Experiences of Activities Perceived as Delegable Among Nurses in Medical and Surgical Settings Can Help to Guide Health Care Policies: A Qualitative Phenomenological Study.

Abstract

Objectives: Nurses may invest up to 70% of their working time in activities outside the nursing scope of practice. Gaining insight into their experiences may inform policy decisions. This paper explores nurses' experiences of activities they perceived as delegable.

Methods: This is a secondary analysis of qualitative data that contributed to a mixed-methods explanatory sequential study. Twenty nurses who work in the medical and surgical wards of four Italian public hospitals were purposively identified and interviewed. Inductive thematic analysis was performed.

Results: Three main themes: (1) missing delegation, (2) losing role identity, and (3) being at the breaking point. The moral obligation to compensate for organizational deficiencies and poor relational dynamics was the main reason for missing delegation. Nurses felt in an assembly line with increased risk of errors and threats to patients' safety, overwhelmed by the workload, dissatisfied with the quality of care provided, and experienced several negative feelings, including anger, annoyance, demoralization, and frustration.

Conclusions: Organizational and educational support is essential to develop effective delegation abilities.