Delegation and Ethics in Nursing

Running Head: NURSING
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Nursing
Student name

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Table of Contents
The scope of practice in nursing............................................................................................................2
Role of delegation in the nursing setting............................................................................................2
Type of delegation.............................................................................................................................3
Roles and responsibilities of the delegator and delegate....................................................................4
Levels of supervision.........................................................................................................................5
Ethical and legal dilemmas in nursing...............................................................................................6
Nursing codes and guidelines in relation to the delegation and ethical/legal dilemmas.....................7
Health care plan.................................................................................................................................8
Respond and resolution to an ethical /legal dilemma.........................................................................9
Conclusion...........................................................................................................................................10
References...........................................................................................................................................12

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The scope of practice in nursing
The scope of nursing practice is described as the variety of roles, accountabilities,
functions, and activities that registered nurses are trained and authorized to do (Parker,
Keleher, Francis, & Abdulwadud, 2009). The wide scope of nursing is practice shows all of
the activities and roles commenced by the registered nurse to deal with the variety of human
experience and reactions to the illness and other health conditions (D’amour et al., 2012).
This involves; health promotion, health maintenance, health protection, health restoration,
palliation, and rehabilitation. Nursing practices are generally directed towards health goals by
the registered nurse to deal with the variety of human experience and reactions to the illness
and other health conditions (Schluter, Seaton, & Chaboyer, 2011). This involves; health
promotion, health maintenance, health protection, health restoration, palliation, and
rehabilitation (CQU Moodle, 2018). Nursing practices are generally directed towards the
target of helping the customers to achieve and manage the optimum quality of life throughout
the lifespan. In other words, the complete scope of nursing practice denotes to the exterior
limits of the boundaries for the specialized and the whole thing therein (NMBA, 2012). The
real scope of practice if separate nurses are continuously thinner than that of the scope of the
nursing specialized as a whole. The scope of practice of the particular nurse is impacted by
the knowledge, employer requirement, practice setting, and patient’s needs (NMBA, 2012). It
is commonly described in the nursing job description and described in the practice e setting
as competencies (Schluter, Seaton, & Chaboyer, 2011).
Role of delegation in the nursing setting
The nursing job is not an easy task to perform, the nurses generally operate in the
extreme pressure atmosphere that requires them to highlight nursing tasks and make rapid
decisions. This is specifically due to the type of the work, however, is also impacted by the

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present requirements for an additional skilled worker in the nursing job (CQU Moodle,
2018). The nursing issues cannot be altered by a lone institution, creating the investment to
develop delegation skills at the personal level can assist in ease a load of in the nurses and
enhance the patent experience at the similar time (Bittner, & Gravlin, 2009). Having the
knowledge of which job can be delegated to the nursing assistants may help to decrease the
stress and pressure, and enhance the efficiency, and permits the nurses to concentrate on the
most essential tasks or responsibilities. The client experience is must always be the priority
and the nurses play a major role in making sure that their clients get the best care. In various
cases, nurses are accountable for duties that others can easily perform (Potter, Deshields,
Kuhrik, 2010). Handling these types of duties to other authorized worker frees up the
valuable time of the nurses to concentrate on the main work for which they are actually
suited. Delegations can also enable the assistive caregiver to definitely add to the patient
result while dropping the price for employers (Gravlin, & Bittner, 2010). The choice to
delicate care must be; made in associations with the diseased person and in cooperation with
the health provider team, be based on the complete assessment of the patient and their
requirements, and evidence-based (Gravlin, & Bittner, 2010).
Type of delegation
There are 3 different types of delegations
 General or particular delegation
 The formal or informal delegation
 Lateral delegation
General or particular delegation
When the authority is instructed to perform a common managerial function like
preparation, establishing, directing etc., the subordinate managers do these functions and

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appreciate the authority needed to perform these duties. The specific delegation might relate
to a separate function or the assigned job. The authority delegated to the health care manager
for performing this function can be a specific delegation (Plawecki, & Amrhein, 2012).
Formal or informal delegations
A formal type of delegation of the authority is the area of the medical setting
structure. Whenever a duty is assigned to a nurse then is needed authority also provided to
her or him. This kind of delegation is part of the simple functioning of the organization
(Potter, Deshields, Kuhrik, 2010). Each nurse is directly provided authority as per his or her
duties. When the healthcare managers’ get power to enhance the quality of healthcare
services then it is the proper delegation of the authority. The informal delegation or allocation
does not occur due to the position or place but rendering to the situations (Potter, Deshields,
Kuhrik, 2010).
Lateral delegation
When a nurse has delegated a duty to accomplish particular takes, he or she may
require the assistance of different individuals. Is might take time to formally reactive the
assistance from these individuals. When the authority is delegated to the nurses informally, it
is termed as a lateral delegation (Motacki, & Burke, 2016).
Roles and responsibilities of the delegator and delegate
The delegation is applied where the midwife or nurse who possess the right for
delivery of healthcare, deliver it to another individual the obligation of a specific role or task
that is common within the scope of practice of the delegators (Kaplan, & Ura, 2010). The
effective delegation is the skill that enhances with training and education and a proper level
of supervision needed by the delegate. The delegation should also make sure that help and

