DELEGATION

INTRODUCTION
Delegation is a major element of the directing function of nursing management. It is an effective nurse
management competency by which nurse managers get the work done through their employees. Delegation
is part of management; it requires professional training and development to accept the hierarchical
responsibilities of delegation. It is the process by which the manager assigns specific tasks/ duties to
workers with commensurate authority to perform the job. By delegating well defined tasks and
responsibilities, the nurse manager can be freed of valuable time that can well be sent on planning and
evaluating nursing programs and activities.
It also trains and develops staff members who desire greater opportunities and challenges in their work
making them more committed and satisfied in their jobs. The process by which authority passes from one
managerial level to another is known as delegation. Delegation of authority means the superior delegates
decision making power to his / her subordinate. Delegation of authority can be taken back by the superior
when the task that is delegated is completed.

DEFINITION
1. Delegation can be defined as getting work done through others, or as directing the performance of one
or more people to accomplish organizational goals.
2. Delegation is the process of assigning responsibility and authority to co-worker and ensuring his/her
accountability.
3. Delegation is one of the most important methods of organizing and also a skill required to a manager. A
manager by dividing his/her work and sharing responsibilities with others, can work smoothly and
effectively.
4. Delegation can be defined as the process, where a manager divides the work assigned to him/her, so as
to get help from others in accomplishing the work.
5. Delegating a technique of time management is a major element of the directing function of nursing
administration.

PURPOSE OF DELEGATION
Delegation is one of the most important management skills. These logical rules and techniques will help to
delegate well (and will help a person to help the manager when he/she is being delegated a task or new
responsibility; delegation is a two-way process). Good delegation saves time, develops people, grooms a
successor and motivates. Poor delegation will cause frustration, demotivates and confuses the other person,
and fails to achieve the task or purpose itself. So it is a management skill that is worth improving. Here are
the simple steps to follow if one wants to get delegation right, with different levels of delegation, freedom
that one can offer. The following are five purposes of delegating:
1. Assigning routine tasks.
2. Problem solving.
3. Changes in the nurse manager's own job emphasis.
4. Capability building.
5. Assigning tasks for which the nurse manager does not have time.
DIMENSIONS IN DELEGATION
Delegation has three essential aspects or dimensions:
1. Assignment of duties: As one person cannot perform all the tasks, he/she must allocate a part of his/her
work to subordinates for the purposes of accomplishment by them.
2. Grant of authority: Delegation of authority means division of authority and powers downwards to the
subordinates. If the delegated duty is to be discharged by subordinates, they must be entrusted with requisite
authority for enabling them to make such work performance.
3. Creation of accountability: Delegation of duties implies accountability from the side of subordinates.
Because of this accountability, the manager must keep for himself/herself some reserved authority and
duties for directing, regulating and controlling the course of work undertaken by his/her subordinates.

PRINCIPLES OF DELEGATION
Delegation is one of the important elements in organizational functions. Through delegation, interrelations
are created in an organization. There are certain principles, which can be followed as guidelines for effective
delegation.
Box 1.1: Principles of delegation

• Principles of delegation by results

• Principles of competence
• Principles of trust and confidence
• Principles of adequate authority for the responsibilities
• Principles of absolute responsibility
• Principles of adequate communication
• Principles of effective control
• Principles of reward
• Principles of receptiveness

1. Principles of Delegation by Results

Purpose of delegation is to get the work done more effectively and efficiently by someone else. To get the
desired result, is the objective of delegation. For that, the goals are already set and properly communicated
to the subordinates and it must be understood by him/ her. If the subordinate is not able to perform and
accomplish the desired objective, there is no point in assigning the task to him/her. Delegation should be
result oriented.
2. Principles of Competence
Delegation should be secured that the subordinate should be competent enough to fulfill the assigned task.
Before delegating the authority, one should examine the person to whom the power is transferred. If he/she
is not competent enough to exercise his/her authority, it could be waste of time and resources.
3. Principles of Trust and Confidence
Superior should trust in subordinate. Also the superior must have the confidence in the ability of subordinate
to perform the duty. As an organization, there must be trust and confidence in between the subordinates/co-
workers. Trust will bring drive and initiative in the work. It is possible only, if the subordinate is mentally
free to exercise his/her authority.
 4. Principles of Adequate Authority for the Responsibilities
There must be enough authority granted to the subordinate in relation to the responsibility. Imbalance of
authority and responsibility could damage the objective of delegation.
5. Principles of Unity of Command
There must be unity in command. If one gets different command from different bosses, there will be
confusion and conflict, which result in inefficiency of the subordinate. The subordinate should report to one
boss and get command from one boss will help him/her to concentrate on his/her duty and it also help
him/her perform very well. If there is more than one boss, there must be unity in command.
6. Principles of Absolute Responsibility
Responsibility is an obligation, which can neither be delegated nor be transferred temporarily. Superior
cannot escape from the responsibility of the activities of his/her subordinates through delegation, because
it is the superior who has delegated the authority and has distributed duties. At the same time, the
responsibility of a subordinate to the superior also cannot be shifted or transferred. The duty allocated to
the subordinates by the superior is absolute and cannot be shifted and are bound to perform the assigned
duties.
7. Principles of Adequate Communication
Free flow of information between the superior and his/her subordinates are a necessity. It will help the
superior to take necessary decision on time. Also it will help the subordinate to understand the nature of the
assigned duty and the degree of his/her authority and perform accordingly.
8. Principles of Effective Control
Superior delegates his/her authority to the subordinate, not the responsibility and should be ensuring that
the transferred authority is used properly.
9. Principles of Reward
An appropriate reward system to reward the Subordinates will help the subordinates to take more
responsibility and assume more authority, which will create a healthy environment and the growth of
the organization. Effective delegation and utilization of the proper authority should be rewarded.
10. Principles of Receptiveness
The superior, who delegates authority should listen and accept the suggestions made by his/her subordinates
to reach a healthy decision. Therefore, delegation needs an understanding between the superior and his/her
subordinates.

