Case: A registered nurse delegates a routine task to an enrolled nurse. The enrolled nurse states they are not comfortable performing the task because they have not done it on this particular ward. Which response by the registered nurse is most appropriate?

Question

BlackTom AI · Accepted Answer

Delegation principles require the registered nurse (RN) to ensure the person to whom a task is delegated is competent, confident, and appropriately supervised for patient safety.

1. Relevant knowledge points and concepts
- Scope of practice and competence: RNs are accountable for patient outcomes and must not delegate tasks beyond the enrolled nurse’s (EN’s) demonstrated competence.  
- Right task/right person/right supervision: Safe delegation involves assessing the task, the environment, and the delegatee’s knowledge and skill, then providing direction, support or supervision as needed.  
- Professional responsibility and autonomy: An EN may legitimately decline a task if they feel unsafe or unfamiliar; this is not automatically misconduct. Documentation should reflect decisions affecting patient safety, but incident reporting is not the automatic or only response.

2. Step-by-step reasoning
- The EN reports discomfort because they have not done the task on this ward. This signals a possible knowledge or contextual gap, not necessarily overall incompetence.  
- The RN must acknowledge the concern, ask what specifically the EN is unsure about, and assess their prior experience and learning needs.  
- If gaps exist, the RN should provide teaching, demonstration, or direct supervision, or reassign the task to someone competent, ensuring continuity of care and safety.  
- If the EN remains unable to perform safely, the RN retains responsibility to find an alternative and document the clinical decision.

3. Calculations
- Not applicable.

4. Why the correct answer is correct
- It follows delegation best practice: acknowledge, assess knowledge gap, provide support or supervision, and make a safe decision. This protects patients and respects the EN’s professional judgment while fulfilling the RN’s accountability.

5. Why the other options are incorrect
- Option 1 (remove from all delegated activities): punitive and disproportionate; expressing discomfort does not prove broad incompetence.  
- Option 3 (instruct to attempt independently): unsafe and violates duty to ensure competence and supervision.  
- Option 4 (document as incident requiring formal investigation): inappropriate escalation; a refusal for safety reasons should be handled clinically, not automatically as misconduct.

6. Conclusion
The most appropriate response is to acknowledge the EN’s concern, assess the specific knowledge gap, and provide appropriate support, teaching, or supervision before proceeding—confirming the provided correct answer.

Case: A registered nurse delegates a routine task to an enrolled nurse. The enrolled nurse states they are not comfortable performing the task because they have not done it on this particular ward. Which response by the registered nurse is most appropriate?单项选择题

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