Accepting,
Rejecting &
Delegating A Work Assignment:
A Guide for Nurses
Developed by the MNA Congress on Nursing Practice
2002
Beth Amsler, RN
Karen Carpenter, RNC, FNP, JD
Marianne Chisholm, BS, RN
Philip Donohue, RN
Ann Goucher, BSN, RNC
Patricia Marinelli, MS, RN
Ann Mullen, BSN, RN
J. Sue Myers, PhD, RN
Bonnie Beth Pierce, BS, RNC
Meg Wiley, BSN, RN
Linda Winslow, BS, RN
The Congress on Nursing Practice is grateful to
those individuals who served on the Congress and contributed to
the publication.
Michelle Colloran Cook, MS, RN
Michael Malone BS, RN
Elizabeth Joubert, RN
May Jo Doolan, MS, RN
The Congress would like to acknowledge the assistance
of MNA staff members Dorothy Upson McCabe, MS, MEd, RN, Shirley
Duggan, MS, RN as well as Erin Servaes, BS, and Alan MacDonald,
Esq. in the completion of this publication.
Statement of Intent:
These guidelines are not intended to be construed or to serve
as a standard of nursing care.
Table of Contents
Purpose and Statement of Problem
Legal Considerations
Responsibilities
Application of the Guide for Decision-Making
Glossary (BORN definitions)
References
The Guide’s purpose is to:
• Support the decision-making ability, responsibility, and
accountability of the nurse in defining and determining his or
her individual scope of practice.
• Improve understanding of the Nurse Practice Act (NPA)
and applicable state regulations among staff nurses, nurse managers,
nurse executives, educators, and employers of nurses as it relates
to accepting, rejecting or delegating a work assignment.
• Provide a framework for the nurses decision to accept,
negotiate, or reject a work assignment and to delegate nursing
acts.
• Outline a process for evaluating the appropriateness of
a work assignment and the delegation of a nursing task.
Statement of Problem
The practice of nursing is dynamic. It is continuously evolving
in response to the changing needs, demands, and resources of our
society. Clarifying the responsibilities of the licensed nurse
(registered nurse and licensed practical nurse) is sometimes a
challenge for nurses and for their employers.
Accepting, Rejecting and Delegating a Work Assignment: A Guide
for Nurses addresses the questions and concerns of Massachusetts
nurses regarding decision-making related to work assignments and
the delegation of nursing acts. The Guide was developed collaboratively
by the Task force on Accepting and /or Rejecting an Assignment
and the Congress on Nursing Practice and modeled after the document
prepared by the Maryland State Nurses Association.
The guide for nurses is based on the premise that each nurse is
responsible and accountable for making decisions and for practicing
in accordance with the Nurse Practice Act (NPA) regulations, and
with the nurse’s educational background, competencies, and
experience. Although the Guide is not legally binding, it is consistent
with nursing practices set forth in the NPA.
The Guide contains a brief review of Massachusetts Regulations
(definitions are in the glossary) concerning nursing practice
standards, and the delegation of nursing acts. Citations to specific
sections of the NPA are given where appropriate. A glossary is
provided for the reader. Readers are encouraged to refer to the
glossary as needed in using the Guide.
Legal Considerations
Nurse Practice Act (NPA)
The purpose of the NPA is to protect the public by assuring safe
and competent nurses. Only licensed nurses have the legal, formal
authority to practice nursing and to delegate nursing care. The
NPA defines nursing practice and is the
Approved , MNA Congress On Nursing Practice 7/02
Approved, MNA Board of Directors 7/02
© MNA, 2002
