Running head: DELEGATIONS AND LESSONS

Delegations and Lessons Learned

Stephanie Rebeiro
California State University, Stanislaus

DELEGATIONS AND LESSONS

Delegations and Lessons Learned

It is proven that patient outcomes are improved when the hospital staff can work as a high
functioning team. In order for this to occur, delegation is often used. Delegation is the process
of transferring the authority and responsibility to another team member to complete a task, while
retaining accountability (Wissman & Knippa, 2011, p. 11). Delegation has five rights including
the right task, circumstance, person, direction, and supervision. When even one of these rights is
not followed, it may lead to inappropriate delegation which may alter the safety and quality of
patient outcomes. The delegation of a task requires adhering to the five rights along with
attention to detail in order to ensure accurate and excellent patient care.
I work as a student nurse extern in the float pool at St. Josephs Medical Center. I am
often delegated tasks by nurses and other staff members. One specific task that stands out to me
was when I was in the emergency department and asked to remove the intravenous (IV) access
from the patient in room four. The nurse reported that this patient was stable and had just been
discharged by the doctor. I am always careful when taking on tasks, so I repeated the request
back to the nurse, who nodded in affirmation. I went into the room and removed the IV. Not even
two minutes later the nurse came in to the room with that patients IV antibiotics. As the nurse
was scanning the patients identification band in preparation to administer the medication, I
reminded her that I had just removed the IV. The nurse was immediately angry with me and
repeated that she needed the IV in room four removed. She paused and realized that this was
room four and that I had done exactly as she had asked. The anger was replaced with frustration
as the nurse explained that this patient was not discharged yet and still needed to receive the
antibiotics. On top of that, the patient was a very difficult stick. She conveyed that it was actually
the patient in room two who needed their IV removed. I apologized multiple times and the nurse

DELEGATIONS AND LESSONS

admitted that it was not my fault. After talking with the doctor, the nurse administered the
antibiotic intramuscularly and then sent the patient home. Although the situation was easily
adjusted, the slight miscommunication resulted in the patient receiving an additional poke that
could have been avoided. Fortunately, this was the only inconvenience to the patient and no
serious harm or damage was done.
When assessing this situation using the five rights of delegation, at least one of these
rights was not carefully observed. The nurse did delegate the right task; the removal of an IV is
an appropriate task for me. She did use the right circumstance; the patient was stable and the task
was not complex. The nurse did delegate to the right person; I am more than capable of removing
IVs. The error lies in the right communication. Although a verbal communication of this
delegation is appropriate, the information that was exchanged was incorrect. The problem does
not lie in the amount of information given, but rather in the accuracy of the information.
Assessing the use of the right supervision is a little more complex. This task did not necessarily
require direct supervision by the nurse, but it would have prevented the error. All in all, the
miscommunication led to the intervention being implemented on the incorrect patient.
In order to prevent this issue from occurring in the future, I now double check the
patients orders in the computer for myself before completing an intervention. This is something
that would have prevented the error. As the delegator, it may have been appropriate to use the
patients name rather than the room number, which may have been less likely to be confused. It
also may have helped to make sure that the task being delegated was given full attention during
communication in order to decrease confusion or mistakes.
Overall, following the five rights of delegation is important when assigning tasks to
colleagues. I have learned to take responsibility into my own hands and to assure that I am

DELEGATIONS AND LESSONS

providing the right interventions to the appropriate patients, at the correct time. I have also
learned to speak up for myself when I feel that one or more of the five rights are not being
followed, when I am delegated a task. Delegation is key to a high functioning team, but
appropriate and accurate delegation is what leads to excellent patient care.

References

DELEGATIONS AND LESSONS

Wissman, Jeanne, and Knippa. Audrey Nursing Leadership and Management: Ati Nursing.
5.0th ed. Overland Park, KS: Assessment Technologies Institute, 2011. 11. Print.