A Comprehensive Guide to Nursing Delegation

RN Delegation in America: NAPs, UAPs, CNAs, CMAs, LPNs, LVNs and more A guide to pass the NCLEX

Estimated read time: 1:20

    Summary

    This video delves into the roles and responsibilities of various nursing personnel, including NAPs, UAPs, CNAs, CMAs, LPNs, and LVNs, essential for passing the NCLEX exam. The creator discusses the importance of understanding delegation within clinical settings across different states and institutions. The content highlights the need for RNs to effectively assess tasks before delegating, considering client needs, personnel competency, and specific nursing laws and rules. With a focus on the key principles of delegation, the video emphasizes the responsibilities of nurses, especially concerning patient safety and maintaining accountability.

      Highlights

      • Delegation is a crucial skill for nurses to pass the NCLEX exam. 🎯
      • Different nursing roles have specific tasks they can perform; knowing these is essential. 🧩
      • UAPs can handle stable patients but not perform tasks requiring nursing judgment. 🤚
      • The RN is responsible for the nursing process and must oversee tasks given to others. 👩‍⚕️
      • Practice and study are vital to mastering nursing delegation principles. 📖

      Key Takeaways

      • Understand delegation: Nurses must assess tasks, considering client needs, personnel competency, and local laws. 💼
      • Scope of practice: Know what tasks each nursing role can perform and delegate accordingly. 🏥
      • Patient stability: Never delegate the care of unstable patients to UAPs or LPNs. 🚑
      • RN responsibilities: Nurses remain accountable for any delegated tasks. 🔍
      • Continuous learning: Practice NCLEX-style questions to master delegation skills. 📚

      Overview

      In this video, NurseKillam breaks down the intricate world of nursing delegation, a key component for those preparing for the NCLEX exam. She emphasizes the necessity for nurses to grasp the scope of various roles, such as NAPs, UAPs, CNAs, CMAs, LPNs, and LVNs, and how these professionals fit into the healthcare team. The lecture provides general guidelines that transcend state-specific regulations, focusing instead on universal principles vital for effective delegation.

        Understanding the scope of practice is crucial. The video outlines which tasks are suitable for different nursing roles, emphasizing the importance of delegating tasks appropriately while maintaining patient safety. RNs must ensure that any given task is legally permissible and within the caregiver's competency level. The importance of knowing when to step in, especially with unstable patients, is crucial for maintaining high standards of care.

          NurseKillam encourages continuous practice and application of the Five Rights of Delegation to hone one's skills. Her advice to embrace the learning process by tackling NCLEX-style questions prepares nursing students for real-world applications of these concepts. This educational reveal not only gears students for exams but also for practical success in nursing roles across diverse healthcare settings.

