The Nurse Practice Act: The Role Of Delegation In Nursing

The American Nurses Association (ANA) Code of Ethics provides many professional traits that can be incorporated to an interdisciplinary team of healthcare professionals such as compassion and respect, advocacy, accountability for nursing practice and participation in advancement of the nursing career (Cherry, 2011). Compassion is a very important aspect of the nursing profession. It would be very difficult to be a nurse without being compassionate. Nurses demonstrate compassion and respect daily in their work by actively listening to patients’ and family members’ problems and concerns and by empathy when appropriate. Advocacy is a nursing trait constantly used by the entire interdisciplinary team. Nurses advocate for patients’ right of autonomy for decision making in regards to their care, treatments and procedures. Also, nurses are in the best position to serve as a bridge between the patient and the interdisciplinary team. Accountability is so essential in the nursing profession. Nurses are accountable for their own nursing practices and for our patients.

They believe that nursing is an art and a science responding to human condition (LMHC, 2017). The Lahey Hospital & Medical Center Model of Nursing is centered around patient focused care, in that not all patients require the same care throughout their life (LMHC, 2017). Watching the patient advance through their healthcare system using a multi-disciplinary method, is something that LMHC takes great pride in (LMHC, 2017). LMHC later adopted Swanson’s Middle Range Theory of Caring & Benners Novice-to-Expert skills acquisition model to use as the outline to their LHMC Nursing Professional Practice Model (LMHC, 2017). The professional practice model stands by their promise of providing superior care to patients and family through a caring, healing, protective environment, through their Nursing Governance Structure (LMHC, 2017). To show their commitment to patient care and professional practice, the follow : “The Lahey Hospital & Medical Center Guiding Principles, The Massachusetts Nurse Practice Act, ANA Nurses Code of Ethics, Scope & Standard of Nursing Practice and for Nurse Administrators Ambulatory Care Nursing Administration and Practice Standards, Nursing Social Policy Statement, ANA Bill of Rights for Registered Nurses, ANA Principles of Delegation, ANA Principles of Documentation, ANA Principles of Staffing”(LMHC,

The rules for safe practice the Registered Nurse is accountable for assuring the actions and behaviors meet all applicable standard for safe competent ethical decision making. Rules for safe practice between California and Texas are similarity the same. The Board of Nursing in each stated requires Registered Nurses to complete schooling from a board approved program. A nurse must pass the state board licensing to become a Registered Nurse, then may use the title RN, and practice nursing according to the state's Nurse Practice Act. The Texas Boards of Nursing, nurses must complete two additional hours of nursing jurisprudence and nursing ethics, complete twenty hours of continuing education, keep the board informed of name and address changes

One possible obstacle in the facilitation of interdisciplinary care is that staff members simply do not know about the available resources that they can offer to their clients. They may be aware that a nutritionist is on the staff, but are unclear how the nutritionist can help a client such as Ms. R, who may need advice about modifying her diet to ensure a healthy pregnancy. From the very beginning of their tenure at the organization, all new staff members should be oriented in the resources available at the facility. Regular meetings should be held involving all staff members to discuss how to better coordinate care for patients, and common issues all staff members deal with serving the community at large. To facilitate the teamwork from 'day one' of a staff member joining the clinic, an orientation program in basic concepts regarding intercultural concerns; healthcare in a multicultural context, and team communication on a theoretical and practical level should be given.

Healthcare reform and politics are on the forefront of most citizens throughout the United States. Our access to healthcare has become a barrier for many citizens, and a hurdle for the advanced practiced registered nurses (APRN) throughout the years. Strict state laws have burdened APRNs and limited their practice throughout Ohio. It would be prudent to follow suit of other states, and retire the Collaborative Agreement; Richards and Polsky (2014) noted an immediate 20 to 30 percent increase in nurse practitioner providers in those particular states after it was retired. House Bill 216 (H.B. 216) helps modernize the Nurse Practice Act and the retire the mandatory collaborative agreement and extensive drug formulary. Within this paper, the contents and purpose will begin to unravel as I describe the meeting Naserin Salameh and I were able to connect with Representative Margaret Ann Ruhl of Ohio House District 68 on March 30, 2016, about H.B. 216.

