Delegation Skills: The Qualitative Connection That Can Make or Break Nurse Staffing Efficiency

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Whether or not nurses on a particular unit are functioning at top efficiency with respect to safety, morale, and cost-effectiveness can be confusing to assess.  What works on one unit may fail dismally on another or there may be conflicting outcomes between shifts or even day to day variations on the same shift.  Even with the same staff!  No wonder staffing is a daunting responsibility for nurse and administrative leaders.

Delegation is an important skill set that will help to both assess staffing need and optimize staffing budgets with patient safety, patient experience and nurse job satisfaction in mind.

What Does Delegation Involve?

In short, delegation is an assertiveness skill that involves asking for, accepting, offering or even refusing help.  Depending on leadership vs colleague role can also be described as demanding, insisting on, or refusing help.  As with all assertiveness skills, the development of one’s capacity to delegate involves training, opportunities to practice, and leadership role-modeling.   Building self-esteem, self-efficacy, and self-respect must be integrated into training with recognition that different nurses have different learning needs.  In addition, successful delegation requires available resources to help when needed.

Why is Delegation So Important?

When individuals on a team have these skills, they are aware of when they need help and trust they will be respected when asking for it.  This trust includes a recognition that help requested may not be granted by the individual being asked because of her/his own demands, yet in such cases, leadership support will be available to provide help and/or advocate for resources.  There is a mutual respect for self and others limits and differences.  When a team is functioning effectively there is a constant give and take to meet the many variables that impact clinical needs of patients and human needs of staff.

What Happens When Delegation Isn’t Working?

Anyone involved in staffing can probably relate to frustrations in juggling constantly changing clinicians, with infinite preferences, limits, and abilities along with budget constraints.  Additional staffing may be added on a particular day without any improvement in productivity or decrease in adverse events.  There are all sorts of complaints from staff and patients, yet there may be little consistency in the nature of complaints or problem-solving suggestions.

Best Practices in Developing Delegation Skills

1.  Provide Assertiveness Training with a focus on Delegation.

2.  Raise awareness about budget constraints.

3. Commit to adequate staffing as an organizational priority.

4. Create opportunities to practice, review, role-model, reward successes, and include skills in evaluation and disciplinary processes.

A team that has delegation skills will provide crucial input into staffing needs that balance safety, money, and respect for nursing work!  

Do you know the 5 Rights of Delegation?  Want a handy checklist or poster?  Check out these free resources at the Pedagogy Online Library!

Beth is an organizational development consultant, author, and medical improv trainer.  Contact to customize a workshop for your staff.


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2 Responses to Delegation Skills: The Qualitative Connection That Can Make or Break Nurse Staffing Efficiency

  1. Ruth Hansten, RN, PhD, FACHE

    Principal Consultant at Hansten Healthcare PLLC

    You are SPOT ON!
    We have a new online CEU course that teaches this:
    we have tracked definite clinical outcomes improvements related to better delegation knowledge and skills (falls w/injury, pressure ulcers etc.)
    Also of course you know Beth about my textbook on this process: Clinical Delegation Skills; A Handbook for Professional Practice, 4th edition, Jones and Bartlett.

    • Hi Ruth! Sounds great and congrats on your work! Any chance I can get a copy of your text to review for confident voices blog and likely reference in the core text I am writing for F.A. Davis on communication (tentatively titled: “Successful Nurse Communication: Safer Care, Positive Workplaces, & Rewarding Careers”. If so, email me for address:

What are your thoughts?