STEPS OF DELEGATION PROCESS

1. Define the task: Confirm in one's own mind that the task is suitable to be delegated. Does it meet the
criteria for delegating?
2. Select the individual or team: What are the reasons for delegating to this person or team? What are they
going to get out of it? What are you going to get out of it?
3. Assess ability and training needs: Is the other person or team of people capable of doing the task? Do
they understand what need to be done. If not, you cannot delegate.
4. Explain the reasons: One must explain why the job or responsibility is being delegated. And why to
that person or people? What is its importance and relevance? Where does it fit in the overall scheme of
things?
5. State required results: What must be achieved? Clarify understanding by getting feedback from the
other person. How will be the task measured? Make sure they know how one intend to decide that the job
is being successfully done.
6. Consider resources required: Discuss and agree what is required to get the job done. Consider people,
location, premises, equipment, money, materials, other related activities and services.
7. Agree deadlines: When must the job be finished? Or if an ongoing duty, when are the review dates?
When are the reports due? And if the task is complex and has parts or stages, what are the priorities?
At this point, one may need to confirm understanding with the other person of the previous points, getting
ideas and interpretation. As well as showing that the job can be done - this helps to reinforce commitment.
Methods of checking and controlling must be agreed with the other person. Failing to agree this in advance
will cause this monitoring to seem as interference or lack of trust.
8. Support and communicate: Think about who else needs to know what is going on, and inform them.
Involve the other person in considering this, so they can see beyond the issue at hand. Do not leave the
person to inform one's own peers of their new responsibility. Warn the person about any awkward matters
of politics or protocol. Inform one's own boss if the task is important, and of sufficient profile.
9. Feedback on results: It is essential to let the person know how they are doing, and whether they have
achieved their aims. If not, one must review with them why things did not go to plan, and deal with the
problems. One must observe the consequences of failure and pass on the credit for success.

ELEMENTS OF DELEGATION
A manager alone cannot perform all the tasks assigned to him/her. In order to meet the targets, the manager
should delegate authority, Delegation of authority means division of authority and powers downwards to
the subordinate. Delegation is about entrusting someone else to do parts of job. Delegation of authority can
be defined as subdivision and suballocation of powers to the subordinates in order to achieve
effective results.

Authority

Accountability Responsibility

Figure 1.1: Elements of delegation

Authority
In context of a business organization, authority can be defined as the power and right of a person to use and
allocate the resources efficiently, to take decisions and to give orders so as to achieve the organizational
objectives. Authority must be well defined. All people who have the authority, should know what is the
scope of their authority and they should not misutilize it. Authority is the right to give commands, orders
and get the things done. The top-level management has greatest authority. Authority always flows from top
to bottom. It explains how a superior gets work done from his/her subordinate by clearly explaining what
is expected of him/her and how he/she should go about it. Authority should be accompanied with an equal
amount of responsibility. Delegating the authority to someone else does not imply escaping from
accountability. Accountability still rest with the person having the utmost authority.
Responsibility
Responsibility is the duty of the person to complete the task assigned to him/her. A person who is given the
responsibility, should ensure that he/she accomplishes the tasks assigned to him/her. If the tasks for which
he/ she was held responsible are not completed, then he/she should not give explanations or excuses.
Responsibility without adequate authority leads to discontent and dissatisfaction among the person.
Responsibility flows from bottom to top. The middle level and lower-level management holds more
responsibility. The person held responsible for a job is answerable for it. If he/she performs the tasks
assigned as expected, the person is bound for praises. While if he/she does not accomplish tasks assigned
as expected, then also the same person is answerable for that.
Accountability
Means giving explanations for any variance in the actual performance from the expectation's set.
Accountability cannot be delegated. For example, if 'A' is given a task with sufficient authority, and 'A'
delegates this task to B and asks him/her to ensure that task is done well, responsibility rest with 'B' but
accountability still rest with 'A'. The top-level management is most accountable. Being accountable means
being innovative as the person will think beyond his/her scope of job. Accountability, in short, means being
answerable for the end result. Accountability cannot be escaped. It arises from responsibility. For achieving
delegation, a manager has to work in a system and has to perform following steps:
1. Assignment of tasks and duties.
2. Granting of authority.
3. Creating responsibility and accountability.