Nursing practice is controlled by the individual, state’s Board of Nursing, which oversees and defines the nurses’ scope of practice; hence, ensures that nursing practice is guided by the nurse practice act of that state. Legislation also influences nursing practice, with technology facilitating new break-through in scientific research; the need for changes and or advances in healthcare are detrimental to new and improved regulations within the individual states or at a national level. Additionally, private and or public corporations also affect the practice of nursing in different ways; the policies and funding within these entities may limit the resources

Knowledge, skill, and independent decision making. The purpose of delegation was put into perspective when Corazzini et al.

It is interesting that each state writes separate Nurse Practice Acts for their nurses. Federal legislation would seemingly be more uniform and standardized. Is this done by design, or have the laws not caught up with the times? Considering that, insurance companies and other payers are often located in states other than where the care is being provided, a more universal set of standards for health care would be appropriate. My only argument in this case would be that a single federal organization would be less effective at monitoring or “policing” individual nurses, like the State Boards are able to do.

The process of delegation can be traced back to Florence Nightingale who is recognized as the Founder of Modern Nursing. “Let whoever is in charge keep this simple question in her head (not, how can I always do this right thing myself, but) how can I provide for this right thing to be always done?” (Nightingale, 1860, Chapter 3). With the increasing demands placed on the registered nurse and the challenges of cost containment efforts, it is vital in today’s nursing practice to equip the registered nurse with the knowledge and training required to achieve and subsequently implement and sustain the ability to delegate effectively. The definition of delegation as stated by the American Nurses Association (ANA) is “The transfer of responsibility for the performance of a task from one individual to another while retaining accountability for the outcome” (ANA, 2012, p.6). Various perceptions concerning delegation influence interpretation and ones’ application or non-application of the delegation process. For states and institutions that currently are without formal delegation policies and/or processes, bringing clarity to what is and what is not delegation may indeed be a step in the right direction. Effective delegation skills have been shown to enhance teamwork, increase job satisfaction, improve patient outcomes and decrease expenses. (Kaernested & Bragadottir, 2012) The desire of this paper is to address current delegation policies at both the state and organizational

The first consideration a registered nurse should determine is if “The Right Task (Cherry 355-356)” is being delegated to the right staff member. Delegation to the right staff member must be in their scope of practice and have proven to competent to complete. An individuals’ scope of practice will be set forth by the facility in which they work. In addition to individual facility polices the nurse must adhere to the scope of delegation set forth in the Nurse Practice Act of Maryland. Per the Nurse Practice Act of Maryland the task to be delegated must be “within the area of responsibility of the nurse delegating the act (Code of Maryland Regulations 10.27.11.03).” An example of incorrect delegating would be having an unlicensed individual, CNA or LPN to

One way to avoid compromising quality care and to make delegating less complicated is to use the Five Rights of delegation. Our Contemporary Nursing text lists the five

Being a nurse, comes along with many rules you need to be familiar with in order to keep yourself in good standing with the law as well as the Board of Nursing. The Nurse Practice Act is a guideline for nurses to follow. This is the “bible” to nurses everywhere. In this paper I will attempt to highlight the basic parts as well as compare the laws of nursing and the Nurse Practice Act.

This article discusses about the process of nursing delegation. For the process of nursing delegation, it must have strong communication, empowered staff, and organizational support. The guidelines identify 5 rights of delegation, which include right task, right circumstances, right person, right direction & communication, and right supervision & evaluation. When a delegator, such as a nurse, delegates, they will remain responsible for the tasks that were delegated. Delegation of an action/task is done based on the patient’s safety and their quality of care. Following the process enables a nurse to appropriately delegate to benefit the care of the patient.

Autonomy, the fourth value, is the right of self-determination as a profession. Nurses are ethically and legally accountable for the quality of their practice by functioning independently and interdependently in a variety of settings. The American Nurses’ Association developed the Standards of Clinical Nursing Practice that

Health care facilities are institutions which provide numerous types of care and in order to provide care to patients there has to be individuals willing and eager to pursue careers in the medical fields. We know that there are a variety of physicians associated with medical facilities and there are also different types of nurses residing in these settings. The duties or roles of these nurses differ in many ways; but the main goal is to provide the best patient care possible. The understanding of the responsibility, authority, and accountability related to delegation is essential in the nursing care process (Mueller & Vogelsmeier, 2013).