| Course | NU144CL Medical-Surgical Nursing II Clinical |
|---|---|
| Unit | Unit 4 |
| Paper type | Delegation write-up |
| Length | About 900 words, 6 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | BSN (prelicensure) |
| Updated | October 2026 |
Free sample paper for NU144CL Unit 4
Vital Signs for Three Rooms, Not the Fourth: A Delegation Write-Up for a Composite Four-Patient Morning, Measured Against the Five Rights, With One Report That Came Back Late
[Student Name]
Purdue University Global
NU144CL: Medical-Surgical Nursing II Clinical
Unit 4 Delegation Write-Up
[Instructor Name]
[Date]
The patients and staff are composite; values and times are bracketed where illustrative, and what may be delegated depends on state law, facility policy and the program's rules for students.
The Morning
Room 6: [Mr. E.], 70, heart failure, stable, diuresing. Room 7: [Mrs. F.], 64, day two after spinal fusion, walking with help. Room 8: [Mr. G.], 59, acute kidney injury from dehydration, improving with fluids. Room 9: [Mr. H.], 67, back from a diagnostic heart catheterization through the right femoral artery at [0915], on bed rest with frequent checks ordered. The nursing assistant, [Ms. R.], has worked on the unit for six years. The assigned nurse and instructor approved the plan before it began.
Delegated Tasks Against the Five Rights
1. Vital signs, rooms 6, 7 and 8, at [0800] and [1200].
Right task: routine measurement on stable patients, within the assistant's training. Right circumstance: all three stable overnight, no new orders. Right person: experienced and checked off on vital signs. Right directions: report at once a systolic below [100] or above [170], heart rate above [110] or below [55], respirations above [24], saturation below [92] percent, or any patient who says they feel worse. Right supervision: I reviewed every value on the flowsheet by [0830] and [1230].
2. Intake and output for Mr. G., totals due at [1100].
Right task: measuring and recording. Right circumstance: catheter in place, no hourly titration depending on the number. Right person: trained in measuring urine and recording fluids. Right directions: totals at [1100], and tell me sooner if any hour's urine is under [30] mL. Right supervision: I compared her total with the catheter bag and the IV pump history.
3. Walking Mrs. F. in the hall after [1000].
Right task: assisting a patient whose tolerance has been assessed. Right circumstance: I assessed her first, pain [3], steady with the walker, no dizziness on standing. Right person: experienced with post-spinal patients and the gait belt. Right directions: walker and gait belt, to the nurses' station and back, stop and call if she reports dizziness, new leg numbness or pain above [6]. Right supervision: I asked Mrs. F. afterward how it went and checked her pain.
Tasks I Kept, and Why
Vital signs and site checks for Mr. H. A patient just back from a femoral catheterization needs his groin site, the pulse below it, the color and warmth of his leg and his vital signs checked at set intervals, and bleeding or a lost pulse must be recognized and acted on in the same moment (Harding et al., 2023). The measurement and the judgment cannot be separated here, so the task stays with the nurse even though the same task went to the assistant in three other rooms. First insulin teaching for Mr. E., newly started on insulin. Teaching requires assessing what he understands and adjusting, which is nursing judgment. Every assessment and every change to a plan. The assistant collects data; interpreting it and choosing the response stays with the licensed nurse (National Council of State Boards of Nursing, 2016).
Measuring can be handed over; meaning cannot. The assistant brings the number, and the nurse decides what it says.
The Report That Came Back Late
At [0805] Ms. R. measured Mr. E.'s blood pressure at [96/58], below the reporting value. I did not hear about it until [0835], when I reviewed the flowsheet; she had charted it and gone on to the next room because, she said, "his pressure is always low after his water pill." Mr. E. was sitting up, alert and not dizzy. I rechecked it at [0840] at [102/62], told my nurse, and the provider was informed before his next diuretic dose, which was held per the provider's decision. What I did about it: I spoke with Ms. R. privately, thanked her for measuring and charting accurately, and explained why the value needed to come to me at once even if it might be his usual, since I could not know that without seeing it. I also asked what would make reporting easier; she said a short list on paper, since I had given the numbers out loud at a busy moment. For the rest of the shift, the reporting values were written on a card in her pocket.
What the Follow-Up Showed
Missed or late follow-up of delegated care is linked to gaps in communication and critical thinking at the point of delegation, not only to the person carrying out the task (Bittner & Gravlin, 2009). My directions were accurate but spoken quickly. Written values and a set time to check back would have caught the low pressure within minutes. Delegation did not end when I handed over the task; it ended when I had reviewed the result.
What I Will Do Differently
Give reporting values in writing as well as aloud. Set a check-back time for every delegated task, not only the ones I worry about. Review the flowsheet within fifteen minutes of each set of vital signs. And when a patient's numbers are usually abnormal, say so in the directions, with the value that should still be reported.
