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Sikma and YoungBalancing Freedom with Risks: The Experience of Nursing Task Delegation in Community-Based Residential Care Settings
nurse delegation increased dramatically over the course of thestudy. As this practice becomes more widespread, ongoingevaluation of the outcomes of interest will be important,particularly the determination of whether nurse delegation hasindeed met the goals of the Washington State legislature toimprove access and quality of care in more cost-effective ways.
The study process illustrated policy implementation and eval-uation in action in a highly politicized environment. It elucidatedmultiple perspectives and experiences with a changing nursingpractice policy. It provides a basis for us to continue to ask criticalquestions such as what parts of our care systems and communitiesare changing, how we can best use professional nursing judgmentand supervision to meet community needs, how we can accom-plish the appropriate array of long-term care services forconsumers, what is the best mix of professional and nonprofes-sional caregivers at the community level, and finally, in an imper-fect world, what are the optimal solutions to bring structure,purpose, quality, and choice to community-based long-term care.Can we, as professional nurses, espouse in statements such as ourSocial Policy Statement24 that we promote health yet supportpolicy decisions that create barriers to choice, barriers that keeppeople from living in a real home versus an institution? Such posi-tions would contradict our professional commitments to theconsumer if taken with the purpose of protecting the scope of thenursing practice. Instead of focusing on fears about the erosion ofthe nursing practice, let us look for creative ways to partner withconsumers to expand nursing’s scope of influence in the commu-nity, enhancing quality of life and care for the growing populationof people with long-term care needs in the home.
We thank Drs Sandra Eyres, Debbie Ward, Barbara Bowers, and Kristen
Swanson for their professional collaboration and Cheryl Allen, Gaye Jensen,
Shannon Fitzgerald, Patty Hayes, Lisa Hoffman, Colleen Erskine, Kathy
Woods, Blythe Strong, Gail Bond, Yvonne Shull, and Darci Mathison for
their participation on the study team. �
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201NURSING OUTLOOK JULY/AUGUST 2001
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Carole A. Anderson, PhD, RN, FAANCollege of NursingThe Ohio State University1585 Neil AvenueColumbus, OH 43210-1289
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