            Chapters

            • 00:00 - 00:30: Introduction to Delegation and Regulatory Considerations The chapter introduces the concept of delegation in nursing, focusing on the roles of NAPs, UAPs, CNAs, CMAs, LPNs, and LVNs. It emphasizes the importance of understanding the scope of these roles, particularly for those preparing for the NCLEX exam, as questions related to delegation may appear. The summary highlights that each state, province, and territory has its own regulations governing what regulated and unregulated personnel can do in clinical settings. Additionally, different institutions may impose restrictions on the scope of their employees.
            • 00:30 - 01:30: General Roles and Guidelines for Delegation This chapter focuses on the general roles and responsibilities of various nursing professionals within a collaborative healthcare team, specifically NAPs, UAPs, CNAs, CMAs, LPNs, LVNs, and RNs. It provides guidelines to help pass the NCLEX exam, emphasizing that the exam tests knowledge of general delegation principles rather than state or province-specific rules. Key tasks associated with different roles are discussed, preparing the reader for delegation in a healthcare setting.
            • 01:30 - 02:30: Tasks for Registered Nurses and Nursing Assistive Personnel The chapter titled 'Tasks for Registered Nurses and Nursing Assistive Personnel' discusses the roles and responsibilities concerning task delegation between registered nurses (RNs) and nursing assistive personnel (NAP). RNs need to understand which tasks they must complete personally and which can be delegated to unlicensed assistive personnel (UAP) or licensed practical nurses (LPNs). Additionally, RNs should know how to prioritize their care responsibilities and when it is necessary to contact a patient's primary healthcare provider. The National Council of State Boards of Nursing (NCSBN) defines individuals working with nurses in structured nursing organizations as Nursing Assistive Personnel. RNs must evaluate if it is suitable to delegate specific tasks.
            • 02:30 - 03:30: Unlicensed Assistive Personnel (UAP) and Their Limitations The chapter titled 'Unlicensed Assistive Personnel (UAP) and Their Limitations' discusses the considerations and legal guidelines involved in delegating tasks to nursing assistive personnel. It emphasizes the importance of understanding the laws and rules governing delegation, as well as the scopes of practice for both the person delegating and the assistive personnel. To successfully delegate a task, it must fall within the legal authority and scope of the nurse, who must also assess the education, competency, and scope of the person being delegated to. The chapter highlights the existence of various types of nursing assistive personnel, each with different qualifications and abilities.
            • 04:30 - 05:30: Certified Nursing Assistants (CNAs) and Medication Assistants (CMAs) The chapter discusses Certified Nursing Assistants (CNAs) and Medication Assistants (CMAs), focusing on their classification as Unlicensed Assisted Personnel (UAPs) by the National Council of State Boards of Nursing (NCSBN). It highlights that UAPs can perform tasks they are trained for, provided they are competent and the client is stable. It also notes the variability in certifications available for UAPs across different jurisdictions and mentions the general nature of the NCLEX exam.
            • 05:30 - 06:30: Licensed Practical Nurses (LPNs) and Their Expanding Roles The chapter discusses the roles of Licensed Practical Nurses (LPNs) and how they are expanding. It emphasizes the limitations of unlicensed assisted personnel, particularly in tasks that require nursing judgment, such as medication administration, assessment, diagnosis, care planning, education, evaluation, nursing care, and nursing judgment. The chapter clarifies that while LPNs may have expanding roles, certain responsibilities cannot be delegated to unlicensed personnel who are not nurses. The importance of understanding delegation rules, particularly concerning state-specific regulations, is also highlighted.
            • 06:30 - 07:30: Key Principles for Safe Delegation The chapter discusses the key principles of safe delegation, emphasizing that unlicensed assisted personnel (UAP) should not be assigned to care for unstable patients. It highlights that only when a patient is stable, basic care activities can be delegated to UAPs. Additionally, once a task is delegated, the nurse must be available to guide the UAPs. The nurse also remains accountable for the delivery of delegated tasks, indicating that delegation involves more than just assigning tasks.
            • 07:30 - 09:00: Recommended Resources and Concluding Remarks This chapter discusses the importance of delegation in safe care, emphasizing the accountability of the Unlicensed Assistive Personnel (UAP) in accepting tasks. It highlights the nurse's responsibility to ensure that the UAP is capable of meeting client's needs. It references the NCSBN website as a resource for a video explaining the delegation process, which includes assessment, delegation, monitoring, and evaluation. Although UAPs can collect observational data and vital signs, nurses are responsible for interpreting this data.

            RN Delegation in America: NAPs, UAPs, CNAs, CMAs, LPNs, LVNs and more A guide to pass the NCLEX Transcription