References
Bittner, N. P., & Gravlin, G. (2009). Critical thinking, delegation, and missed care in nursing practice. Journal of Nursing Administration, 39(3), 142-146. https://doi.org/10.1097/NNA.0b013e31819894b7
Harding, M. M., Kwong, J., Hagler, D., & Reinisch, C. (2023). Lewis's medical-surgical nursing: Assessment and management of clinical problems (12th ed.). Elsevier.
National Council of State Boards of Nursing. (2016). National guidelines for nursing delegation. Journal of Nursing Regulation, 7(1), 5-14. https://doi.org/10.1016/S2155-8256(16)31035-3
The Purdue Global NU144CL Unit 4 instructions
Unit 4 in many sections asks students to describe tasks they delegated during a clinical shift and evaluate each against the five rights of delegation: task, circumstance, person, directions and supervision. Prompts usually also want the tasks the student kept and why, and an account of how delegated work was followed up. Instructors look for the difference between collecting data and interpreting it, for directions with clear values to report, and for honest reflection when something went wrong. State law and facility policy decide what may be delegated, so the write-up should not claim more than the setting allows. Papers run three to four pages, with the national delegation guidelines cited in APA 7.
How the NU 144CL Unit 4 example is put together
The write-up opens with the four patients and the assistant's experience. Three delegated tasks follow as numbered entries, each tested against all five rights, with the reporting values written out. A section on kept tasks explains why the same task, vital signs, stayed with the nurse for the man after catheterization, citing the medical-surgical text, and a highlighted line separates measuring from meaning. The late report is told in time order: the reading, the delay, the recheck and the provider's decision. A paragraph explains how the student talked with the assistant and changed the directions. The follow-up analysis cites a study on delegation and missed care, and the paper closes with four changes.
Where the points sit in the NU144CL Unit 4 rubric
Delegation rubrics in this course commonly award points for correct use of the five rights, appropriateness of tasks delegated and retained, quality of directions, supervision and follow-up, reflection and APA writing. Five-rights points depend on applying each right to the specific task, not listing them once. Appropriateness points reward recognizing when circumstance makes a usually delegable task a nursing task. Direction points go to specific values and times. Supervision points are earned by showing how results were reviewed. Reflection points require an honest account of a gap and a concrete change. A missed or late report examined fairly usually scores higher than a write-up where everything went perfectly.
NU144CL Unit 4 help from the desk
Delegation papers frequently lose points by listing the five rights as definitions without applying them to each task. Another common error is delegating a task because it is on the assistant's job list, without considering the patient's condition. Some write-ups give directions with no numbers, then blame the assistant when a value is not reported. Others describe only successes. Apply every right to every task, explain why a task stayed with you, write directions with values and times, show how you checked each result and describe one problem honestly, including what you changed in your own practice. Keep the tone respectful toward the assistant, who usually knows the patients well and can help you write clearer directions next time.
Get an NU144CL Unit 4 example written to your instructions
Describe the assignment broadly, how many patients, how stable, and who was available to help, then attach the delegation prompt and the rubric used to mark it. The model applies the five rights to an invented morning of that shape, kept duties named. Decisions from your own shift are yours alone to report. First custom sample free, delivered in 24-48h. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
More NU144CL papers and BSN samples
- NU144CL Unit 1: Clinical Criteria Discussion Post
- NU144CL Unit 2: Four-Patient Shift Plan
- NU144CL Unit 3: Tracheostomy Patient Workup
- NU144CL Unit 5: Clinical Journal
- NU144CL Unit 6: Deterioration Write-up
- NU144CL Unit 7: Case Study Analysis
- NU144CL Unit 8: Post-conference Post
- NU144CL Unit 9: Competency Self-evaluation
- NU144CL Unit 10: Transition to Practice Reflection
- NU144 Unit 4: Hypoventilation Care Plan
- NU143CL Unit 4: Newborn Assessment Note
- NU143 Unit 4: Care Plan
- NU142CL Unit 4: Clinical Journal
NU144CL Unit 4 questions, answered
Where can I find a free NU144CL Unit 4 sample paper?
The complete NU144CL Unit 4 delegation write-up appears on this page, testing three delegated tasks against the five rights, explaining the tasks kept and following up a late report, with three sources. Ask us about a write-up matched to your own shift.
What are the five rights of delegation?
They ask whether the task can be handed over, whether this patient's condition allows it, whether this worker is trained for it, whether the directions were clear and whether the result was supervised and reviewed.
Why weren't vital signs delegated for the man after catheterization?
After a femoral catheterization, the site, pulse and leg must be checked with the vital signs, and bleeding must be recognized and acted on at once. Measurement and judgment cannot be separated.
Who is accountable for a delegated task in NU144CL Unit 4?
The assistant is responsible for doing the task correctly, and the nurse remains accountable for the decision to delegate, the directions and the follow-up of the result.
What should happen when a delegated report comes back late?
Recheck the patient, report the finding, then talk privately with the assistant about why the value matters and how the directions could be clearer next time.