Overview
This lecture covers safe and effective delegation for nurses, focusing on which tasks are appropriate for RNs, LPNs, and nurse aides, as well as guidelines for patient assignments, floating, and room assignments on the NCLEX.
RN (Registered Nurse) Tasks
- RN tasks always include planning, teaching (initial/discharge), evaluating, and interpreting patient data.
- RNs handle patients with new conditions, admissions, post-surgery, or first-time activities (e.g., first meal/walk after surgery).
- RNs are responsible for restraints and triage.
LPN (Licensed Practical Nurse) Tasks
- LPNs care for stable and chronic patients—not those who are acute or unstable.
- Can perform routine treatments, routine assessments, and collect specimens.
- May insert Foley catheters, place NG tubes, perform sterile dressing changes, and do tube feedings.
- Allowed to provide follow-up teaching, but not initial or discharge teaching.
- Do not start IVs, hang IV fluids, or give IV medications for NCLEX scenarios.
Nurse Aide Tasks
- Aides are assigned the most stable patients and assist with activities of daily living (ADLs) like bathing, dressing, and feeding.
- Can transport stable patients to other departments (e.g., X-ray).
- Feeding combative patients is still an aide’s responsibility unless the situation specifically requires a nurse.
Delegation Pitfalls
- Ignore circumstantial or irrelevant details; focus on the core task and patient stability.
- Do not over-assign tasks based on the potential for non-urgent problems (e.g., possible combativeness).
Floating Nurse Assignment
- Assign the most stable patient to floating nurses.
- Confirm floating nurse skills with a competency checklist or recent assessments, not with open-ended questions about comfort.
Room Assignments
- Group patients with similar infections or conditions together (“like with like”).
- For infection control, place patients requiring contact isolation together.
- In psych units, group patients with similar mental health states (e.g., depression with depression).
Key Terms & Definitions
- Delegation — Assigning patient care tasks to appropriate staff members based on role and scope.
- RN — Registered Nurse; responsible for assessment, planning, teaching, evaluation, and unstable or new patients.
- LPN — Licensed Practical Nurse; manages stable, chronic patients, routine care, and follow-up teaching.
- Nurse Aide — Assists with basic daily tasks for stable patients.
- Floating Nurse — Nurse temporarily working outside their usual unit.
- Room Assignment — Placing patients in rooms based on infection control and condition compatibility.
Action Items / Next Steps
- Review isolation precautions for various diseases.
- Practice NCLEX-style delegation and assignment scenarios.