Advice and development

Nurses need to master the art of delegating

Nurses must develop the ability to know when and how to delegate – and never give someone else a job they aren’t willing to do themselves

Nurses must develop the ability to know when and how to delegate – and never give someone else a job they aren’t willing to do themselves


Picture: iStock

While delegation is an everyday aspect of nursing practice, for many newcomers it can be a nerve-wracking prospect.

‘I think some see it as a bit of a dirty word – if you’re delegating you’re passing the buck. But that’s not true,’ says Lucy Tyler, a clinical nurse teacher at King’s College London. ‘One person can’t be expected to do everything.’

‘The point of a team is to help each other achieve all that needs to be done’

Lucy Tyler,  clinical nurse teacher at King’s College London Tyler

Ms Tyler has helped to design a board game that helps nursing students practise delegation, teamwork and communication in a safe way. ‘These kinds of skills can be tricky to teach and are often something you master over time and through experience,’ she says.

Playing the game

During the game, which lasts for an hour, each person takes on a different role – including ward manager, staff nurse and healthcare support worker – with the overall aim of admitting and discharging a set number of patients.

Tips on delegation

Communication is key. ‘If you look at where things go wrong, it’s often the lack of communication,’ says Lucy Tyler, a clinical nurse teacher at King’s College London. ‘Think carefully about your choice of words and explain the reasons why you’re delegating something.’

Award-winning dementia nurse consultant Yvonne Manson agrees. ‘Until you’re out there you don’t realise the value of communication skills. They are everything. Even the tone of your voice and your body language are important.’

Match people’s abilities to the responsibilities you want to give them, advises staff nurse Joleen McKee. ‘And make appropriate timelines too,’ she says.

Make people feel valued

Don’t just say “can you that for me” – if you give a precise time when you’d like it done by it’s more likely to happen. Give affirmation when the job is done well.’

Think about what will support your team members to grow and develop, says Ms Manson. ‘The person will then want to do well because they feel valued,’ she says. ‘It helps to build trust.’

Remember that delegation works both ways. ‘If someone asks you to do something, help them. And if you see someone who looks like they might need a hand, offer it,’ says Ms Tyler. ‘If you open up that way of working, delegation becomes part of the nursing culture.’

As the game progresses, participants pick up cards detailing different events, such as a crash call, the sluice blocking or a patient urgently needing the bathroom. ‘They are things that come up in day-to-day nursing practice,’ says Ms Tyler. ‘It’s about them working together as a team to see who is in the best place, and the most appropriate, to deal with what happens.’

After playing the game, students debrief, looking at what they might have done differently. ‘The discussions can go in all kinds of avenues,’ says Ms Tyler. ‘They often start to talk about the difficulties they’ve experienced so far on their placements.

Space to reflect

‘Students don’t always have the opportunity to reflect on what’s happened, as it’s difficult for staff to find the time, so part of my role is providing them with that space.’

Common concerns about delegation include having to ask older and more experienced staff members to take on tasks, and dealing with those who are simply unwilling to help. ‘We talk about how you encourage someone to do what you want them to do, without it sounding as if you’re dictating – that’s a fear they have,’ says Ms Tyler.

‘They also see it as a failure if they’re not able to do everything themselves. But the point of a team is to help each other achieve all that needs to be done, keeping patient safety uppermost.’

Stress and burnout

The value of delegation cannot be overstated, Ms Tyler believes. ‘It can make or break your day,’ she says. ‘If you don’t feel confident to delegate, you’ll end up doing everything yourself, which means you probably won’t take a break.

‘And if you’re doing that every day it will increase your stress levels and lead to burnout. We need to empower nurses to delegate and for it not to be seen as a bad thing.’

For staff nurse Joleen McKee, who qualified in 2016, those words ring true. ‘Nurses, including me, have an overwhelming desire to do everything themselves, even when it’s not realistic,’ she says.

‘I thought I was Superwoman’

‘I used to think I was Superwoman and put too much pressure on myself, then felt as if I was letting myself down by not being able to do it all. My workload was neverending – but since then I’ve learned that delegation is one of the most important things.’

‘If you don’t feel confident to delegate, you’ll end up doing everything yourself’

Lucy Tyler

She suggests always acknowledging the expertise of others. ‘It’s worth remembering that role models aren’t always registered nurses, and you can learn from other members of staff too,’ says Ms McKee, who works at the Royal Victoria Hospital in Belfast.

‘They may be older and have been doing the job for years – they’re going to be your saving grace,’ she adds. ‘They know so much about the ward and how to treat patients. Ask for their advice on what they’ve done before and what’s worked best.’

Professional friendships

Ms McKee believes delegation, when done well, can build professional friendships. ‘It helps the person to know that you trust them and believe in their abilities. Your strength as a leader can improve through delegation.’

But it can also be approached poorly. ‘The wrong way is to think that healthcare assistants are there to do what you don’t want to do,’ she says. ‘Don’t make them feel they have to do everything at your beck and call.

‘While it’s fine to delegate toilet visits if you’re tied up doing a drugs round, do them yourself sometimes too. These are core skills of nursing and you learn so much about patients when you’re carrying out these tasks. You also need to show staff that you’re willing to do the same jobs as them.’

Be a team player

Dementia nurse consultant Yvonne Manson, winner of the leadership award at this year’s RCNi Nurse Awards, agrees. ‘Never delegate something just because you don’t want to do it,’ she says.

‘Role models aren’t always registered nurses, and you can learn from other members of staff’

Joleen McKee, staff nurse

‘You can fall into the trap of giving what you might call the worst jobs to certain people, and that’s poor delegation. Don’t give someone a job you’re not willing to do yourself. Instead, show you’re a team player and will do whatever comes along.’

Newly qualified nurses should start by observing staff first, she advises. ‘Know your team and see where their strengths and weaknesses lie,’ says Ms Manson, who works for the Balhousie Care Group and is based in Perth, Scotland.

‘Never delegate something that you’re not confident they’ll be able to do. It can really give staff a boost if they’re given charge of something – but it can do the complete opposite if they’re not prepared or ready for it.’

Delegation and the code

The Nursing and Midwifery Council (NMC) defines delegation as ‘the transfer to a competent individual of the authority to perform a specific task in a specified situation’.

In practice, delegation can be from one registered professional to another, a registered professional to an unregulated member of staff, or a registered or unregistered person to a carer or family member.

The NMC advises:

  • Only delegate tasks and duties that are within the other person’s scope of competence, making sure they fully understand the instructions
  • Ensure that everyone is adequately supervised and supported, so they can provide safe and compassionate care
  • Confirm the outcome of any delegated tasks meets the required standards.

Lynne Pearce is a health journalist

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