Purpose and Statement of Problem
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 is 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 Massachusetts Board of Registration in Nursing (BORN), 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. 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.