Delegation is the primary process by which leaders establish formal relationships between people in an organization. However, it is one of the most misunderstood and misapplied concepts of governance. Without fully understanding the need for delegation or what is required to increase its effectiveness, many physicians and nurses fail to delegate tasks properly (Duffield et al., 2019). To get close to understanding how to delegate effectively, it is necessary to understand the associated concepts of responsibility and organizational authority. This report will analyze a case in my student clinical practice where improper delegation became a problem for a registered nurse (RN) and a certified nursing assistant (CNA).
To entrust work without taking into account the readiness of the employee is the main problem of delegating. In the case under review, the RN delegated the task of insertion of a peripheral intravenous catheter (PIVC) to the CNA. The insertion of intravenous catheters is an ambiguous manipulation since neither doctors nor nurses have widespread requirements for intravenous catheterization, but this manipulation is widely used in daily clinical practice. Since the CNA did not deal with it before, the catheter was inserted into the vein incorrectly, the vein was damaged, and there was edema of the tissue around it, which prevented the correct blood flow. Since the solution was retained and flew out into the surrounding tissues, infiltration occurred, that is, the unintentional introduction of a solution of the drug into the tissues surrounding the vein.
This situation happened not only due to the incompetence of the CNA but also due to the incorrect delegation. Before assigning a new job to an employee, the RN had to think about what the consequences might be. The RN was supposed to distribute tasks based on the strengths of the staff and proper supervision. Good mentoring is one of the most important components of delegation (Duffield et al., 2019). The RN should have told the CNA how the results could affect the patient’s health and the nurse’s reputation. In such a way, she would increase the emotional and psychological return of the CNA. The subordinate would better realize her responsibility and try to do her job more carefully and efficiently. Delegation requires effective communication, so the main problem with delegating authority in the nursing practice is often insufficient communication between the subordinate and the leader, as in the considered case (Puskar et al., 2017). Thus, for the proper implementation of responsibilities, the CNAs must understand exactly what RNs request.
As seen in this case, the lack of selected control is another problem. In parallel with the delegation of particular tasks, management must establish effective control mechanisms to obtain information on the performance of subordinates. Feedback from these controls helps to guide the subordinate toward achieving goals (Puskar et al., 2017). It also assures the manager that the problem will be identified before it develops into a disaster. If control mechanisms are ineffective, management will be concerned about delegating additional authority to subordinates.
Delegation in nursing is fraught with great difficulties and barriers, both of an organizational and psychological nature. In the considered case, the problem of delegating was associated with the incorrect choice of the CNA, insufficient control of the RN, as well as a lack of communication and supervision. Delegation is not only a way to relieve a leader of unnecessary burden but also a tool for the correct development of subordinates. The expectations and commitments created by delegation can be a powerful force for harmony and unity. However, if management does not make a concerted effort to address the personality traits and needs of the subordinates, then big problems can arise for both the leader and the recipient.
Duffield, C., Twigg, D., Roche, M., Williams, A., & Wise, S. (2019). Uncovering the disconnect between nursing workforce policy intentions, implementation, and outcomes: Lessons learned from the addition of a nursing assistant role. Policy, Politics, & Nursing Practice, 20(4), 228-238.
Puskar, K., Berju, D., Shi, X., & McFadden, T. (2017). Nursing students and delegation. Nursing made Incredibly Easy, 15(3), 6-8.