This set of guidelines is an exclusive excerpt from a new online continuing education course for nurses I’ve created with Pedagogy online learning systems. The course is called 4 Essential Communication Strategies that Promote Patient Safety and this excerpt is from Chapter 7-Delegation.
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Communication Guidelines for Effective Delegation
1. Respect that delegation is an essential nursing function. You will need help to complete your job, some days and some specialities more than others and this is true for your colleagues too. We have to be very careful in nursing not to judge ourselves or each other as being inadequate or inferior when we need help. This is very common in blaming or bullying cultures and shows up in our communication when we gossip about others, criticize each other, act superior, or delegate to certain staff without creating opportunities to teach others. There may be times when a nurse needs more training or practice to become efficient or a job match that isn’t suitable. That’s okay, the solutions to those are to get more training, optimize the use of my strengths in teamwork, or try out a different shift or specialty.
2. Use language that is clear, confident, kind, and authoritative. “Please fill the linen cart before you go on break.” Resist the urge to ask. “Would you mind filling the linen cart?” This suggests that completing the task is optional and unless it is, don’t give the option. Minimize apologies or extra words. “I’m sorry, I have to ask you a favor. I know you are really busy and I hate to add more work to your plate, but would you please fill the linen cart?” This kind of language is confusing and staff may think you are not serious about the request or lack confidence.
3. Build trusting and respectful relationships with all of your staff and colleagues. Use your basic listening skills to answer questions and validate concerns. When staff complain about unfair treatment consider what might be going on and what solutions there are. For instance a difficult patient that does well with one particular nurses’ assistant may lead to that staff member getting that patient more often and feeling unfairly treated. There may be times where you have to be assertive about expectations and use your listening to validate their feelings. “I understand that you feel you are doing more than your fair share of the work. Mr. Smith is very challenging and I know you’ve been taking care of him all week. I won’t change your assignment tonight but let’s discuss how I/we can help you and I’ll see what can be done about training others”. Training other staff to work with this patient may be a sensible approach and creates an opportunity for discussing the same with your supervisor, if not that day, soon.
4. Don’t make delegation decisions based on whether people will like you or not. Do make them based on the clinical needs of your patients, scope of practice of your support staff, and to the extent you can, fairness. This may seem obvious, but it happens all the time especially in toxic cultures where alignments may seem unavoidable and lead to resentments and fuel the organizational dysfunctions. If you feel like you have to appease someone in order to get the job done, avoid being bullied, or wasting time dealing with passive or passive-aggressive behaviors, it is your judgment call. Nevertheless, doing so consciously ensures that you are aware that you are compromising your professionalism. This is significant because you’ll be more in tuned to how it affects you and your practice which may lead to you getting support for yourself as well as as having a discussion with your supervisor if you feel safe.
5. Offer to lend a hand with your staff when you can and encourage others to do the same. I’ve worked on adjacent units where staff on one side is sitting down reading and staff on the other are running ragged. I delegate to nurse’s assistants who have downtime by saying, “Please go next door and see if they can use your help for 15 minutes” or something like that. I hope by doing this that I am distributing the workload as well as promoting positive relationships among staff. Be mindful that you need to complete your own work and from a budgetary perspective it costs the organization more for an RN to make a bed than a nurses’ assistant. Be careful of helping too much so that staff become overly dependent on your help or helping in ways that chronically avoid conflict. For example, it may be tempting to help one assistant in order to avoid his or her conflict with a peer. This may be necessary in the moment, but getting at the root of the conflict soon and being clear about expectations will serve everyone better in the long run. Staff will learn that they must work together effectively, that you will help when necessary, and that you are in charge. Plus, you’ll get more practice with your delegation skills!
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Do you know the 5 Rights of Delegation? Want a handy checklist or poster? Check out these free resources at the Pedagogy Online Library!