Delegating Tasks to an LPN

Scenario

You are the RN team leader on a medical-surgical unit working with one LPN and one CNA.
One of your assigned patients requires a dressing change on a stable surgical wound and a new IV line insertion for antibiotic therapy.

Question: How do you appropriately delegate tasks while maintaining accountability for care?

Best Practice Answer

1. Apply the Five Rights of Delegation:
   These rights form the foundation of safe, legal, and effective task delegation:

   • Right Task: Within scope of the delegatee.
   • Right Circumstance: Patient’s condition is stable.
   • Right Person: The delegatee is competent and qualified.
   • Right Direction/Communication: Clear, specific instructions are given.
   • Right Supervision/Evaluation: RN remains accountable and evaluates outcomes.

2. Delegate According to Scope and Competency:

   • To the LPN:
     • Assign routine wound dressing for a stable, healing incision, as this is within most LPN scopes under RN supervision.
     • Do not delegate the new IV start, as IV initiation may be restricted by state Nurse Practice Act or institutional policy.
     • Reinforce that any new assessment or acute change must be reported to you immediately.
   • To the CNA:
     • Assign vital signs, hygiene care, intake/output monitoring, and patient repositioning.
     • CNA tasks should be predictable, repetitive, and low-risk.

3. RN Responsibilities (Non-delegable):

   • Perform initial assessments, patient teaching, and IV initiation (if required by policy).
   • Evaluate wound healing progress and overall patient response to therapy.
   • Supervise the LPN’s wound care performance and verify documentation accuracy.
   • Ensure communication continuity during shift handoff.

4. Provide Clear Communication:

   • Use SBAR (Situation, Background, Assessment, Recommendation) format when assigning tasks.
   • Example:

     “Maria (LPN), please perform the wound dressing change for Mr. Lee in 312. The wound is clean and stable; note any odor, drainage, or redness and report immediately. I’ll handle his new IV start myself.”

5. Follow-Up and Evaluate Outcomes:

   • After tasks are completed, reassess the wound dressing outcome and review CNA vital trends.
   • Address any missed details through coaching, not blame — this builds a strong, collaborative culture.

Real-World Application

Effective delegation demonstrates leadership, prioritization, and understanding of scope of practice — all essential traits in charge or preceptor roles.
Many hospitals evaluate this in onsite or behavioral interviews, especially for RN applicants moving into team-lead or preceptor positions.

A strong answer emphasizes:

• Knowing what cannot be delegated.
• Maintaining accountability despite assigning tasks.
• Communicating clearly and professionally across roles.

Tip: In interviews, state:
“I delegate based on the five rights of delegation — ensuring safety, scope alignment, and clear follow-up.”
That phrasing shows you understand both the legal and clinical framework of teamwork.