TYPES OF DELEGATION
1. Formal delegation: The formal delegation is found in the exercise of authority defined by organizations
role.
2. Fimak delegation: It is ‘downward delegation’ and is effective to the extent of the acceptance and respect
for formal authority.
3. Informal delegation: It occurs because people want to do something not they are told to do. It is
something that is not formally required to be done. When there is problem in the exercise of formal
authority, informal delegation is accepted.
4. Bottom-up delegation: In first hour organizations informal group leaders, without formal authority
assume authority to restrict supply and workers accept such informal delegations.
5. Lateral delegation: In modern organization, few positions are independent and teamwork exists in
members of a group entrusting the authority, responsibility to others in the group at their level. The process
of entrusting in a teamwork, to the other members of the group is called lateral delegation. Bottom up
delegation and lateral delegation mostly occurs in informal organizations.

PREREQUISITES FOR EFFECTIVE DELEGATION

The process of delegation is an art. It depends on the personality, skills and attitudes of two persons namely
the delegator and delegates. The following are some of the essential preconditions for effective delegations:
• Good organizational climate
• Clarity in objectives and goals
• Responsibility and authority
• Motivation
• Training
• Effective controlling
• Centralization vs decentralization.

Centralization and decentralization are two methods of organizing extended of delegation. Delegation
refers to downward transfer of responsibility and authority at individual level, whereas the same process
is done at organizational level in a systematic way, it is known as decentralization. Centralization is the
process, where the authority in the organization is not delegated, but concentrated at higher levels of
management.

ROLE OF NURSE MANAGER IN DELEGATION

List of ways or steps for nurse managers to successfully delegate are:
1. Train and develop subordinates: It is an investment. Give them reasons for the task, authority,
details, opportunity for growth, and written instructions if needed.
2. Plan ahead: It prevents problems.
3. Control and coordinate the work of subordinates: Develop ways of measuring the accomplishment
of objectives with communication, standards, measurements and feedback to prevent errors. Nursing
employees want to know the nurse manager's expectations of them. They understand expectations from
clearly defined jobs, work relationships, and expected results.
4. Visit subordinates frequently: Spot potential problems of morale, disagreement and grievance.
5. Coordination to prevent duplication of effort.
6. Solve problems and think about new ideas. Emphasize employees solving their own problems.
7. Accept delegation as desirable.
8. Specify goals and objectives.
9. Know subordinate's capabilities and match task or duty to the employee. Be sure the employee
considers it important.
10. Agree on performance standards.
11. Relate managerial references to employee performance.
12. Take an interest.
13. Assess results: The nurse manager should accept the fact that employees will perform delegated tasks
in their own style.
14. Give appropriate tasks.
15. Do not take back delegated tasks.

BARRIERS IN DELEGATION

Barriers in the situation

Barriers in the Barriers in the

delegator delegate

Figure 1.2: Barriers in delegation

Barriers in the delegator

1. Preference for operating by oneself.
2. Demand that everyone know all the details.
3. “I can do it better myself” – fallacy.
4. Lack of experience in the job or in delegating.
5. Insecurity.
6. Fear of being disliked.
7. Refusal to allow mistakes.
8. Lack of confidence in subordinates.
9. Perfectionism, leading to excessive control.
10. Lack of organizational skill in balancing work loads.

Barriers in the Delegate

1.Lack of experience.
2. Lack of competence.
3. Avoidance of responsibility.
4.Overdependence on the boss.
5. Disorganization
6. Overload of work.
Barriers in the Situation
1. One-person-show policy.
2. No toleration of mistakes.
3. Criticality of decisions.
4. Urgency, leaving no time to explain.
5. Confusion in responsibilities and authority.
6. Understaffing.

