Nurses can delegate routine, predictable tasks to unlicensed assistive personnel (UAPs) as long as those tasks don’t require clinical judgment, assessment, or independent decision-making. The most commonly delegated activities include basic hygiene care, vital sign measurement, ambulation, feeding stable patients, and specimen collection. But the line between what’s safe to hand off and what must stay with a licensed nurse depends on the task itself, the patient’s condition, and your state’s regulations.
Tasks Commonly Delegated to a UAP
UAPs, which include certified nursing assistants (CNAs), patient care technicians, and orderlies, are trained to handle direct care activities that follow a set procedure and don’t change based on the patient’s response. These are tasks where the expected outcome is predictable and the steps don’t vary from patient to patient.
Routine delegable tasks typically include:
- Activities of daily living: bathing, dressing, grooming, toileting, and oral care
- Mobility assistance: ambulation, repositioning, transfers, and range-of-motion exercises
- Vital signs: measuring temperature, pulse, respirations, and blood pressure on stable patients
- Intake and output: recording fluid intake and measuring urine output
- Nutrition: feeding patients who are not at risk for aspiration, setting up meal trays, and documenting food intake
- Specimen collection: obtaining urine or stool samples using standard procedures
- Weight and height measurement
- Simple dressing changes: applying non-sterile bandages in some settings
- Blood glucose monitoring: performing fingerstick glucose checks in facilities where UAPs are trained and authorized to do so
Some states allow expanded tasks beyond this core list. About 22% of states permit CNAs to take on activities like medication administration (such as witnessing a resident take prescribed medications), wound care, catheter or tube care, and managing medical information. Whether a UAP in your facility can perform these expanded tasks depends entirely on state law and your employer’s policies.
Tasks That Cannot Be Delegated
The clearest rule in delegation is that any activity requiring nursing judgment stays with the nurse. Virginia’s nurse practice act, which mirrors language used in many states, specifically prohibits delegating “activities involving nursing assessment, problem identification, and outcome evaluation that require independent nursing judgment.” This principle holds across the country even when the exact wording differs.
In practical terms, you cannot delegate:
- Initial and ongoing assessments: evaluating a patient’s condition, interpreting symptoms, or identifying changes in status
- Care planning: developing or modifying a nursing care plan
- Evaluation: determining whether a patient is improving, worsening, or responding to treatment
- Patient or family teaching: educating about diagnoses, medications, or self-care
- Medication administration: in most states, giving injections, IV medications, or oral medications
- Triage decisions: prioritizing patients based on clinical urgency
A helpful shortcut: if the task requires you to think about what the data means rather than simply collect it, it belongs to a licensed nurse. A UAP can take a blood pressure reading. Deciding what to do about an abnormal reading is nursing judgment.
The Five Rights of Delegation
The National Council of State Boards of Nursing and the American Nurses Association use a framework called the “five rights of delegation” to guide every handoff. These aren’t optional best practices. They’re the standard against which your delegation decisions are measured.
Right Task
The task must be legally appropriate to delegate under your state’s nurse practice act and permitted by your facility’s policies. If no one on your team has the proper skill set for the task, delegating it creates safety risks you’re accountable for.
Right Circumstance
Even a normally delegable task can become inappropriate depending on the patient. The ANA uses a specific example: feeding a patient is typically fine to delegate, but if that patient is at high risk for aspiration, the task may need to stay with the nurse. You have to assess care complexity before every delegation decision.
Right Person
Match the task to the individual UAP’s knowledge, skills, and availability. This means verifying they’ve been trained, asking whether they’ve had problems performing this task before, and confirming they have enough time to do it properly alongside their other assignments.
Right Direction and Communication
The UAP needs to know exactly what the task involves, when it needs to be completed, how to document it, what the patient’s limitations are, and what outcomes to expect. Vague instructions like “keep an eye on the patient” aren’t delegation. The UAP should also know when to stop and come find you, particularly what changes in the patient’s condition should trigger an immediate report back.
Right Supervision and Evaluation
Delegation doesn’t end when you hand off the task. You’re responsible for following up on the outcome, checking that the task was completed correctly, and giving the UAP feedback. This ongoing loop of communication and trust is what separates safe delegation from simply offloading work.
How Context Changes What You Can Delegate
The same task can be appropriate or inappropriate to delegate depending on the setting and the patient. Taking vital signs on a stable postoperative patient on day three of recovery is a reasonable UAP task. Taking vital signs on a patient showing early signs of sepsis is not, because the nurse needs to be the one observing and interpreting the full clinical picture in real time.
Facility policies also play a major role. A hospital’s delegation policies may be more restrictive than what state law technically allows. If your hospital doesn’t authorize UAPs to perform fingerstick blood glucose checks, the fact that your state permits it doesn’t matter. You follow the more restrictive standard.
Staffing levels and workload affect delegation too. If a UAP is already stretched thin with a heavy patient load, delegating additional tasks may compromise quality even when those tasks are otherwise appropriate. Part of the “right person” assessment is making sure the person actually has capacity to do the job well.
Accountability After Delegation
One of the most important things to understand about delegation is that the nurse retains accountability for the outcome. You are not transferring responsibility when you delegate. You are transferring the performance of the task while remaining answerable for the decision to delegate it, the adequacy of your supervision, and the result.
The UAP is responsible for their own actions, meaning they’re accountable for performing the task as directed and reporting back appropriately. But if something goes wrong because you delegated a task to someone who wasn’t qualified, didn’t give clear instructions, or failed to follow up, the accountability falls on you. This is why the five rights framework exists: it protects the patient, the UAP, and the nurse by building checkpoints into every delegation decision.
If a UAP reports a change in a patient’s condition, acting on that information is your responsibility as the licensed nurse. Train your UAPs to report specific, objective findings (“the patient’s blood pressure is 88/52” rather than “the patient seems off”) so you can make timely clinical decisions based on accurate data.