tasks
🩺Vital signsstable client
🚶Ambulationstable client
🛁ADLsbathing, grooming, feeding, toileting
🔄Position changesturning, repositioning
📋Record I & Orecording only
⚖️Weighingroutine daily weight
🧠 "SAP" = Stable, no Assessment, Predictable. If a task is routine and doesn't require interpreting data, it's usually delegable to a UAP.
❌ CANNOT delegate to UAP/CNA — RN judgment tasks
🧠Assessmentinitial or ongoing
📊Evaluationinterpreting labs, vitals trends, pain
🗣️Teachingany patient education
💉IV push medsRN only
🩸Blood productstransfusions
🧪Central line drugschemo, TPN
🧠 "ATE-B" never leaves the RN — Assess · Teach · Evaluate · Blood/high-risk meds. Say it like "eat a B" — the RN always eats that whole plate alone.
CAUTION IV push scope for LPN/LVN varies state to state — always verify your specific state's Nurse Practice Act and facility policy.
🧠 LPN/LVN = "Secondary, Reinforce, Follow-up." Never the first anything — first assessment, first teaching, and IV push all stay with the RN.
🛡️
STAY SAFE
STEP 3 · SUPERVISE & PROTECT
You can delegate a task — you cannot delegate the responsibility for the outcome.
🚨 Keywords that mean "do NOT delegate — RN territory"
🆕New admission
⚡Sudden change in status
🥇First time doing anything
🏥Post-op / returning from a procedure
📉Unstable vitals, labs, blood sugar
🧾Discharge teaching
🧠 "New, First, Sudden, Unstable" = RN. Any client who is new to the unit, newly changed, or newly unstable needs the RN's own eyes first.
🚦 Stable vs. unstable — the same task, two different answers
🧠 Vital signs on Monday ≠ vital signs on the day of a code. A task being "usually delegable" never overrides an unstable client in front of you right now.
🔁 The supervision loop never breaks
🧠 Delegation is a loop, not a handoff. The RN's job doesn't stop until the outcome has been evaluated and reassessed.
⚖️ Legal liability
The RN (or LPN/LVN) may be legally liable if negligent in supervising the UAP/CNA — even though the UAP performed the task itself.
Delegating the task transfers the action, not the accountability.
Failing to check competency, give clear direction, or follow up = negligent supervision.
🧠 "You picked them, you own the pick." If the delegation decision itself was unsafe, the licensed nurse who made it is accountable.
📝 ATI-style scenario: delegating vital signs to an AP
An RN delegates routine vital signs to an assistive personnel (AP). Which actions should the nurse plan to take?
Confirm the client is stable and the task is appropriate to delegate right now.
Confirm the AP has the skill/competency to perform vital signs correctly.
Communicate the specific time frame for when the AP should report results back to the RN.
Tell the AP what values require an immediate report (e.g., outside expected parameters).
Follow up — review the results and reassess the client as needed.
🧠 Vitals aren't just "go take them." Every delegated vital-sign check still needs a time frame and a reporting threshold attached.
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QUICK RECALL
SAY IT OUT LOUD
✋ TCP-DSTask · Circumstance · Person · Direction · Supervision
❌ RN onlyassessment, evaluation, teaching, IV push, unstable client
⚖️ Still liablenegligent supervision = RN/LPN accountability
🎯 Cover & check — 4 rapid-fire questions
Q1: Name all 5 Rights of Delegation.
Right Task, Right Circumstance, Right Person, Right Direction/Communication, Right Supervision/Evaluation.
Q2: A newly admitted client needs vital signs — can this be delegated to a UAP?
No — a new admission requires the RN's initial assessment; "new admission" is a keyword that keeps the task with the RN.
Q3: Can an LPN/LVN reinforce diabetic teaching a patient already received from the RN?
Yes — LPN/LVN can provide secondary/reinforcing teaching, but never initial or first-time patient education, which stays with the RN.
Q4: If a UAP performs a delegated task incorrectly and the client is harmed, who can be held liable?
The RN/LPN can be held liable if negligent in supervising — delegation transfers the task, not the nurse's accountability for the delegation decision and follow-up.