ADVANTAGES OF DELEGATION
1. Delegation serves as a vehicle of coordination. The various levels of the organization are used
appropriately.
2. A sound system of delegation tends to develop an increased sense of responbility and enhanced potential
work capacity of individual employee.
3. It reduces the executive burden; it relieves the superior of time consuming, minor duties and allows to
concentrate more effectively on major responsibilities of his/her own position.
4. Delegation minimizes delay, when decision has no longer to be referred up the line.
5. As delegation provides the means of multiplying the limited personal capacity of the superior, it is
instrumental for encouraging of business.
6.Delegation permits the subordinates to enlarge their jobs, to broaden their understanding and develop
their capacity.
7. Delegation raises subordinate's position in stature and importance and increases their job satisfaction.

EFFECTIVE STRATEGIES OF DELEGATION

Delegation is a fundamental skill in today's business. However, one of the main components of effective
delegation is leadership. As a leader, the following strategies are effective:
1. Assignment: Assign the job to someone who can get it done, when required. Be sure to match the right
job to the right person.
2. Communication: Once a person has delegated, he/she should communicate the conditions, which the
job requirements to eliminate any uncertainty.
3. Work plan: Create a plan to streamline the work involved in the delegated task.
4. Feedback loop: Establish a feedback loop with the appointed worker so that one can give suggestions
and answer questions.
5. Build motivation: Discuss how success has an impact on the financial condition and future opportunities
with the parties involved.
6. Maintain control: Discuss the project deadlines and time lines up front, and schedule a checkpoint to
review the progress. Along with periodic reviews, take time to review all the submitted work.
 7. Focus on results: Facilitate trust and success by allowing the other person to control methods and
processes. As sociate oneself with whatever is accomplished and focus on results.

DISADVANTAGES OF DELEGATION
Good supervisors and managers are able to delegate effectively. Delegation is a key to good time
management and an important skill in developing employees to take on greater responsibility. While,
delegation is an important management skill, it is not without is disadvantages. There are several barriers
to effective delegation and times, when work should not be delegated. Good managers must be aware of
these drawbacks and know when to avoid delegation or how to leap over the barriers.
Insufficient Training or Skills
It is not enough to simply hand a task to an employee and tell him/her to do it. The employee must be
sufficiently trained and possess the skills needed to perform the task well. If the employee does not have
the necessary skills or training, the manager is setting the employee up for failure. To overcome this barrier,
managers/supervisors needs to take the time to train an employee in how to do the task and coach his/her
performance before handing it off permanently.
Morale Issues
Delegation can be a tricky issue for the employees to whom the delegation is being made. If they feel they
are being asked to do a task simply because the manager does not prefer the task or because it is unpleasant,
they are unlikely to help make the delegation successful. Even if they do perform it to the best of their
abilities, it can harm their morale and make them less motivated to perform other tasks. An employee may
also feel insecure about the task, if he/she does not feel, has the necessary skills or may feel that does not
have the time to do the task along with his/her regular duties.
Lack of Authority
There are some tasks that require a certain amount of authority to accomplish. This authority may come in
the form of being able to secure funds or get the cooperation of people in other departments. If a task is
given to an employee, who lacks the proper authority to secure the necessary resources, the delegation is
likely to fail. Managers must ensure that sufficient authority is delegated along with the task.
Lack of Experience
An employee, who lacks experience with an organization may shy away from delegated task, even if one
has the necessary skills and training. Some tasks require a familiarity with the organization and its
employees. An inexperienced employee may lack the confidence needed to secure the proper resources and
perform the task consistently well. How ever, given that delegated tasks are one way that an employee can
gain experience, this is a barrier that can be overcome with patience and persistence on the part of the
manager It must be recognized that the trainee could need more time and more coaching than a more
experienced employee would need.
Perfectionism
Another barrier to delegation is when the manager or supervisor engages in perfectionism. Demanding that
the task be performed exactly as the manager or supervisor would perform it can lead to difficulties in
delegation. Unless the task is hazardous or related to safety or money, it may be necessary to allow the
employee to develop one's own way of performing a task. The manager also must be able to tolerate errors,
when the task is first being performed until the employee gains experience and knowledge.
DELEGATION IN NURSING
Delegation in nursing is defined as to entrust or to assign to another person a responsibility for a task. As
one can see, a key part of the definition is contained in the word 'entrust'. For delegation to occur, trust must
be present. The trust that the registered nurse (RN) has in the other staff member will determine what and
how much he/she is willing to delegate? Those who delegate must also have trust in their decision-making
ability. Delegation is a legal and management concept, an art and a skill, and a decision-making process. It
is never absolute, as the delegator retains final accountability for the decision-making process and the
results.
The decision to delegate essentially involves the use of the nursing process, i.e. appropriate assessment of
the circumstances (staff available and patient acuity), planning, implementation and evaluation by the
delegator. It is up to the RN to make a professional judgment based upon the information available to
him/her in each specific situation. General guidelines for delegation in nursing include the following:
1. Delegation of acts beyond those taught in the basic educational program for the license of practical
nurses (LPN) should be based upon a conscious decision of the RN. It should not be automatic nor
should it be based solely on length of experience. It cannot be assumed that because someone has
been a nurse for X number of years that he/she is competent in a task.
2. Records of any educational activities, in services, nursing classes that were taken. etc. that provide
additional information beyond entry level capability must be maintained by the employer and the
employee. Records should contain an outline of the educational content and documentation, which
indicates that the staff member achieved the educational objectives and demonstrated the desired
skills.
3. Practice must be limited to those activities addressed in the written policies and procedures of the
agency. It is important for the employer to have in its job. descriptions and policies functions that
the LPN or unlicensed person will be expected to perform.
Many nurses find it difficult to delegate tasks to other members of their healthcare team. It is not
unсоmmon to hear a nurse say that they could finish the task themselves in the time that it takes to
explain it to someone else. While this may be true, it is shortsighted. When done well, delegation can
be a very effective management tool. It frees professional nurses to attend more complex patient needs.
At the same time, delegation helps to develop the skills of nursing assistive personnel and it is also more
cost-effective for the organization.

