Delegation and assignment: what the RN can hand off, and to whom
NCLEX-RN topic: Assignment, delegation, supervision
- The RN stays accountable for the client after delegating a task.
- Check the five rights: task, circumstance, person, directions, supervision.
- Stable and routine can go; judgment and teaching stay with the RN.
- Assistive personnel never assess, teach new content or use clinical judgment.
- Only the RN starts a blood transfusion.
Key facts
- Assignment covers routine care within a team member's normal scope; delegation hands off a task outside that routine role to someone with extra training and checked competence.
- The five rights of delegation are right task, right circumstance, right person, right directions and communication, and right supervision and evaluation.
- Right circumstance means the client is stable; vital signs on a stable client can go to assistive personnel, but vital signs on an unstable client cannot.
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- The delegating nurse keeps accountability for the client, while the delegatee is responsible for doing the delegated task correctly.
- Assistive personnel cannot assess, teach, delegate, or do tasks that need clinical judgment; they can reinforce teaching and must report changes to the nurse.
- LPN/VNs care for stable clients with predictable outcomes; they do not do admission assessments, create care plans, titrate medications, give high-risk drugs like heparin, or discharge clients.
- Only the RN initiates a blood transfusion; an LPN/VN may monitor it after the RN starts it, if agency policy allows.
Quick check1 question · 2 more at the end
An RN delegates a stable client's 1000 vital signs to an assistive personnel (AP). The AP accepts the task. Which statement about responsibility for this client is most accurate?
Correct answer: C.
Delegation transfers a task, not accountability. The delegating nurse remains answerable for the client's overall care, while the delegatee who accepts the task is responsible for completing it correctly and reporting back on time.
A Incorrect: the delegatee is responsible for the delegated task only, not for the client's overall outcome.
B Incorrect: the nurse who delegates keeps accountability; it does not move up to the charge nurse.
C Correct: the licensed nurse keeps overall accountability, and the delegatee is responsible for the accepted task.
D Incorrect: accountability is not split equally; the roles carry different responsibilities, whatever paperwork is signed.
Full lesson
Each part starts with its main idea. Open a part when you want the details.
The short answer: The RN can hand a task to another team member, but stays accountable for the client. Before handing off, check the five rights: right task, right circumstance (the client is stable), right person, right directions and communication, and right supervision and evaluation. Assessment, care planning, teaching and anything needing nursing judgment stay with the RN.
1 What is the difference between assignment and delegation?Assignment is routine work inside a person's normal scope, while delegation hands off something extra. 1 min
Assignment is routine work inside a person's normal scope, while delegation hands off something extra. An assignment is care that a team member learned in their basic program and that fits their job description. An example is an LPN/VN giving routine oral medications to a stable client.
Delegation is handing a task that sits outside a person's usual role to someone who has had extra training and has shown they can do it. An example is a trained aide giving medications where agency policy allows it. Either way, the RN is still answerable for the client's overall care.
2 Who can do what on the nursing team?Each role has a clear scope, and the safest rule is that judgment stays with the RN. 1 min
Each role has a clear scope, and the safest rule is that judgment stays with the RN. State law (the Nurse Practice Act) and agency policy set the exact limits. An agency may be stricter than the state, never looser.
| Team member | Typical work | Not theirs to do |
|---|---|---|
| RN | Assessment, care plans, client teaching, admission and discharge, IV push and high-risk drugs, starting blood | Tasks outside RN scope; the RN may also do any LPN/VN or AP task |
| LPN/VN | Stable clients with predictable outcomes: data collection, routine meds, enteral feeding, routine dressings, urinary catheters, stable trach care | Admission or first post-op assessment, care plans, titrating drugs, heparin or chemotherapy, discharge, new teaching |
| Assistive personnel (AP) | ADLs, vital signs on stable clients, intake and output, weight, transport, routine urine specimens | Assessment, teaching, delegating, anything needing clinical judgment |
Two classic details: an LPN/VN may monitor a transfusion only after the RN has started it. And feeding a client with dysphagia is not routine AP work, because of aspiration risk.
3 What are the five rights of delegation?Every handoff must pass all five rights, and failing one means the RN keeps the task. 1 min
Every handoff must pass all five rights, and failing one means the RN keeps the task. Run them in order:
- Right task. The task is allowed for this person by law, job description and agency policy.
- Right circumstance. The client is stable and staffing allows safe supervision.
- Right person. The delegatee has the training, has shown competence and is willing to accept.
- Right directions and communication. The RN states what to do, for which client, what data to collect, what to report, and by when. The delegatee may ask questions and may not change the plan on their own.
- Right supervision and evaluation. The RN stays available, follows up, checks the client's outcome, and makes sure the work is documented.
4 Who is accountable when something goes wrong?The delegating nurse keeps accountability for the client, even after handing off a task. 1 min
The delegating nurse keeps accountability for the client, even after handing off a task. The delegatee is responsible for doing the accepted task correctly and reporting back on time.
A delegatee cannot pass the task to someone else. If they cannot finish, they tell the nurse right away, and only the nurse decides what happens next. If the nurse doubts the handoff is safe, the nurse does the task personally.
5 What the nurse doesThe nurse matches each task to the client's stability and the person's scope, then follows up. 1 min
The nurse matches each task to the client's stability and the person's scope, then follows up. A quick sequence works on any shift:
- Assess first. Initial assessments, teaching plans and care-plan evaluation stay with the RN.
- Sort by stability. Routine care for stable clients can go to the LPN/VN or AP; anything for an unstable client returns to the RN.
- Give clear, two-way directions. Use closed-loop communication and set exact reporting triggers, such as a blood pressure value.
- Supervise and give feedback. Watch directly or review the chart, then give specific, supportive feedback.
Common mistakes
The traps students fall into most. Read these before you practice.
Watch out: The RN keeps accountability after delegating, not the delegatee alone.
Watch out: Assistive personnel reinforce teaching the RN already gave, not teach new content.
Watch out: Vital signs go to assistive personnel only when the client is stable, not whenever the RN is busy.
Watch out: A delegatee who cannot finish a task reports back to the nurse, not hands it to another aide.
Watch out: Agency policy may be stricter than the state Nurse Practice Act, not looser.
How to remember it
Memory hook: "Stable and routine can go; judgment and teaching stay." If a task asks someone to decide, interpret or teach something new, it belongs to the RN.
Self-check:
- Say the five rights from memory, in order.
- Name three tasks an LPN/VN cannot do for a client on your unit.
- Explain why taking vital signs is fine to delegate in one situation and not in another.