Leadership qualities and competencies are essential for all registered nurses, regardless of whether they occupy a formal leadership position. Nursing responsibilities that rely on leadership qualities include patient advocacy, project management, professional communication, and promoting necessary changes and improvements to patient care (Leadership in nursing, n. d., para. 2). Advocating for patients by promoting the best possible available care, effective delegation of nursing tasks, and supervision of assistive personnel are core nursing skills that ensure positive patient outcomes and define the nurse’s leadership role.
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Advocacy and Delegation of Care as Leadership Roles in the Nursing Practice
A graduate registered nurse is expected to be an efficient leader. The Australian Nursing and Midwifery Council competency standards stipulate that a registered nurse should take the leadership role in the coordination of nursing and health care to facilitate optimum health outcomes (as cited in Conroy, 2018, p. 47). According to Thomas et al. (2016, para. 1), registered nurses should act as agents of change to drive processes, policies, and leverage technology to provide better and more affordable care. Leadership qualities and initiatives are expected of all registered nurses, with the most important of them being the ability to delegate and patient advocacy.
Advocacy is one of the fundamental underpinnings of nursing that encompasses caring, respect, and empowerment. Registered Nursing describes patient advocacy as promoting quality care and patient safety, which includes protecting patients, being their voice, provision of proper care, communication, and educating patients (Nsiah et al., 2019, p. 1124). When providing care, a nurse often has to take the role of a leader, counseling patients, advocating for them, striving to protect their rights, and, sometimes, representing patients when they cannot do it themselves (Murray, 2017, p. 8). For a nurse leader, advocacy also includes communication with other practitioners and engaging the community in the development of quality care, plans, and potential solutions to health-related problems. Having more contact with patients than any other healthcare professional, nurses are in the best position to advocate for them and promote a patient-centered approach to care.
Effective delegation is considered a core skill for professional nursing practice, with nurses at all levels being required to assign and delegate tasks and act as leaders supervising other healthcare workers (Leadership in nursing, n. d.). According to the National Guidelines for Nursing Delegation (National Council of State Boards of Nursing, 2016, p. 8), each licensed nurse’s responsibilities include not only determining which tasks and when to delegate, but also ensuring availability and appropriateness of delegation and supervising the outcomes. Delegation is essential to effective leadership and management and is necessary for obtaining desired results through the coordinated work of a nursing team (Murray, 2017, p. 255). Delegation both reduces healthcare costs and increases the efficiency of patient care by improving patient outcomes.
Patient Outcomes Resulting from Effective and Ineffective Delegation of Care
Delegation of care is especially important for nurses working in inpatient, acute care settings where they often have to address multiple patient care concerns and demands simultaneously. Modern care delivery models often involve unlicensed assistive personnel (UAP), which requires nurses to be accountable for the care they deliver and serve as leaders when delegating care to UAP (Wagner et al., 2017, p. 1). Failure to delegate the care properly often results in negative patient outcomes, higher healthcare costs, and patient dissatisfaction.
The successful delegation includes the ability to determine which task and when to delegate. For nurses working in acute care settings, the tasks that are most often entrusted to UAP’s include turning, bathing, feeding, ambulating, and personal care, all of which have a significant impact on patient health (Wagner et al., 2017, p. 3). The ineffective delegation, resulting in omitted or delayed care, can lead to negative patient outcomes, including catheter-associated infections, development of pressure ulcers, vein thrombosis, falls, and reduced patient satisfaction (Wagner et al., 2017, p. 3). Multiple studies show that nurses tend to delay delegation decisions (Wagner et al., 2017, p. 8) and take a reactive approach to meet patients’ needs, delegating tasks only if they are unable to complete them themselves (Hill et al., 2018, p. 4). Delegation requires problem-solving skills, critical thinking skills, and clinical judgment (Murray, 2017, p. 255). The failure to provide sufficient explanations to assistive personnel, supervise, and evaluate results is also among the most common delegation problems.
Effective delegation is the key to increasing the number of positive patient outcomes. Depending on the role of a nurse, they can delegate tasks to a higher or lower level depending on their scope of practice and providing that the task is in line with the delegate’s skills (When should a nurse delegate? 2020). For example, a registered nurse can ask a nurse practitioner for a diagnosis so that they can provide care instructions. In acute care, when a patient arrives with a sore throat, the registered nurse can ask the nurse practitioner to determine whether a patient has strep throat. It ensures that a patient is diagnosed by a higher-level health care worker and receives timely and appropriate treatment, which ensures better chances of a positive outcome. When a more difficult case emerges, a nurse can delegate it to s specialist with a narrower scope of practice.
Nurses can also delegate minor tasks, such as feeding or ambulating the patient to UAP’s. It prevents health care delays and simplifies the nursing practice. For example, when a nurse is busy admitting a patient, they can ask a UAP to pass meds for them, ensuring a better quality of care. Through the delegation of routine procedures, nurses can concentrate on complicated nursing objectives: monitoring significant medical changes, counseling patients, identifying nursing diagnoses, organizing care plans, and evaluating patients’ overall outcomes (Yoon et al., 2016, p. 676). Being able to focus on the most important tasks ensures a higher quality of patient care and provides more positive outcomes.
All registered nurses sometimes need to act as leaders and require a comprehensive set of leadership qualities crucial to both patient care and establishing a safe and productive working environment. In nurse-patient relations, advocacy is the most important leadership role, which makes nurses protect patients’ rights and interests in their practice on a daily basis (Murray, 2017, p. 91). Delegation of care is crucial to ensuring positive patient outcomes and the coordinated functioning of a nursing team. The effective delegation includes successful communication between nurses and assistive personnel, strict adherence to delegation guidelines, and supervision of outcomes. The failure to delegate tasks results in poor patient outcomes, which are especially damaging in acute health care settings, higher health care costs, and patient dissatisfaction. Patient advocacy and delegation of care are the core skills of every registered nurse that allow them to be a successful leader when it is required in their practice.
Conroy, T. (2018). Factors influencing nurses’ delivery of the fundamentals of care in acute hospital wards [Unpublished doctoral dissertation]. The University of Adelaide. Web.
Hill, B., Sugg, J., & Pearce, S. (2018). Nurses’ perception of effective delegation in the acute care setting [Master’s thesis, University of Mount Olive]. ProQuest Dissertations Publishing. Web.
Leadership in nursing. (n. d.). Nurse Focus. Web.
Murray, E. (2017). Nursing leadership and management: For patient safety and quality care. F. A. Davis. Web.
National Council of State Boards of Nursing. (2016). National guidelines for nursing delegation. Journal of Nursing Regulation, 7(1), pp. 5–14. Web.
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Nsiah, C., Siakwa, M., & Ninnoni, J. (2019). Registered Nurses’ description of patient advocacy in the clinical setting. Nursing Open, 6(3), pp. 1124–1132. Web.
Thomas, T. W., Seifert, P. C., & Joyner, J. C. (2016). Registered nurses leading innovative changes. The Online Journal of Issues in Nursing, 21(3), pp. 1–15. Web.
Wagner, E., O’Connor, N., & Hasenau, S. (2017). Improving patient care outcomes through delegation-communication among nurses and assistive personnel. Journal of Nursing Care Quality, 33(2), pp. 1–17. Web.
When should a nurse delegate? (2020). Web.
Yoon, J., Kim., M., & Shin, J. (2016). Confidence in delegation and leadership of registered nurses in long-term care hospitals. Journal of Nursing Management, 24, pp. 676–685. Web.