PRINCIPLES OF DELEGATION IN NURSING

The following “Five Rights of Delegation” delineate accountability for nurses at all levels from
nursing service administrators to registered nurses.

NURSING SERVICE ADMINISTRATOR STAFF NURSE (RN/APRN)

1. RIGHT TASK

• Identify appropriate delegation activities in • Identify appropriate delegation activities are

unlicensed assistive person (UAP) job
description/role delineation.
• Describe expectations of and limits to
organizational policies, procedures and standards.
for specific client(s).
• Identify appropriate activities for specific
unlicensed assistive person (UAP).
 2. RIGHT CIRCUMSTANCES

• Assess the health of the client community,
analyze the data and identify collective nursing
care needs, priorities and necessary resources.
• Provide appropriate staffing and skill mix,
identify clear lines of authority and reporting, and
provide sufficient equipment and supplies to meet
the nursing care needs.
• Provide appropriate preparation in management
techniques to deliver and delegate care.
• Assess health status of individual client(s),
analyze the data and identify client-specific
goals and nursing care needs.
• Match the complexity of the activity with the
UAP and competency with the level of
supervision available.
• Provide for appropriate monitoring and
guidance for the combination of client, activity
and personnel.

3. RIGHT PERSON

• Establish organizational standards consistent
with applicable law and rules that identify
educational and training requirements and
competency measurements of nurses and UAP.
• Incorporate competency standards into
institutional policies; assess nurse and UAP
performance; perform evaluations based upon
standards; and take steps to remedy failure to meet meet standards.
standards, including reporting nurses who fail to
meet standards to Board of Nursing.
• Instruct and/or assess, verify and identify the
UAP’s competency on an individual and client-
specific basis.
• Implement own professional development
activities based on assessed needs; assess UAP
performance; evaluate UAP based upon
standards; and take steps to remedy failure to

4. RIGHT DIRECTION/COMMUNICATION

• Communicate acceptable activities, UAP • Communicate delegation decisions on a client-

competencies and qualifications, and the
supervision plan through a description of a
nursing service delivery model, standards of care,
role descriptions, and policies or procedures.
specific and UAP-specific basis. The detail and
method (oral and/or written) vary with the
specific circumstances.
• Situation-specific communication includes:
o Specific data to be collected and method
and timelines for reporting.
o Specific activities to be performed and
client-specific instruction and limitation.
o The expected results or potential
complications and timelines for
communicating such information.

5. RIGHT SUPERVISION/EVALUATION

• Ensure human resources, including time and
supervision, to ensure care is adequate, meets
clients’ needs.
• Supervise performance of specific nursing
activities or assign supervision to other licensed
nurses.
• Provide directions and clear expectations of
how the activity is to be performed:
 • Identify by position, title and role delineation the o Monitor performance.
licensed nurses responsible for providing
supervision needs. o Obtain and provide feedback.

• Evaluate outcomes of client community and use o Intervene if necessary.

information to develop quality assurance and to o Ensure proper documentation.
contribute to risk management plans.
• Evaluate the entire delegation process
including the client and the performance of the
activity.

