Effective Communication in Nursing Delegation

The assignment delves into the significance of clear communication within nursing delegation practices. It examines the National Council of State Boards of Nursing's guidelines, along with the NMBA Code of Conduct and Ethics for nurses in Australia. Drawing on scholarly articles like Hezaveh et al. (2014) and Sonntag et al. (2016), it analyzes the impact of effective communication on successful delegation, referencing its role in handover situations within emergency departments as highlighted by Redley et al. (2017).

Running head: EFFECTIVE COMMUNICATION DURING DELEGATION
Effective communication during delegation
Name of the Student
Name of the University
Author note

1EFFECTIVE COMMUNICATION DURING DELEGATION
Communication is at the heart of the process of delegation. Timely and detailed
communication between the delegating RNs and members of the healthcare team is linked to
patient health outcomes and quality of care. Miscommunication that occurs between nurses has
negative outcomes like medication errors, failure to rescue and even patient falls. Moreover,
nurses are held accountable for any outcomes and so they have to communicate effectively
during the delegation process as it directly affects patient safety and quality of care. In a research
conducted by National Council of State Boards of Nursing, (2016) stated that communication
issues are the root cause of deaths that is associated with delays in treatment and giving rise to
sentinel events. Communication greatly shapes the process of delegation and patient safety
outcomes. The way a delegated nurse explains the patient condition greatly affects the
willingness of the team member to respond. Therefore, the following discussion involves the
importance of effective communication pertinent to new graduate nurses in Australia to ensure
patient safety and quality of care.
Delegation is multi-faceted that begins with understanding of the practice act for a nurse
outlining their legal responsibility, accountability and authority for patient care. It is a core
competency for the newly graduate RNs. They have the responsibility to conduct delegation
process that requires sophisticated clinical judgment and accountability for patient care. RNs are
considered the brokers of resources of patient care (Sonntag et al., 2016). They synthesize data
that is collected by nurses in coordinating individualized care, patient safety and addressing the
needs of patients and their families by maximizing the available resources. Fresh graduate RNs
are new to the clinical environment and often find directing care during delegation quite
challenging. Delegation is central to the nursing practice and it is expected that graduate RNs
should have the skill, knowledge, judgment and personal attributes in delegating nursing care

2EFFECTIVE COMMUNICATION DURING DELEGATION
effectively in the current complex and challenging environment (Nursingmidwiferyboard.gov.au,
2018). Although, they have passed as RNs, they lack confidence and through teamwork and
delegation process, they are able to perform delegation process effectively. It is important to
make the new nurses in Australia understand that they are responsible for care needs assessment
of patients and know the person whom they are delegating. Through the process of delegation,
nurses facilitate patient’s journey to preferred health outcomes. Therefore, it is important for the
new graduate nurses to perform effective delegation for better patient outcomes and ensure
safety.
Delegation is not only an important skill rather a leadership skill directly affecting
patients. According to supervision guidelines for nursing practice under Nursing and
Midwifery Board of Australia (NMBA) it is stated that delegation should be done for those tasks
suitable to the person’s role being supervised with their scope of competence, training and
supervisee capability (Nursingmidwiferyboard.gov.au, 2018). According to Bach and Grant,
(2015) there are five rights of delegation. Firstly, it is a fundamental aspect reflecting the primary
commitment of a nurse towards health, welfare and safety of patients. Therefore, it is important
for the new graduate nurses to be responsive to patient’s needs. Secondly, nurses should use their
critical thinking skills in making clinical judgments on how to allocate resources to staffs in the
delivery of patient care. The needs for care and patient condition must be considered to avoid
any kind of harm and evaluate the abilities of the personnel of healthcare team to whom the task
is to be delegated. Thirdly, nurses should delegate care aspects that is consistent with
competencies and scope of practice of the member to how the task is being delegated.
Accountability is important to retain for nurses for patient outcomes while making delegation
decisions. The patient’s plan of care need to be adapted, modified or continued depending upon

3EFFECTIVE COMMUNICATION DURING DELEGATION
the evaluation of nurse of the patient’s condition. The personnel assigned with delegation duties
must be responsible for the completion of the delegated task and accountable for safe task
performance. Finally, the most important principle is interpersonal relationships or
communication essential in the process of delegation (Birks et al., 2016).
Communication is the biggest driving factor for effective delegation process. Style of
communication greatly influences interpersonal relationships and teamwork. An open, honest
and direct communication is a characteristic of good delegation and therefore, the quality of
delegation and ability to delegate driven by interpersonal relationships greatly influences the way
the task is delegated. This statement supports the fact that the way RN performs delegation
influences the responsiveness and performance of personnel who is being delegated to (NMBA
code of conduct, 2018).
According to Harris (2017), critical thinking skills of nurses are important during the
delegation process. As nurses work in complex clinical situations, they need to synthesize
information and think in a complex manner making critical decisions about patient care during
the process of delegation. The main findings suggested that ineffective communication during
delegation could result in poor patient outcomes that influence the quality of care and patient
satisfaction. The findings also supported the fact that establishing healthy interpersonal
relationships between delegating RN and personnel can help to reduce the chances of omitted or
missed routine care that directly affect patient safety. Another study conducted by Hezaveh,
Rafii and Seyedfatemi, (2014) stated that novice nurses are unprepared for the delegation process
in their professional role that has severe consequences for the healthcare system leading to
reduction in patient care quality. The results highlighted that communicative problems are one of
the main reasons for ineffective delegation hampering patient safety and care.

