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Autumn 2003

Be Crystal Clear on Your Duty of Care

‘Duty of care’ is now a central consideration in modern nursing. It is one of the most important parameters within which nurses should be making their decisions.

It is therefore vital nurse members are crystal clear about what that means.

There are many legal realities that govern what duty of care constitutes and this includes responsibility and accountability when delegating tasks to other staff - both nursing and non-nursing.

The Nursing Board of Tasmania (NBT) and Australian Nursing Council (ANCI) have clear Guidelines around the topic of delegating care.

These can be found on the respective websites. See below. However, what must always be remembered is that whilst a Registered Nurse can delegate care, the accountability for that care remains with them. When delegating care a RN must:

• conduct an assessment on the patient/client,

• be sure the person to whom they are delegating the care to is trained and competent to undertake the care duty being assigned to them,

• re-assess the patient/client as required.

RN's can delegate care to an EN or unregulated care worker (eg ECA). However, at all times the RN is accountable for the care that is delegated.

That means if there is any question regarding how the delegated care is administered, it is the RN who will be held accountable for what occurred.

The NBT also has guidelines for the supervision of ENs and student nurses that provide for direct or indirect supervision of tasks.

All nurses should be fully aware of these guidelines.

Enrolled Nurses should also be aware they are accountable for any tasks they choose to delegate to unregulated care workers.

As nurses are responsible for conducting patient/client assessments, then this is not a duty that should be delegated to other staff.

It is therefore extremely important that any documentation of assessments of patient or client status is documented by nursing staff only.

Further information about delegation of care can be found at the following websites:

http://www.nursingboardtas.org.au (NBT)

http://www.anci.org.au (ANCI)

Your employer should also be able to provide you with copies of ANCI and NBT publications.