Five Rights of Delegation Case Study Approach

Mark is a new graduate registered nurse who has recently completed nursing orientation. He is now on
his second week of non-precepted practice on a busy medical-surgical unit. During the middle of his
busy night shift, Mark has several tasks that need to be completed quickly. These tasks include a linen
change for a patient who just vomited, an assessment of a possibly infiltrated intravenous line, and the
administration of intravenous pain medication for a patient who rates her pain 10 out of 10. Mark also
needs to make hourly rounds within the next few minutes, and he is very behind on his charting. He
knows he must delegate some of the tasks to his coworkers. However, Mark is unsure what he can
delegate and to whom. He decides to use the five rights of delegation to help with his delegation
decisions.
Right tasks
First, Mark needs to determine which tasks are right to delegate. Some questions he may ask at this
time would include (1) which tasks are legally appropriate to delegate and (2) can I delegate these
tasks based on this organization’s policies and procedures? Correctly answering these questions will
require familiarity with institutional and nurse practice act guidance. Generally, registered nurses are
responsible for assessment, planning, and evaluation within the nursing process. These actions should
not be delegated to someone who is not a registered nurse.
Right circumstances
After determining the right tasks for delegation, Mark considers the right circumstances of delegation.
In so doing, Mark may ask the following questions: (1) are appropriate equipment and resources
available to perform the task, (2) does the delegatee have the right supervision to accomplish the task,
and (3) is the environment favorable for delegation in this situation? To appropriately answer these
questions, it is imperative that Mark completes an assessment on each client. Patients who are or may
become unstable and cases with unpredictable outcomes are not good candidates for delegation. For
example, it may be appropriate for unlicensed assistive personnel to feed patients requiring assistance
with the activities of daily living. However, if a patient has a high risk for aspiration and a
complicated specialty diet, delegation of feeding to unlicensed assistive personnel may not be safe.
Right person
If a task and circumstance are right for delegation, the next “right” of delegation is the right person.
Mark needs to consider if the potential delegatees have the requisite knowledge and experience to
complete delegated tasks safely, especially concerning the assessed patient acuity. Before delegating a
task, the registered nurse must know the delegatee’s job description and previous training. Mark may
be unsure about his potential delegatee’s qualifications. Therefore, he might ask the following
questions before delegating a task: (1) have you received training to perform this task, (2) have you
ever performed this task with a patient, (3) have you ever completed this task without supervision, and
(4) what problems have you encountered in performing this task in the past?
Right direction and communication
Finally, the delegator must give the right direction and communication to the delegatee. All delegators
must communicate performance expectations precisely and directly. Mark should not assume that his
delegatee knows what to do and how to do it, even for routine tasks. Mark must consider whether the
delegatee understood the assigned task, directions, patient limitations, and expected outcomes before
the delegatee assumes responsibility for it. The delegatee also must comprehend what, how, and when
to report back after the delegated task is complete. Delegatees also need a deadline for task
completion for time-sensitive tasks.
Right supervision
The right supervision must be available in all delegation situations. Nurse practice acts require the
registered nurse to provide appropriate supervision for all delegated tasks. In the case study, Mark
must be sure that the delegatee will provide feedback after the task is complete. Following task
completion, Mark is responsible for evaluating the outcome of the task with the patient. Registered
nurses are accountable for evaluation and the overall patient outcomes.
Using the five rights of delegation, Mark appropriately took care of his patients’ needs. Mark
delegated the linen change to trained unlicensed assistive personnel, and he entrusted his hourly
rounds to his shift charge nurse. Mark opted to assess the patient with a possibly infiltrated
intravenous site first. Upon finding the site infiltrated, he assessed his patient, removed the
intravenous line, and placed a warm compress on the patient’s elevated extremity. He then
administered another patient’s requested pain medications after delegating new intravenous catheter
placement to an intravenous-certified coworker for the patient with the infiltration. Mark was able to
complete all his documentation requirements by the end of his shift.

CONCLUSION
Delegation is the process by which the manager assigns specific tasks/duties to workers with
commensurate authority to perform the job. By delegating well-defined tasks and responsibilities, the
nurse manager can be freed of valuable time that can well be spent on planning and evaluating nursing
programs and activities. It also trains and develops staff members who desire greater opportunities
and challenges in their work making them more committed and satisfied in their jobs. The process by
which authority passes from one managerial level to another is known as delegation. Delegation of
authority means the superior delegates decision-making power to his/her subordinate. Delegation of
authority can be taken back by the superior when the task that is delegated is completed.
 COORDINATION

MEANING OF COORDINATION
Coordination is the process in which different people or things work together to attain specific goals or
aims. It is the way through which people can be made to work together and to cooperate with each other to
attain the final aims of the organization. Henry Fayol viewed coordination as a function of a manager.
Mooney JD considered it as the first principle of organization. Ralph C Davis looks upon coordination
primarily as a vital phase of controlling.
Coordination means working together in a logical way toward some common result or goal. The operational
definition of coordination, however, varies among personnel from different agencies. Definitions of
coordination range from centralized coordination to simple information sharing between organizations. The
greatest challenge to coordination is the inherent difficulty of identifying a common purpose and approach
among agencies whose mandates, methods, resources and systems are diverse. The incentive to coordinate
comes from experiences where the lack of coordination results in conflicts and misunderstanding.

