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Delegation is a widely-spread practice and, today, delegation is applied in different fields, including health care. At the same time, the use of delegation may raise a number of challenges and, what is more, it can even lead to internal conflicts. In such a situation, it is very important to organize the delegation properly to maximize the effectiveness of delegation and to minimize the risk of conflicts and raise of the internal tension within a health care organization. As the matter of fact, the delegation in the health care setting should be carefully planned and meet needs of patients and health care organizations to maximize the effectiveness of work of health care professionals and to minimize the loss of time, when health care professionals undergo the process of delegation.
As a rule the delegation occurs, when a health care professional is not available at the moment and the patient still needs the assistance of health care professional or when there is no time to wait for the target health care professional and it is necessary to maintain the state of a patients' health stable. At this point, it is important to lay emphasis on the fact that the delegation does not necessarily occur in case of emergency. Instead, this is a regular practice when health care professionals can delegate their duties and functions to other health care professionals with no risk to the patients' health. On the other hand, a health care professional, who delegates his or her duties and functions to another health care professional, should be confident in the professional knowledge, skills and abilities of another health care professionals, who is about to perform his or her functions and duties. At this point, it is possible to dwell upon such positions as doctor, registered nurse, licensed practical nurse, and certified nursing assistant.
Basically, doctors can delegate their duties and functions, when they are fully confident in the qualification of a health care professional they delegate their duties and functions to. Often, a registered nurse can be a subject to delegation because registered nurse are well-trained and often they are experienced health care professionals, who have an extensive experience of work with patients. At the same time, the delegation cannot occur spontaneously. In stark contrast, the delegation should be carefully and prepared. Doctors should work with registered nurses to prepare them to perform their functions and duties. Registered nurse should get the full information about health problems of patients and recommendations of doctors on actions to be undertaken in relation to patients in case of changes in their health. In this regard, registered nurses should perform recommendations of doctors strictly to avoid errors in their work with patients in the course of delegation but this is exactly where conflicts can emerge because registered nurses may rely on their experience instead of recommendations of doctors that may be dangerous to patients' health. In such a situation, doctors should identify clearly registered nurses capable to follow their recommendations accurately.
At the same time, registered nurses can delegate their duties and functions to licensed practical nurses. Such delegation occurs when registered nurses perform their regular work and they need the assistance and when the tasks they perform meet the qualification of licensed practical nurse. In this regard, registered nurses often prefer to delegate their functions and duties to licensed practical nurses, who work on the improvement of their qualification level and who have an extensive experience. In fact, many licensed practical nurses aim at becoming registered nurses. Therefore, licensed practical nurses, who are the most successful in their professional development can count for the delegation. In such a situation, conflicts may occur if licensed practical nurses are negligent in the delegation in relation to patients.
Well-qualified licensed practical nurse can delegate their duties and functions to certified nursing assistants, for instance. In this regard certified nursing assistants should have an extensive experience and be capable to perform functions and duties of licensed practical nurses at the extent defined in terms of the delegation. This means that they perform a set of duties and functions that meets their qualification but which is normally performed by licensed practical nurses. Conflicts may occur at the interpersonal level, when nurses and certified nursing assistants have problems in interpersonal relationships. In such a situation, licensed practical nurses should delegate their duties and functions to certified nursing assistants they are confident in.
Finally, positive interpersonal relationships are essential for all cases of delegation, a health care professional cannot delegate his or her duties and functions to another health care professional if he or she is not confident in his or her professional functions and duties. In addition, health care professionals should well-developed skills of conflict management to tackle problems and conflicts that may arise in the course of delegation. Thus, health care professionals should be responsible in the process of delegation and maintain contacts with each other to perform their functions and duties properly.