Nurse Delegation Decision Making

Nurse practice in today's world requires that nurses be adept at directing a multi-skilled and diverse workforce. In the U.S. the registered nurse must be clinically competent while simultaneously be knowledgeable of their practice guidelines to ensure safe and effective patient care delivery. In South Africa nurses practice under the South Africa Nursing Council Nursing Act guidelines; in the United States the National Council for State Board of Nursing provides rules and regulations for nurse practice. Nursing care practice guidelines, including delegation, are regulated by individual state boards of nursing with written nurse practice acts in the United States of America. The shortage of nurses may have an impact on safe and effective care to individuals with complex, acute, and chronic health care. Delegation of nursing procedures must be done in both countries to facilitate prudent use of the nurses' time for higherlevel duties. In the United States increased longevity and expensive interventions directed toward preventable disease, and in South Africa the Acquired Immune Deficiency Syndrome epidemic are taxing health delivery resources in our respective countries. Clearly, the nurse must include management expertise, and especially nurse delegation in their practice skills repertoire. This article will share delegation via patient care management and decision-making models; review the nurses' role in specialty nursing areas; and offer strategies to best use the existing workforce, which includes unlicensed health care workers.