What Makes a Good Leader? Delegation and Prioritization of Patient Care

Definition of Terms

  • Delegation- It indicates that the registered nurse (RN) has the authority to request an individual to perform a task that the individual may not normally be authorized to perform. However, registered nurses are responsible for overseeing individuals to whom responsibilities have been
  • Assignment- is the assignment of responsibilities to each employee within a given work
  • Supervision- Checking in with persons throughout the day to determine what tasks they have finished and what tasks they may still need to
  • Prioritization- figuring out which needs or problems need to be dealt with right away and which ones can wait.
  • Functional nursing- is a form of nursing whereby the focus is on the task and not necessarily providing holistic patient
  • Team nursing is a group of nurses who come together to care for a group of
  • Total patient care- a nursing delivery model whereby a registered nurse only assumes the role of caring for one
  • Primary nursing- is a nursing model whereby all the decision-making roles are distributed to the nurses caring for a


Today, the demand for nursing care exceeds the number of nurses available to deliver it.

As a result of demographic changes, increased life expectancy, and novel, more sophisticated therapies, the demand for nursing care continues to increase. Changes to the healthcare law require nurses to learn how to appropriately interact with other healthcare delivery team members, particularly nursing assistants. Understanding how and when to delegate is essential for future nurses entering the sector.

Nurses must have the ability to prioritize patient care effectively. Prioritization determines the importance of picking one action or activity over several alternatives (Weiss et al., 2019). At times, nurses make decisions based on their values, while at other times, they make decisions based on imperatives. Knowing what to do first is critical, but it is equally important to understand what to do subsequently. Understanding the repercussions of delaying an action is vital. If delaying the action could result in an unfavorable outcome, the priority of this task is elevated.

Nurses must examine and assess each circumstance or requirement for completing a given task. Certain nursing care competencies, including assessment, planning, and evaluation, will always fall under the purview of the registered nurse. Understanding the technique for assessing and defining patient care priorities is essential for managing assignments and delegating patient care responsibilities to others.

Major Concepts

The Nursing Process and Delegation

The nurse must determine the needs of each client, develop treatment plans tailored to each individual, and match the caregivers’ abilities to the tasks at hand before making care allocation decisions (assessment). Planning can help avoid issues once you delegate (plan). The nurse then delegates responsibilities to the right team members (implementation). As a result, the nurse is responsible for monitoring the care provided and assessing whether or not the client’s requirements have been fulfilled (evaluation). The nurse must also schedule time for daily feedback. This way, everyone on staff can see what has been done and what remains to be done. Care for multiple patients must be coordinated by the nurse before she may effectively delegate to other staff members (Weiss et al., 2019). In addition to caring for patients, the nurse must keep in mind his or her obligations. This entails having a clear voice, helping coworkers prioritize, providing additional clarification, and taking stock.

Safe Delegation

The NCSBN created a delegation Decision-Making Grid in 1997. This grid acts as a guide for nurses when they delegate work. The nurse can use the measurement as a grading reference for seven delegation-related characteristics. Components comprise the client’s acuity, the competence of unlicensed assistive personnel, the competence of the licensed nurse, the risk of injury, the frequency with which the skill has been performed by unlicensed assistive personnel, the degree to which the activity calls for independent judgment, and the client’s capacity for self-care.

The nurse can evaluate potential outcomes, client needs, and the availability of healthcare workers to meet those needs by assigning weights to each factor. With a low grid score, the task can be safely outsourced to someone other than the RN, whereas a high score indicates that delegation is not recommended. Nurses should evaluate the risk to patients, the task’s difficulty, the need for critical thinking and innovation, the certainty of the outcome, and the degree of involvement before delegating.

Barriers to Delegation

It is common for nurses, especially newer ones, to struggle with being able to delegate tasks. The reasons for this are as follows: problems with experience, problems with licensure, problems with legal concerns, and problems with the quality of care.

Models of Care Delivery

Functional nursing, team nursing, whole-client care, and primary nursing are examples of the many types of care delivery developed to strike a balance between patient needs and nurse capacity. Coordination and continuity of care, independent of the assignment method or care delivery system, are essential in the nursing field, which is why most care is provided through a group practice paradigm. Nurses, no matter the care setting, must have the skills necessary to delegate tasks and communicate with patients effectively.

