Considerations for Determining Assignment of Care

The Newfoundland and Labrador College of Nurses¹ has the legislated authority to set the scope of practice for nurses² in the province of NL. Nurses are accountable to practice independently and in collaboration with the health care team while understanding and respecting other team members’ scope of practice and contribution in the delivery of safe, competent, and ethical care. Nurses use their knowledge and understanding of the client, the scope of practice of various nursing disciplines, and the environment in which client care is provided to determine assignment of care.

The purpose of this document is to provide direction for decision-making related to the assignment of care considerations for nurses who work collaboratively to meet the client’s health care needs.

Assignment of Care

Assignment of care is the process of assigning the accountability and responsibility for meeting client(s) care requirements for a specific period of time to a nurse who has the knowledge, skill, and judgement to provide that care; and the care is within their individual scope of practice. It is a knowledge-based process of matching the most appropriate nurse with the appropriate client, based on the assessment of client needs. RNs and LPNs are both prepared through entry-level competencies for the leadership role involved in determining assignment of care. The nurse must determine who is the right health care provider for the client, in the right place, at the right time, and for the right reason. To do this, the nurse must reflect on the following three considerations:

• Client
• Nurse
• Environment

When considered in combination, these three elements will help determine whether it is appropriate for an individual nurse to be assigned to the client. These considerations are explained throughout this supporting document.

The nurse responsible for the assignment of care is not responsible for the care being provided by other nursing professionals under that assignment. Each health care professional is responsible for practising within their own scope of practice and individual competence and for documenting the care they provide. If the client has care needs that are not within the individual scope or competence of the assigned nurse, it is the responsibility and accountability of the assigned nurse to communicate that to the person creating the assignment.

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