# Situation: A 30-bed adult medical ward admits many clients with diabetes, liver disease, and thyroid disorders. It uses team nursing: each team has a registered nurse team leader, one or two staff nurses, and a nursing attendant. The head nurse is working to improve how the teams work with the laboratory, pharmacy, and dietary services. A team leader asks the nursing attendant to give a bed bath to a stable client. Because the attendant is busy, the attendant asks a utility worker to give the bath instead. Why is this inappropriate?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=630452  
> language: ko  
> subject: Nursing Practice IV — Care of Clients with Problems in Nutrition and Gastrointestinal, Metabolism and Endocrine, Perception and Coordination

## 문제

Situation: A 30-bed adult medical ward admits many clients with diabetes, liver disease, and thyroid disorders. It uses team nursing: each team has a registered nurse team leader, one or two staff nurses, and a nursing attendant. The head nurse is working to improve how the teams work with the laboratory, pharmacy, and dietary services.

A team leader asks the nursing attendant to give a bed bath to a stable client. Because the attendant is busy, the attendant asks a utility worker to give the bath instead. Why is this inappropriate?

## 보기

1. Utility workers may bathe clients only with a nurse physically present
2. A worker who accepts a delegated task may not pass it to someone else **✔ 정답**
3. Bathing a client is a nursing act that only licensed nurses may perform
4. Only the head nurse may decide which worker bathes a stable client

**정답: 2**

## 해설

A delegatee may not re-delegate: the attendant accepted the task and should have told the team leader that it could not be done, so the team leader could decide who would do it. Bathing a stable client is itself a task that may be delegated to a trained nursing attendant.

## 심화 해설

The rule broken here
The team leader delegated a bed bath for a stable client to the nursing attendant. The attendant then passed the task to a utility worker. A worker who accepts a delegated task may not pass it on to someone else; only the delegating nurse decides who performs a task. The attendant should have told the team leader that the bath could not be done, so the team leader could reassign it, adjust the timing, or do it personally.

Why re-delegation is not allowed
Delegation is a deliberate decision by the registered nurse, who matches a task to a person whose training and competence are known. The nurse remains accountable for the delegation decision and for supervising the outcome. When the delegatee passes the task to another person, the nurse no longer knows who is caring for the client, whether that person is trained, or what will be reported back. A utility worker is usually not trained or assigned to give direct client care, so client safety and the line of accountability are both broken.

| Element of delegation | Who is responsible |
| --- | --- |
| Choosing the right task and person | Delegating registered nurse |
| Performing the task correctly | Delegatee who accepted it |
| Reassigning the task if needed | Delegating nurse only |
| Supervision and evaluation | Delegating nurse |

Why the other options are wrong
The issue is not the level of supervision; even with a nurse present, the attendant had no authority to reassign the task. Bathing a stable client is not an act reserved for licensed nurses; it is routine care that may be delegated to a trained nursing attendant. And the decision does not need the head nurse: the team leader who delegated the task is the one who decides who performs it.

Watch out! Do not conclude that the original delegation was wrong. Delegating a bed bath for a stable client to a trained nursing attendant is appropriate. The error happened at the next step.

Exam takeaway
The five rights of delegation are the right task, circumstance, person, direction and communication, and supervision and evaluation. A delegatee who cannot complete a task reports back rather than passing it on. Key point! Delegated tasks cannot be re-delegated; the delegatee returns the task to the delegating nurse.

## 임상 시나리오

No Re-DelegationTeam nursing delegation
The team leader delegated a bed bath for a stable client to the nursing attendant, an appropriate delegation.

The attendant passed it to a utility worker. A delegatee may not re-delegate; only the delegating nurse reassigns a task.

The attendant should have reported back so the team leader could reassign or reschedule the bath.

CautionThe registered nurse stays accountable for delegation; an unknown, untrained caregiver breaks both safety and accountability.

## 핵심 개념

- **Delegation** — Transferring responsibility for performing a task to a competent person while the nurse keeps accountability.
- **Delegatee** — The person who accepts and performs a delegated task.
- **Re-delegation** — Passing a delegated task on to another person, which a delegatee may not do.
- **Five rights of delegation** — Right task, circumstance, person, direction and communication, and supervision and evaluation.

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