DEFINITIONS
‘Coordination is the achievement of orderly group efforts and unity of action in the pursuit of common
goals.
- Mooney and Railey
‘Coordination is the integration of several parts into an orderly whole to achieve the purpose of
understanding’.
- Charles Worth
‘To coordinate is to harmonize all the activities of a concern so as to facilitate its working and its success.
In a well-coordinate enterprise, each department or division works in harmony with others and is fully
informed of its role the organization. The working schedules of the various departments are constantly
attuned to circumstances’
- Henry Fayol
‘Coordination is the orderly synchronization of efforts of the subordinates to provide the proper amount,
timing and quality of execution so that their unified efforts lead to the stated objective, namely the common
purpose of the enterprise.
- Haimann
Coordination is thus the unification, integration, synchronization of the efforts of group members so as to
provide unity of action in the pursuit of common goals. It is a hidden force which binds all the other
functions of management.

FEATURES OF COORDINATION
Group Effort
Coordination is a relevant to group effort and leads to integration of all activities in the nursing organization
to render the best possible nursing care. There is no need for coordination when an individual works in
isolation without affecting anyone's functioning.
Essence of Management
Coordination is not a distinct function, but the very essence of management. It is inherent in the managerial
job.
Conscious Activity
Coordination does not arise spontaneously or by force. Coordination is conscious activity since various
skills are required to have the coordination within the department.
Responsibility of Management
Coordination is the basic responsibility of management and it can be achieved through managerial
functions. No manager can evade or avoid this responsibility. As coordination is the responsibility of each
and every manager.
Continuous and Dynamic Process
Coordination is a continuous or on-going process. It is also a dynamic process. It has to achieve through
the managerial activities and required to be maintained continuously.
Unity of Actions
All the activities in the department are unified in pursuit of common goal.
Unity of Purpose
The heart of coordination is the unity of purpose which involves fixing the time and manner of performing
various activities.
Integration of Activities
Coordination is achieved through integration of various activities.
Pervasive Function
It is required at every level and by every manager
Common Purpose
Coordination has a common purpose of getting organizational objectives accomplished.

PURPOSES OF COORDINATION
The logic behind coordination is the presence of dependencies between departments and their activities.
And the goal of coordination is to manage these dependencies in such a way that the activities become part
of the organization's objective (Holt, 1998).
NEED AND IMPORTANCE OF COORDINATION
Coordination among the employees and the upper and lower management is considered very important
within an organization Many studies were conducted regarding effect of coordination in health organization.
Many studies were conducted regarding effect of coordination in health organization. The results indicate
that:
• It plays an important role in performance, efficiency and cost effectiveness of health care
organization. Coordination helps to improve the efficiency of operations by avoiding the
overlapping of efforts and duplication of work.
• Effective coordination of staff leads to better clinical outcomes (Gittell et all., 2000; Yougn et al,
1997; Young et al., 1998). The quality of coordination determines the effectiveness of organized
efforts.
• Coordination reduces the conflicts among the people because of understanding and helps to improve
team spirit and morale of employees.
• Coordination also makes the people to move equally for attaining objectives and it increases the
capability of the people to solve the problems.
• It facilitates the stability and growth of an organization.
• It provides a framework for strategic decision making on issues of common concern.
• Coordination eliminates gaps and duplication of services in meeting the needs of clients.
• Coordination is an all-inclusive concept and the end result of management process.

ELEMENTS OF COORDINATION
There are three elements of coordination: balancing, timing and integrating.
Balancing
To create a balance between the resources of different departments and individuals.
Timing
Timing means adjusting the time schedules of different activities so that they support and reinforce each
other.
Integrating
Integrating is involving unification of the diverse interests under the common purpose.

PRINCIPLES OF COORDINATION
According to Mary Parker Follett, there are four principles for effective coordination that can be applied
for nursing services:
Direct Personal
Coordination is best achieved through direct personal contact with people concerned, Direct face-to-face
communication is the most effective way to convey ideas and information and to remove misunderstanding.
Early Beginning
Coordination can be achieved more easily in early stages of planning and policy-making. Coordinated plans
when put into operation are always successful.
Reciprocity
This means that all factors in a given situation are interdependent and interrelated. Coordination becomes
easier when people appreciate the reciprocity of relations.
Continuity
Coordination is an on-going or than a once-for-all activity: never-ending process rather than a once-for-all
activity.

TYPES OF COORDINATION
On the Basis of Scope
• Internal:
When the coordination is between the different units of an organization within and is achieved by
integrating the goals and activities of different departments of the organization.
• External:
It refers to coordination between an organization and its external environment comprising government,
community, customers, investors, suppliers, competitors, research institutions, etc. It requires proper match
between policies and activities of the organization and the outside.