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resources are there to the individual to whim the role r task has been delegated (McInnis, &
Parsons, 2009). The nurse to whim the specific task or activity is assigned is responsible for
delivering the delegated duty or task in the appropriate way and is responsible for the proper
performance of that tasks or actions. The delegator must make sure that the principal
motivation for delegation is to assist the interest and requirement of the diseased person
(Weydt, 2010). He or she should assess the risk associated with the delegation, and make sure
that the delegation s proper with the reference to the definition and theories of midwifery or
nursing. The delegators should also decide on the standard of supervision and feedback,
needed. Not delegate to the junior colleagues or other HCW activities and duties that are
beyond their co-workers’ competence to do (McInnis, & Parsons, 2009).
Levels of supervision
There are total two different levels of supervision; direct and indirect supervision.
Direct supervision
In this type of supervision, the supervisor takes the direct and major responsibilities
for the midwives and nursing care provided (e.g. the assessment and the treatment of the
particular patient) (Löfmark, Thorkildsen, Råholm, & Natvig, 2012).
Specifications; the supervisors should be physically available at the workplace, noticing at all
intervals when the supervisee is delivering clinical care, rendering to the overseen practice
plan. Supervision by mobile or telephone is secondary and not allowable (Reid‐Searl,
Moxham, Walker, & Happell, 2010).
Indirect supervision
In this kind of supervision, the supervisor and supervisee share the duties for the
specific patients. The supervisor is effortlessly contactable and is obtainable to perceive ad

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argue the nursing and midwifery upkeep the supervisee is bringing (Reid‐Searl, Moxham,
Walker, & Happell, 2010).
Specification; according to the overseen practice plan, the supervisors should be physically
available at the unit, ward or clinic, for most of the time whenever the supervisee is
delivering clinical care. The supervisee should notify the supervisee at settled intervals about
the maintenance of every patient; this may be after providing care (Franklin, 2013).
Ethical and legal dilemmas in nursing
Informed consent
Worries that patients and their relatives have not been fully informed related to their
treatment or clinical prognosis is the usual ethical distress of nurses. This can generate great
worries for nurses and the patient may sense more relaxed querying the nurse to code what
was said. However, it is the ethical problem related to how much they must convey (Lo,
2012).
Disclosing medical condition;
Another specimen of the ethical dilemma is expressing the fact to a patient or being
misleading. The nurse has the responsibility to the patient and the moral values of non-
maleficence and faithfulness (Fouka, & Mantzorou, 2011).
Incompetence among peers
Another dilemma relating nursing morals is when a nurse minutes ineffectiveness in a
colleague health care squad member and fights with talking or remaining quiet. They might
feel the conduct should be informed due to the risk to patient security but hesitate to do so as
it would deteriorate poor staffing (Ulrich, Taylor, Soeken, O’Donnell, Farrar, Danis, &
Grady, 2010).

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Broader ethical issues
The Code of Morals for Nurses with Explanatory Statements is perfect that nurses are
destined in their responsibility to defend human health. It is significant to take a robust place
on issues distressing human self-respect and societal wellbeing (Ulrich et al., 2010).
Legal dilemmas
Correctional nurses might be particularly vulnerable to the lawsuit due to correctional
patient populace has a legitimate right to wellbeing care. Irrespective of the process, the nurse
has the lawful and ethical duty to respond to the appeal for upkeep (Huston, 2013). In overall,
the nurse must see the diseased person to assess health requirements and regulate the level of
upkeep mandatory. It is continuously suitable for the nurse to track assessment the inmate’s
reaction to the intervention (Huston, 2013).
Nursing codes and guidelines in relation to the delegation and ethical/legal dilemmas
The scope of nursing practice is well-defined and set out by all state’s nurse exercise
act and by mutual law. Public Law: resulting from values rather than the cause; it is wide-
ranging and is founded on fairness, cause, and common logic (Potter, Deshields, & Kuhrik,
2010). Negligence: ways that are missing in care; upkeep delivered by non-specialists,
Standard of upkeep: nonconformity from what a sensible individual would do in the similar
state; numerous sources might be used to regulate standards of upkeep, professional
carelessness and professional movements by expert individuals (Motacki, & Burke, 2016).
Delegation and Supervision: nurse executive is accountable for sensible movements of
delegation and supervision actions. Miscarriage to delegate and supervise may lead to
malpractice (Weydt, 2010). Privacy is considered as the diseased person’s right to defense
against irrational and unjustified intrusion with the patient’s privacy. Confidentiality is the