The function of Delegation in Leadership Practice

Roles of Bedside Nurse

“Bedside nursing” characterizes nursing positions that involve direct patient involvement in hospitals and other in-patient facilities. Bedside nurses give drugs, change bedding, obtain vital signs, collaborate with physicians, and attend to the patient’s urgent needs. Typically, patients have physical demands, but a professional bedside nurse will also meet their emotional needs. Bedside nursing includes coordinating patient care and educating and advocating for the patient. Delegating generates manageable workloads, allowing experienced nurses to fulfill the professional tasks that can only be performed with their training and expertise while still providing patients with the necessary care and observations.

Roles of Public Health Nurse

Public health nurses may work alone or in teams. In both cases, public health nurses participate in an interprofessional review, assurance, and policy creation. Interventions or approaches may target multiple levels, depending on where impacts are most likely. Populations, families, and individuals are targeted. Public health nurses prevent disease, damage, and disability, promote health, and maintain population health. Sharing and transferring duties promotes good teamwork and clarifies roles and responsibilities. Increased responsibility motivates a team to work together.

Roles of Chief Nursing Officers

The highest-ranking nurses in a hospital or healthcare organization are known as chief nursing officers (CNOs). They are in charge of all elements of patient care, such as clinical services, quality assurance, and staffing (Ingwell-Spolan, 2018). Delegating roles by the CNOs can free up service and employee development time. Delegation can thus be viewed as an investment in the future of the service and its personnel.

Importance of Delegation in Nursing

Delegating work in nursing maintains responsibility. The person allocated a work may have other obligations, and the assignment may be outside their typical tasks. Delegating in nursing requires specific steps (Campbell et al., 2018). The National Council of State Boards of Nursing (NCSBN) lists five delegation rights: Right task, whereby the allotted work fits the individual’s job description of knowing expectations. Right situation, whereby the delegate’s patient is healthy and steady. Right person, whereby, when delegating, a nurse ensures the delegate has the necessary knowledge and abilities. Right direction and communication, whereby the nurse gives clear directions and answers questions to help the patient comprehend their work. Right supervision and evaluation, whereby the assigning nurse supervises and makes modifications as needed to ensure a good outcome.

Personal Growth regarding Delegation and Prioritization of Patient Care

Delegation has improved my level of patient care because of the additional patient care responsibilities that have been delegated to me by the registered nurses. This has also enhanced the level of satisfaction that I can render to my patients because I can watch how experienced nurses handle the various needs of the patient. My confidence while handling patients has also improved tremendously because of my increased involvement in patient care.

SWOT Analysis


I am driven to learn, am organized with my work, am a hardworking student, have great memorization abilities, accurately remember vital materials, am timely and always on time, and complete my work on time. Also, I am an excellent note taker; I take important notes that I may utilize for subsequent study, and I am a good team player.


English is my second language, and I lack confidence; I have a short attention span and am easily distracted, my time management is poor, and I constantly procrastinate; I am impatient and can be too single-minded.


Extra assistance from registered nurses and assigned roles provide opportunities for personal development, and experienced nurses provide feedback. Furthermore, work placement improves my interpersonal abilities, and there are readily available study materials and excellent study modules.


Working late or working too many hours can negatively impact my studies due to a lack of time and time constraints.

Traits of a Good Nurse

Critical Thinking

Nurses make critical decisions based on various factors in their patients’ best interests. As the team’s authority, a nurse leader must use critical thinking to guide their team through periods of transition or decision-making.

Effective Communication

To be successful as a whole, a nurse leader must have excellent communication skills.

Effective communication can help people at different levels and in different jobs in the healthcare sector work together (Prezerakos, 2018). Excellent communication is clear and accurate and includes active listening and feedback, which is especially important when dealing with trainee nurses.


The leaders of nursing teams split out tasks and duties among the members of their nursing staff in order to increase overall productivity. The ability to efficiently divide labor, improve patient care, and keep team members happy by encouraging them to use their finest abilities requires the nurses to have a thorough understanding of each other’s specialities and their limitations and strengths.


Delegation is not new. In today’s healthcare setting, full RN staffing is unrealistic. RNs must know delegation principles. Delegation requires personal organization and prioritizing patient care. The nurse must identify patient requirements before delegating work. The Delegation Decision-Making Grid helps nurses delegate safely. Nurses must know the skills of each staff member, the responsibilities that can be delegated, and their own duties. RNs delegate using critical thinking and professional judgment. Professional judgment is based on evidence- based practice and national nursing standards. Institutions decide what NAPs and other health care workers do, but the rules have to follow state nurse practice acts. The nurse assigns the work but remains accountable for the decision. Delegation helps the novice nurse focus on client care. Knowing the personnel simplifies delegating. Utilizing personnel abilities promotes a pleasant and productive workplace