On the Basis of Hierarchy

• Vertical:
When the coordination is between different levels of the organization and has to ensure that all the
levels in the organization act in harmony and in accordance with the goals and policies of the
organization. Vertical coordination is assured by top management through delegation of authority.
• Horizontal or lateral:
It refers to coordination between different departments and other units at the same level of the
management hierarchy.

PRECONDITIONS TO COORDINATION
The chances of achieving effective coordination are greatly enhanced when several preconditions have
been met. These are: Participation, impartiality and transparency.
Participation
Coordination becomes viable when organization actively participates in the coordination process.
Organization need to participate in deciding the policies, procedures, strategies and plans that will affect
their operations. Participants must act to secure and maintain the confidence of others, thereby creating an
atmosphere of respect and good will.
Impartiality
Coordination should advocate the principle of impartiality
Transparency
Coordination requires trust and trust requires transparency; the willing flow of information and open
decision-making processes.

BARRIER OF EFFECTIVE COORDINATION

Loss of Ad hoc Communication
Lack of informal communication can lead to ineffective coordination. Kraut and Streeter found in their
study that informal communications is the primary way information flows into and through research and
development organizations.
Lack of Contact among Employees
An unanticipated barrier to coordination occurs from the lack of contact among team members.
Time to Initiate Contact or Communication
The amount of time to initiate contact or communication can sometimes be a barrier to coordination.
Communication Differences or Preferences
If differences exist in communication style, there may be a reluctance to communicate with other team
members. Ultimate this leads to some loss and a higher cost in coordination.
Lack of Trust
Lack of trust is also an issue or barrier to coordination.
Personal Work Style Differences
Personal work style differences definitely affect coordination. Some individuals prefer to work
collaboratively, while others prefer to work alone.
Different Backgrounds of Members
A wide range of experience and capabilities, from novice to expert led to some difficulties in
coordination.
Not Realizing there is a Need to Communicate
Communication plays a large role in the relationships of individuals and teams.

SKILLS TO ACHIEVE EFFECTIVE COORDINATION

Sound Planning
The goals of its units must be clearly defined. Planning is the ideal stage for coordination. There should
be clear-cut objectives, harmonized policies and unified procedures and rules to ensure uniformity of
action.
Effective communication
Effective communication is the key to coordination. It helps in resolving differences and in creating
mutual understanding. Personal and face-to-face contacts are the most effective means of communication
and coordination.
Effective Leadership and Supervision
A good leader can guide the activities of his subordinates in the right direction and can inspire them to
pull together for the accomplishment of common objectives. Effective supervision is an important method
of resolving differences of opinion.
Proper Delegation
Delegation is often required; hence delegations skills are required to get the work done.
Voluntary Coordination
Self-coordination is possible in a climate of dedication and mutual cooperation. It results from team-spirit
among the members of the organization.
Evaluation Skills
The evaluation skills are required to determine either the outcomes are achieved as well as when to make
adjustments.
Coordination Through Committees
Committees ensure that the problem arise out of relationship can be solved by group decisions.
Meetings
Periodic meetings are very effective in promoting the coordination, if organized properly

CONCLUSION
Coordination is the essence of nursing management. It is the life line for the management. Health Care
Organization which is unique and complex entity consisting of groups of specialized people with specific
purpose in the set of rules, policies, procedures, relationships and culture, coordination is must.
 10 YEARS QUESTION

a. What is delegation? (1) Discuss the steps of delegation. (5) What are the common delegation
errors usually observed in nursing service? (5) 2014

BIBLIOGRAPHY
1. Clement, Nisha. Essentials of management of nursing service & education, 1st edition; 2012, Jaypee
Brothers Medical Publishers (P) Ltd. Page no. 270-279.

2. Vati, Jogindra. Principles and practice of nursing management & administration, 1st edition; 2013,
Jaypee Brothers Medical Publishers (P) Ltd. Page no. 271-274.

3. Clement, I. Management of nursing services and education, 1st edition; 2011, Elsevier India (P) Ltd.
Page no. 245-248.
4. https://www.bon.texas.gov  pdfs  delegation_pdfs.
5. https://www.ncbi.nlm.nih.gov  books  NBK519519.
 CONTENT
ON
DELEGATION AND
COORDINATION
SUBMITTED TO SUBMITTED BY
MADAM DIPANWITA SENGUPTA SUSMITA HALDER
PROFESSOR CUM ACTING PRINCIPAL M.SC. NURSING 2ND YEAR
GOVT. COLLEGE OF NURSING GOVT. COLLEGE OF NURSING
PURBA BARDHAMAN PURBA BARDHAMAN