4EFFECTIVE COMMUNICATION DURING DELEGATION
There are severe consequences of ineffective communication during delegation process.
According to Graan et al., (2014) miscommunication results in medical errors that greatly affect
patient outcomes. The quality of information is important during delegation and communication
should be rightly directed being the cornerstone of delegation and instrumental in shaping safety
and quality outcomes. The right communication is defined in a manner where information should
be timely communicated between the delegating RN and personnel reducing the likelihood of
missed, inappropriate or delayed care that may result in poor outcomes. Newly graduate nurses
experience may find it challenging to integrate into the uncertain and challenging hospital
environment and make sense of events and conversations made with the healthcare team
members. Therefore, they may struggle to work in these complex situations like delegation and
there might be breakdown in communication. As a result, there is conveying of insufficient
information that can hinder provider’s ability to deliver care (Hayes et al., 2015).
In 2013, a report published by Safety and Quality, Australia, around 440,000 people die
every year as a result of medical errors representing third leading cause of death (Hezaveh, Rafii
& Seyedfatemi, 2014). The Joint Commission’s 2012-2013 analysis stated that communication
was one of the major leading causes of sentinel events affecting patient safety resulting in
permanent harm, death or any other negative outcomes.
There are several barriers to communication in nursing during the process of delegation.
The first barrier is the poor interpersonal relationships between RN and personnel. Poor
interpersonal relationships resist the delegating process that hampers patient safety and quality of
care. The second barrier is the attitude of the nurses as attitudinal barriers can result in
ineffective delegation. Conflicting attitude among the members of healthcare team create
resentment and hamper delegation. There are various sources of conflict like work, age,

5EFFECTIVE COMMUNICATION DURING DELEGATION
personality, confusion and dissension. The third barrier is the absence of clear chain of command
in delegation. The nurses who delegate have to witness uncertainty in the daily healthcare
working environment as they continuously negotiate the boundaries of scope of practice, staff,
procedures and policies. The fresh graduate RNs are new to the healthcare working environment
and they face conflict between the organizations, staffing and policies of facilities. Hierarchical
confusions may cause ineffective delegation that need to be removed (Redley et al., 2017).
Several communication theories have been developed in nursing that guide and explain
interactions between nurses, patients as well as healthcare professionals. One such theory is
Dyadic Interpersonal Communication Model that greatly focuses on interpersonal
communications in the therapeutic process. Communication is a two way dynamic and
interactive process between two people. The sender and recipient being the encoder and decoder
greatly influence the way message being provided and processed. The model greatly highlights
the fact that there should be clarity and awareness when the information is being conveyed. The
encoder or sender should provide the message and the decoder or recipient should process the
information conveyed. Similarly, during delegation, the delegated RN should convey the
message in clear and succinct manner so that decoder or receiver is able to understand the
message being conveyed (Siegman & Pope, 2016). This theory is dynamic and powerful bond
between tow counterparts constantly evolving and intensifying. Furthermore, communication
should be intimate between the two people and should anticipate each other’s behavior. This
model helps to improve one’s role-play between speaker and listener and there is effective
conveying of right information during the process of delegation. Through deepening of dyadic
bond, members of the healthcare team can elevate their performance level and anticipate each
other’s style and choices of work. Feedback is also important in this communication model that

6EFFECTIVE COMMUNICATION DURING DELEGATION
help to understand that message is propagated effectively to the decoder or receiver. This is
important during delegation as it help the delegating nurse to understand that patient information
is conveyed effectively to the receiver (Siegman & Pope, 2016). The recommendations and
strategies for enhancing effective delegation is discussed in the subsequent section.
For effective delegation, concepts of delegation should be conveyed to nee graduate RNs
in a clear, non-intimidating and safe manner. The delegation nursing tasks should be
demonstrated to them that are expected in their new job role. Nurse educators should explain the
principles of delegation to the new RNs through stimulation-based learning promoting their
confidence and increasing their assessment skills in the delegation process. There should also be
increase in interaction of new nurses with the members of healthcare team through didactic
instruction through active learning techniques. Effective leadership and management skills
employed by nurse educators can help to bridge the gap between knowledge and competency.
With these recommendations, RNs transforms from primary care to contemporary care
developing the traits of intelligence, integrity, respect, trust and compassion for effective
communication (Yoon, Kim & Shin, 2016).
From the above discussion, it can be concluded that effective communication and way the
information is delivered affects delegation process and patient safety. Fresh graduate nurses are
new to the environment and face challenges during the delegation process. Lack of
understanding about concepts of delegation can result in ineffective communication posing
barrier to the delegation process. Dyadic Interpersonal Communication Model explains that
communication is a two way process focusing on clarity of information. Nursing educators
should focus on these issues and provide learning opportunities to the newly graduate nurses so
that it allows them to develop competency and confidence to execute the process of delegation.

7EFFECTIVE COMMUNICATION DURING DELEGATION
References
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8EFFECTIVE COMMUNICATION DURING DELEGATION
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9EFFECTIVE COMMUNICATION DURING DELEGATION
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