NCLEX Wednesday #8 – Delegation
We know the National Council Licensure Examination can be scary. With so much information to cover, preparing for it can feel impossible, but we at AmeriTech are committed to helping our nursing students pass. Every week we offer a new set of NCLEX study tips, and unlike our more general strategies from last week, today we’re focusing on one common topic: Delegation.
Like with all of our NCLEX study tips, of course we can’t guarantee you’ll come across these questions. That said, it’s common to be asked about what an RN can delegate to another RN, an LPN (Licensed Practical Nurse), or a NAP (Nursing Assistive Personnel—same thing as CNA and NA).
1. Never step out of line
Remember: Any actions you delegate to the NAP must be defined, monitored, and directed by a RN. Even so, you can never assign nursing judgments or steps of the nursing process to anyone except a registered nurse (RN). Keeping this at the front of your mind should help you cross out choices and pick the right answer.
2. Base everything on the nursing process
In everything you do and delegate, you must implement the nursing process. “Assessment, Diagnosis, Outcomes/Planning, Implementation, and Evaluation” should always guide your actions, especially when deciding if delegation is appropriate. You must always make judgments for client care based on the nursing process.
3. Only let nurses teach
If the scenario involves client teaching, you can cross NAP off your potential delegation list. Client teaching must be performed by the RN and cannot be delegated to anyone except another RN.
4. Begin and end treatment with nurses
Though NAP can provide valuable support during the middle of (some) treatments, everything begins and ends with nurses. Both admission assessment and discharge teaching must be done by an RN.
5. Consider specificity and stability
Before you consider delegation as an option, consider the specificity of the task, and the stability of your client. The RN can delegate tasks that have specific guidelines which are used in the care of stable clients.
6. Remember this list
Tasks that can be delegated to NAPs include bathing, providing personal hygiene, collecting urine samples, assisting with ambulation, taking vital signs, and taking capillary blood sugar. NAPs can document data that they specifically gathered including: intake and output, vital signs, and blood sugars.
7. Mind RN keywords
When you see words like evaluate, assess, determine, teach, instruct, and decide, these are all things only the RN can do.
Happy studying, and see you with more NCLEX study tips next week!
– Cheryl Armstrong, MS, RN
– Britt Baer, RN, MSN-HCSM, SANE
For more NCLEX study strategies and advice, you can download our full NCLEX ebook here, for free!
About NCLEX Wednesday: AmeriTech’s NCLEX review course has helped our nursing students pass the NCLEX with flying colors. We’re spreading the love to all nursing students as part of a weekly series. Nurses unite!