With the help of Michele Bromberg, RN, MSN, APN, BC, nursing coordinator for the Illinois Department of Financial and Professional Regulation, and Linda B. Roberts, RN, MSN, manager, IDFPR/Illinois Center for Nursing, this series will offer various resources regarding the act and nursing in Illinois.
In the third installment of our six-part series on the Illinois Nurse Practice Act and its rules, we examine delegation for nurses in an outpatient setting.
Question: In an outpatient setting, who can delegate patient care to an RN, and to whom can an RN delegate nursing tasks and activities?
Answer: In simple terms, nurses must cut out the middle man. RNs can receive delegation only directly from a licensed physician, dentist, optometrist, podiatrist, PA or APN.
For example, medication orders should be delegated directly from the physician to the RN, not passed along or conveyed by a medical or office assistant, according to Bromberg.
After the RN has received delegation from the physician, the act provides guidance on further delegation by the RN of nursing tasks and activities to other office personnel. RNs cannot delegate nursing activities to unlicensed persons. Nursing activity as defined by the act means any work requiring the use of knowledge acquired by completion of an approved program for licensure. Therefore, an RN cannot delegate nursing activities such as medication administration to unlicensed persons, including medical assistants and office staff. RNs can delegate to other RNs and LPNs.
RNs can delegate nursing tasks to unlicensed individuals. The act defines a task as work not requiring nursing knowledge, judgment or decision-making.
To fully understand delegation issues, nurses should read the definitions of registered professional nursing practice (Section 65/50-10) and delegation (Section 65/50-75) in the act, Bromberg said.
Coming in the next issue: What nurses can do to get back into practice after being out five years or more.
Barry Bottino is a regional editor and Jennifer Thew, RN, BSN, MSJ, is the national nurse editor at Nursing Spectrum.