What aspects of delegation must the EN take into account as the recipient of this delegation? Include rationales for your answers. You may benefit from reviewing the NMBA's Decision Making Framework (NMBA, 2013) and the ACORN Standards (ACORN, 2016) when considering your response
The registered nurse (RN) has delegated the intraoperative care of a patient to the enrolled nurse (EN) instrument nurse. During the procedure, another EN enters the theatre to relieve the RN for a meal break.
What will be an ideal response?
Answer:
The EN needs to have the education, experience and competence to safely perform this role, be willing to accept the delegation, and understand their level of accountability in performing this role. The EN should also be aware of the need to have an RN participate in the surgical count in order to comply with the ACORN Standards. The NMBA states that ‘RNs are accountable for making decisions about who is the most appropriate person to perform an activity that is in the nursing plan of care' (NMBA, 2013, p. 7). All nurses are accountable for making informed decisions about accepting delegated activities. The EN in this situation can do so by asking whether it is within or beyond their abilities and/or their scope of practice to perform this activity/the instrument nurse role on this day (consider the patient's condition, the technical requirements of the surgery, the level of supervision and educational support etc). This decision-making process may also require that the EN consults with, or refers to, another nurse such as the RN who has more appropriate skills and knowledge.
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