Nursing Delegation Rules: The Complete NCLEX Guide

The Five Rights of Delegation

1. Right Task

Is this task appropriate to delegate? Can it be performed without clinical judgment?

2. Right Circumstance

Is the patient stable? Is the setting appropriate?

3. Right Person

Does the delegate have the competency and legal authority?

4. Right Supervision/Communication

Are clear instructions provided? Is the RN available for questions?

5. Right Direction

Clear, concise communication including expected outcomes and when to report back.

Scope of Practice Quick Reference

RN (Cannot Delegate)

• Initial patient assessment
• Nursing diagnosis formulation
• Care plan development
• Patient/family teaching
• Evaluation of patient outcomes
• Medication administration of IV push meds
• Blood product administration
• Unstable patient care

LPN/LVN (Can Perform)

• Medication administration (oral, IM, SQ, some IV)
• Wound care and dressing changes
• Urinary catheterization
• Vital signs on stable patients
• Data collection (not initial assessment)
• Reinforce teaching (not initial teaching)

UAP/CNA (Can Perform)

• Vital signs on stable patients
• Bathing and hygiene
• Ambulation and positioning
• Intake and output measurement
• Feeding stable patients
• Specimen collection
• Bed making and room setup

NCLEX Delegation Decision Tree

1. Is the patient stable and predictable? → If NO, RN must perform
2. Is the task within the delegate's scope? → If NO, cannot delegate
3. Does the delegate have the competency? → If NO, cannot delegate
4. Can the RN provide appropriate supervision? → If NO, cannot delegate
5. If all YES → Delegation is appropriate

Common NCLEX Delegation Traps

• Never delegate assessment: even to an experienced LPN
• Teaching vs. reinforcing: RN teaches, LPN reinforces
• Charge nurse role: prioritize and delegate, don't do everything

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