In most US states, a registered nurse cannot delegate the parts of care that need nursing judgment: assessing a patient, planning care, evaluating how a patient responds, teaching patients, and anything that requires a clinical decision. Routine, stable, predictable tasks can be delegated to licensed practical nurses or assistants. The exact list depends on the state board, so check yours.
What stays with the nurse
- Assessment. Deciding what is going on with a patient.
- Care planning. Deciding what should be done about it.
- Evaluation. Deciding whether it worked.
- Patient teaching. Explaining a condition or treatment.
- Clinical judgment. Any step where the next action depends on reading the situation.
What can be delegated
Tasks that are routine, have a predictable outcome, do not need a judgment call mid-task, and have a clear way to check they were done: vital signs on a stable patient, help with meals and movement, documented routine care.
The five rights
Nursing's test for any delegation: the right task, under the right circumstances, to the right person, with the right direction, and the right supervision. The last two are the ones every other profession forgets. Direction means a clear brief. Supervision means someone checks the result.
Why the rule travels
Replace "patient" with "client" and the rule describes any team. Delegate routine work with a predictable outcome. Keep judgment, direction and evaluation. Give clear instructions and check the result. The nurses wrote it down because the stakes are high. The logic is the same when the stakes are a client report.
Where M-Tracker fits
The fourth and fifth rights are what M-Tracker does for work outside the hospital. The task's brief is the direction: result, audience, must-haves. When the work is sent, M-Tracker compares it with the brief and writes a plain review the person sees first, which is the supervision step done the moment the work is ready. Judgment stays with the person who should hold it.
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Questions people ask
Can an LPN delegate to a nursing assistant?
In some states, within limits. The state board's rules decide.
Who is accountable if a delegated task goes wrong?
The nurse who delegated keeps accountability for the decision to delegate and for supervision.
Does this apply to medication?
It depends on the state and the setting. Many states restrict medication administration tightly. Check the board.
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