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common right to secrecy of the medicinal record. Individual people with the “requirement to
know” must be allowed access to a person's data (Weydt, 2010).
Health care plan
Decision making
The nationwide decision-making structure, advanced in the setting of national staff
strategies endorsing variety, flexibility, and duties in the labor force, shows a whole-of-
wellbeing workforce viewpoint (NMBA, 2013). The reason for the scheme is to substitute
steadiness across authorities by recognizing the decided basis principles for decision-making
techniques and representing the use of the principles and ideas in the nursing occupation
(NMBA, 2013).
Care plan
 The first procedure in the implementation of a care plan is the assessment of the
patient. A nurse must evaluate the patient’s health history, analysis, lab standards,
medicines, and understand the patient. This data is acute to make an actual and precise
care plan.
 The nurse must then generate the main motivation for the patient's disease
management. Nurses frequently apply the “A, B, C’s” (airway, breathing, and
circulation) throughout this concentration. Their emphasis must come from the NMBA
regulations.
 The nurse must then find the concentration on the NMBA regulation to help grow the
“associated to” and “as showed by” share of the nursing identification statement
(Carpenito-Moyet, 2009).

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 The nurse must select certain results and interventions founded on the nursing analysis.
Minimum three results must be designated for the diseased person. Results need to be
quantifiable, patient precise and have a positive time-frame.
 Intervention must also be quantifiable, patient-particular, and have limitations. The
intervention must relate to the results. Sometimes, it is relaxed to develop the results
earlier the interventions (Carpenito-Moyet, 2009).
 Assessment the care plan to ensure that all of the info is right.
 Implement the health upkeep plan into the nursing activities to deliver health care for
the diseased person.
 Re-assess the care strategy as treatment remains. A nurse should make any
amendments if essential if the patient’s illness improves or deteriorates (Carpenito-
Moyet, 2009).
Respond and resolution to an ethical /legal dilemma
The ethical importance of informed consent is founded on the chance that the
procedure develops for the patient to employ autonomy. For ethical philosophers, the value of
autonomy signifies the ethical right to select and track one's individual design for life and
act. Knowledgeable consent signifies a puzzling dilemma for nurses (Lo, 2012). To create
active informed consent, nurses need to balance their responsibility to defend the patient's
wellbeing through generosity and their duty to respect the patient's independence. The ethical
value of self-determination is the subset of independence usually related to informed consent
(Ulrich et al., 2010).
Extra ethical tension might arise among admiration for patient independence and the
exercise of authoritarianism in health care. While surgeons or nurses exercise paternalism

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throughout the informed consent procedure, they supersede or ignore patient likings in the
effort to benefit or improve the patient's well-being. Morally, paternalism signifies the health
care worker's confidence that generosity is more significant than independence (Huston,
2013). One appearance of paternalism might be undervaluing the degree of a surgeon's effect
on the patient's self-governing decision. Though the surgeon's approvals have an appropriate
part in the informed consent procedure, surgeons and nurses might change the patient's
impartial frame of orientation by unreasonably highlighting either the welfares or risks of an
operation (Huston, 2013).
Conclusion
The scope of practice is identified as the different roles, actions, function, and duties
that an RN is skilled and allowed to perform. The nursing practice is normally focused on the
goal of helping the patient to achieve and manage their good health quality. The delegation is
the essentials tool in the nursing practice which plays various roles including; release the load
form the nurses, providing the tasks that can be performed by other health providers, and to
allow the nurses to do their job by decreasing the pressure. There are three types of
delegation; general specific delegation, formal or informal, and lateral delegations. Role of
delegators includes; ensuring the accuracy of the delegation, they should ensure that the
values motivation for delegation is to help the requirement and choice of the patient, to
decide on the level of the supervisor and feedback required. Levels of supervision are of two
types; direct and indirect supervision. The ethical and legal dilemmas include informed
consent, disclosing a medical condition, incompetence among the peers, and broader ethical
issues. Legal dilemmas include proving optimum health care quality, respecting the people
from every type of culture and race. Nurse managerial is answerable for practical actions of
delegation and supervision activities. Blunder to delegate and oversee might leads to

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misconduct. The care plan steps include assessing the patient’s data and history, applying
ABC and generating main motivation ton the person’s disorder management. Following the
NMBA regulation, including, patient in decision making, applying interventions, and re-
assessing the outcomes of the interventions and patient’s health. The ethical and legal
dilemma of confirmed consent is the important dilemma that every nurse should focus on.
For ethical philosophers, the value of autonomy signifies the ethical right to select and track
one's individual design for life and act. Knowledgeable consent signifies a puzzling dilemma
for nurses.

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References
Bittner, N. P., & Gravlin, G. (2009). Critical thinking, delegation, and missed care in nursing
practice. Journal of Nursing Administration, 39(3), 142-146.
Carpenito-Moyet, L. J. (2009). Nursing care plans & documentation: nursing diagnoses and
collaborative problems. Lippincott Williams & Wilkins.
CQU Moodle (2018). Delegation. Retrieved from:
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Huston, C. J. (2013). Professional issues in nursing: Challenges and opportunities.
Lippincott Williams & Wilkins.

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Kaplan, B., & Ura, D. (2010). Use of multiple patient simulators to enhance prioritizing and
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