In "Delegation Alert" (February) a clinical situation is used to demonstrate the professional nurse's responsibility when the provision of nursing care is shared with unlicensed assistive personnel (UAP). While I appreciated the acknowledgment, in the section labeled Essentials of effective delegation, that it's important to know state and institutional policies, this cannot be overemphasized.
For instance, in New York State, it is unprofessional conduct to delegate a nursing task that requires the skills of an RN or LPN to an unlicensed person. A UAP can be assigned only such health-related tasks as vital signs, venipuncture, and assistance with ambulation or EKGs. Delegation of a nursing task can only be between licensed nurses-RNs and LPNs-depending upon the level of knowledge or skill required.
Nurses must understand that the performance of any task, nursing or health related, depends upon the patient's need for care, the competency level of nurses and other caregivers, standards of nursing care, and the laws and regulations of a particular state. There is no magical solution inherent in delegation or assignment, regardless of state differences. It's essential for professional nurses to understand how to deliver safe, quality nursing care to all patients in accordance with the legal scope of nursing practice, thus preventing harm and supporting both recovery from illness and maintenance of health.
Karen A. Ballard, MA, RN, Director
Nursing Practice & Services Program New York State Nurses Association Latham, NY