Knowing when to say no

Roz Hooper, from the RCN’s legal team, explains why you must speak out if you’re uncomfortable with work delegated to you

“I’ll sue you if you do anything wrong!” That’s something none of us want to hear. But what happens if you do get it wrong in the workplace? 

If you break a local policy, you could face disciplinary action but is it possible you could end up in court?

Health service providers must make sure their work meets legal requirements – they’re accountable to both the criminal and civil courts.

So when are you personally accountable? Pretty much all the time

If your employer is taken to court as a result of your actions, they’ll have insurance cover in place to pay any compensation. But you might have to give evidence and explain your actions. 

So when are you personally accountable? Pretty much all the time. You have a duty of care when it’s “reasonably foreseeable” that you might harm patients through your actions or just as importantly, by not doing something.

This applies to whatever you’re doing in work, from something straightforward, like giving a patient a bath, to performing complex surgery. You’re accountable if you accept the responsibility to perform a task. So, you need to be sure that you have the ability to competently perform tasks allocated to you, and you must tell a senior member of staff if you’re unsure.


Delegation

So are you still accountable if a task has been delegated to you by a registered nurse? Absolutely yes. They may be in overall charge of the nursing care, but they can’t do everything so will need to appropriately delegate some care to colleagues.

To help keep you safe we’ve pulled together some key questions that you should always ask before accepting a delegated task (see box below).

Make no mistake, if you can’t answer yes to all of these questions you mustn’t accept the task. Don’t be afraid to say no. You’re not being difficult and you should never be made to feel bad about doing this. 

You're expected to keep your skills and knowledge up to date

Sometimes refusing a delegated task is the only thing you can do to protect the patient, the organisation, yourself, and even the delegator. If you’re unsure, always seek further advice or clarification. You might prefer to observe a task before asking to do it under supervision, to give you the skills and knowledge you need.

Even after you’ve accepted the delegated work you’re still expected to keep your skills and knowledge up to date so don’t be afraid to ask for regular updates with your supervisor if you’re not offered them. You also need to make sure you’re working in accordance with local policies and make sure your job description is up to date.

If you feel uncertain about a delegated task, and it’s difficult to resolve the issue locally, call RCN Direct for advice on 0345 772 6100.

Download Accountability and Delegation. A Guide for the Nursing Team

What to consider before accepting a delegated activity

    • Do you have the knowledge required to undertake the task?
    • Do you have the skills required to undertake the task?
    • Is it within your job description?
    • Are you confident about the communication and interpersonal skills required as well as your clinical competence?
    • Are you sure the activity isn’t too complex for you to accept?
    • Are you sure you’re not compromising patient care by accepting it?
    • Does the person delegating have the authority to delegate the work?
    • Are you sure that accepting the work will not impact on your performance?
    • Are you confident the delegator has the appropriate clinical knowledge to delegate the activity to you?
    • Do you have the capacity to take on additional work?

      If you’ve answered yes to all the questions then accept the delegated activity. If not, say no.


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