            • 00:00 - 00:30 you need to learn what naps uaps CNAs CMAs LPN and LVN do because there may be questions about delegation on the enlex I have talked to some students that have had lots of Delegation related questions on their enlex keep in mind that each state Province and territory have their own laws around what regulated and unregulated Personnel can do in the clinical setting to complicate things different institutions May restrict the scope of their employees however in this
            • 00:30 - 01:00 video I am going to review the general roles of naps uaps CNAs CMAs LPN LVN and RNs within the collaborative Healthcare team and provide some general guidelines that will help you pass the enlex remember that the enlex is textbook based and written to test your knowledge of General delegation principles it is not state or Province specific you need to know what tasks
            • 01:00 - 01:30 need to be completed by the registered nurse and what tasks can be assigned to unlicensed assisted personnel and licensed practical nurses you also need to know how to prioritize your own care and when to contact the patient's primary health care provider but I will cover that in another video the ncsbn refers to people who work with nurses in structured nursing organizations as nursing assisted Personnel it is up to the registered nurse to assess if a task is appropriate for deleg delation that
            • 01:30 - 02:00 means you need to know any laws or rules for delegation your scope and the scope of the nursing assisted Personnel client needs and the competency of yourself and the nursing assisted Personnel in order to delegate a task it must be within your scope you need to legally have the authority to delegate it and you need to know the education competency and scope of the person you are delegating to there are many different types of nursing assisted personnel
            • 02:00 - 02:30 unlicensed assisted Personnel or uaps are able to be given tasks that they are trained to complete as long as they are competent to perform the task and the client is stable the ncsbn classifies all nursing assisted Personnel that do not have a license as unlicensed assisted Personnel or uaps regardless of the titles that they may have earned the types of certifications available for uaps varies in different jurisdictions remember that the enlex is more General than that so
            • 02:30 - 03:00 they will not ask you about State specific delegation for the enlex remember that unlicensed assisted personnel must not be assigned to anything that requires nursing judgment that makes sense right since they're not nurses so any activities that involve medication administration assessment diagnosis care planning education evaluation nursing care or nursing judgment can cannot be
            • 03:00 - 03:30 assigned to a UAP unlicensed assisted personnel must not be assigned to care for unstable patients under any circumstances when a patient is stable there are a lot of basic care activities that can be delegated to an unlicensed assisted Personnel once a task is delegated the nurse must be available to guide the uaps delegation involves more than just assigning tasks the nurse delegating remains accountable for the delivery of
            • 03:30 - 04:00 Safe Care the UAP is also accountable for their decision to accept the delegation and perform the task however the nurse needs to be sure that the UAP has the ability to meet the client's needs the ncsbn website has an excellent video you should watch that talks about the process for delegation that involves assessment delegation monitoring and evaluation uaps can collect observational data for the nurse and take vital signs but the nurse needs to be the one to interpret the data and
            • 04:00 - 04:30 decide if the vital signs are abnormal or if an intervention is needed interventions like providing bedside care are often delegated uaps often encourage patients to drink provide bed bath position patients feed patients and remind them to do other things that other members of the healthcare team have already taught the patient how to do uaps can record intake and output weigh patients gather equipment for the nurse and in many
            • 04:30 - 05:00 situations and help with other activities of daily living one commonly talked about UAP is the certified nurse assistant or CNAs they are supervised by LPN and RNs they are certified to help people with activities of daily living hygiene measuring Vital Signs they also help with other tasks like making beds or emptying catheters their schooling means that they have some basic knowledge of how to do these things training exists in some states for uaps to become
            • 05:00 - 05:30 certified to do more like administer medications at which point they get a new title like certified medication assistant or CMA these CMAs are able to administer medications under the supervision of a nurse a licensed practical nurse or LPN is essentially the same thing as a licensed vocational nurse or LVN registered practical nurses or rpn in Ontario and Quebec are equivalent to an LPN in other parts of Canada and the
            • 05:30 - 06:00 United States what you see in practice may vary as the role of the LPN is rapidly expanding and governed by the laws of the state Province or territory you are practicing in however for the enlex remember that you can assign most medication administration to LPNs you cannot assign them to care for unstable patients or to do an initial or focused assessment or evaluate a client the RN remains responsible for the nursing process and under the supervision of an RN advanced practice
            • 06:00 - 06:30 nurse or physician LPN can perform sterile procedures and photomy take Vital Signs change dressings and help with activities of daily living I recommend looking at the appendix of the American Association of critical care nurses delegation handbook in the link below as it outlines in more detail what LPN can and cannot do as a registered nurse you need to make decisions about patient assignments and transferring clients to another unit
            • 06:30 - 07:00 as a general rule be sure to assign the most critical patient to the most experienced and qualified nurse do not delegate care of unstable patients to uaps or LPNs if you need to make a decision about who to discharge pick the most stable person keep the most unstable patient in the Intensive Care Unit or transfer them there as needed never delegate an initial patient assessment or subsequent assessments LPN can do routine physical assessments but RNs must complete assessments once in each 24-hour period lpn's cannot assess
            • 07:00 - 07:30 patients in emergency situations a lot of interventions will get delegated but never delegate any that require specialized knowledge judgment or skill lpn's can do a lot more than uaps like administer medications but they are limited never delegate the formulation of a nursing diagnosis or goal identification never delegate creating or updating a care plan never delegate educating the patient and or family to a
            • 07:30 - 08:00 UAP LPN can educate clients but they cannot assess learning barriers never delegate evaluation of progress towards meeting goals to UAP lpn's can resolve problems on the care plan in consultations with an RN never delegate discussion of patient issues with a physician the enlex is designed to test your critical thinking and professional judgment The Joint statement on delegation from the American Nurses Association and the ncsbn
            • 08:00 - 08:30 provides a guide to help you make a decision regarding what tasks can be delegated with practice you will get better at delegation decisions and you will be able to answer enlex questions after watching this video I recommend that you review the delegation process and the Five Rights of Delegation then practice enle style questions as much as you can until you get good at delegation remember it is a skill that needs to be practiced much like your other nursing skills students recommend using the charity book I have
            • 08:30 - 09:00 provided some links to some other helpful resources below I hope you have found this video helpful please comment below if you feel there's anything that needs to be added as a Canadian nursing Professor I had to do quite a bit of researching all the roles to understand and simplify them for you so please let me know what you thought of this video there are several links below the video to helpful delegation information you may also want to subscribe and check out more of my enle study tip videos thank you