Delegation and Assignment

Every shift, a registered nurse (RN) decides who will do what for which patient. Those decisions look administrative, but they are clinical: they determine whether a changing patient is seen by someone with the authority, competence and resources to recognize and manage the change. Delegation and assignment are therefore patient-safety skills, not scheduling skills. In Canada, nursing is regulated provincially and territorially. Each province or territory has its own legislation and its own regulator (for example, the College of Nurses of Ontario, the BC College of Nurses and Midwives, the College of Registered Nurses of Alberta, and the Ordre des infirmières et infirmiers du Québec). Whether "delegation" is a defined legal term, which activities are restricted or controlled, and how the practical nurse role is titled and scoped all vary by jurisdiction. The principles are national: the nurse who makes an assignment or delegates is accountable for that decision, the person who accepts it must be authorized and competent, instructions must be clear, someone must supervise and evaluate, and the arrangement must be reassessed whenever the patient changes. Delegation in...