Interprofessional Collaboration and Delegation

Health Care Team Members and Their Roles

Role of the Registered Nurse in Collaboration or Delegation

Primary care providers (PCPs): provide medical care, including diagnosing, treating, and preventing disease; may be a physician or nurse practitioner

Collaborates with PCPs to enhance patient well-being and care, and promote positive patient outcomes

Medical specialist physicians: provide medical care for patients with diseases and disorders within their speciality

Consults medical specialist physicians when providing specialised care for specific diseases and disorders

Surgical specialist physicians: perform diagnostic, ablative, constructive, reconstructive, transplantation, palliative, or cosmetic surgeries and procedures

Works together with surgical specialist physicians during the preoperative, intraoperative, and postoperative periods to provide patient care and monitor patient progress

Registered nurses (RNs): coordinate, direct, supervise, and provide patient care and patient education

Works cooperatively with other registered nurses to coordinate care for groups of patients and with specialized nurses, such as wound ostomy care nurses (WOCN), when necessary

Counsellors: help patients cope with physical, emotional, psychological, or social issues

Works in partnership with counselors when patients need extra emotional or mental health support with issues surrounding their illness or situation

Dieticians: use knowledge of food and nutrition to enhance patient wellness, healing, and recovery

Refers patients to dieticians for nutritional support while addressing medical or surgical conditions, such as hypertension, dysphagia, or diabetes

Social workers: evaluate the patient’s financial situation, support system, and home environment and determine availability of resources

Confers with social workers to determine hospitalization and home care coverage, as well as community referrals for home care needs

Unlicensed assistive personnel (UAP): perform direct patient care as delegated by the RN

Delegates to the UAP when patients require direct personal care and assistance with bathing, toileting, mobility, etc. UAPs are delegated to and supervised by the RN.

Laboratory technicians: collect and perform tests on samples of body fluids and tissues

Requests laboratory technicians to obtain and test samples for ordered laboratory tests

Pharmacists: prepare and dispense medications and IV fluids

Collaborates with pharmacists to obtain the correct ordered medications and IVs for each patient in the correct dosage

Spiritual advisors (clergy, priests, ministers, rabbis, imams, etc.): counsel patients on spiritual matters and provide emotional support

Turns to spiritual advisors to provide spiritual support for ill and dying patients and their families

Licensed practical/vocational nurses (LPNs/LVNs): provide direct patient care, including medication administration, wound care, and vital signs

Depends on LPNs/LVNs to provide patient care, perform treatments and administer oral medications and some IV medications depending on the training of the LPN/LVN

Speech pathologists and audiologists: evaluate and treat speech, language, hearing, swallowing, and communication disorders in patients

Consults speech pathologists and audiologists for assessment and interventions in patients with swallowing or speech deficits

Respiratory therapists: treat patients with diseases of the cardiopulmonary system and administer respiratory medications and treatments

Works in partnership with respiratory therapists to administer ordered respiratory medications to patients

Physical therapists: evaluate and treat patients with mobility deficits

Joins forces with physical therapists to assess mobility, crutch walking, or walker stability or to provide rehabilitation for postsurgical or postinjury patients

Occupational therapists: evaluate activities of daily living (ADLs) and rehabilitate patients with deficits that affect ADLs and occupational tasks

Collaborates with occupational therapists to evaluate and care for patients with deficits in ADLs

Interventions That Can Be Delegated Following the Five Rights of Delegation

Interventions That Cannot Be Delegated

• Routine vital sign assessment of stable patients

• Hygiene care such as bathing, shampooing, oral cleansing, and bed making

• Back massage

• Toileting

• Turning and positioning of patients

• Range-of-motion exercises

• Assistance with ambulation

• Application of antiembolism hose or sequential compression devices

• Changing a simple nonsterile dressing on an established wound in some facilities

• Application of wraps, bandages, or binders

• Collecting sputum, stool, and voided urine specimens

• Blood glucose testing

• Oral and oropharyngeal suctioning

• Care of an established tracheostomy

• Changing the pouch, or care of an ostomy without complications

• Assessment

• Care planning

• Development of a patient teaching plan

• Changing dressings on acute wounds

• Irrigating a wound

• Collecting a wound culture or a urine specimen from a catheter

• Tracheostomy, nasotracheal, or nasopharyngeal suctioning of a patient

• Care of a new tracheostomy

• Care of chest tubes

• Changing the pouch of a new ostomy, or care of an ostomy with complications

• Inserting a Foley catheter

• Bladder irrigation

• Medication administration

• Starting and maintaining a peripheral IV

• Patient education

• Discharge instructions