| Course | NSG 126 Transition to Professional Nursing |
|---|---|
| Unit | Unit 6 |
| Paper type | Delegation decision record |
| Length | About 800 words, 5 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | BSN |
| Updated | October 2026 |
Free sample paper for NSG 126 Unit 6
Four Handoffs on an Inpatient Hospice Unit: A Yes, a No, and Two Conditional Yeses, Each With What the Registered Nurse Keeps
Student Name
Department of Nursing, Herzing University
NSG 126: Transition to Professional Nursing
Instructor Name
February 18, 2026
Four Handoffs on an Inpatient Hospice Unit: A Yes, a No, and Two Conditional Yeses, Each With What the Registered Nurse Keeps
Setting and Sources
A composite 12-bed inpatient hospice unit on an evening shift. The registered nurse (RN) has six patients and works with one licensed practical nurse (LPN) and one certified nursing assistant (CNA). Each case is judged against the national delegation guidelines, which set out who may delegate, what may be delegated, and what the delegating nurse retains (National Council of State Boards of Nursing [NCSBN] & American Nurses Association, 2016), and against Wisconsin's standards of practice, which tie what an RN hands over to the training and shown competence of the person receiving it, and oblige the RN to guide, watch over, and judge that work (Wisconsin Board of Nursing, 2025). Facility policy and the job description of each role are assumed to have been checked for every case.
Case 1: Repositioning and Mouth Care for a Patient Near Death
Situation: a woman in her eighties, unresponsive, in the last days of life, comfortable on a stable regimen, needs turning every two hours and mouth care. Person: the CNA, certified, oriented to the unit, observed doing both tasks competently last week.
What the guidelines and rules say: routine personal care for a patient whose condition is stable and predictable, within the CNA's training and the facility's job description, can be delegated.
Decision: yes.
What the RN retains: assessment of her comfort and of changes that signal a new need, such as noisy breathing, grimacing, or skin breakdown; the plan of care; and evaluation. Checking that follows: the RN tells the CNA to report at once any grimacing, moaning, change in breathing pattern, or new redness, and checks in after the 2000 turn. Record: the RN's assessment, the delegation, and the CNA's report.
Case 2: Feeding a Patient Whose Swallowing Has Just Changed
Situation: a man in his seventies with advanced dementia coughed on thin liquids at lunch for the first time. Person: the CNA.
What the guidelines and rules say: a task that requires ongoing clinical judgment, or that involves a patient whose condition is unstable or unpredictable, is not delegated. A new swallowing change needs assessment before any feeding plan is set.
Decision: no, for this meal.
What the RN retains: the whole task. The RN assesses him, positions him, feeds the evening meal herself, and contacts the team about a swallowing evaluation and goals of care for eating. Once a plan exists, feeding with that plan may become delegable. Record: the assessment, the decision not to delegate and why, and who was notified.
Case 3: Scheduled Oral Morphine Solution for a Stable Patient
Situation: a woman with metastatic cancer receives scheduled oral morphine solution every four hours; her breathing and alertness have been stable for three days. Person: the LPN, licensed, with medication competence documented by the facility.
What the guidelines and rules say: an LPN may give medications to patients whose condition is stable and predictable, under the direction of an RN, within the LPN's scope under state law and facility policy.
Decision: conditional yes. Condition: the RN assesses her at the start of the shift and confirms she is stable; the LPN checks and reports respiratory rate and sedation before each dose, as opioid monitoring guidance recommends (Jarzyna et al., 2011), and holds and reports if either has changed.
What the RN retains: assessment, the decision that the patient remains stable, and evaluation of pain control. Checking that follows: the RN reviews the LPN's pre-dose findings at 2000 and 0000. Record: the RN's assessment, the LPN's administration and findings.
Case 4: Watching for New Pain Overnight
Situation: a man with bone metastases has had well-controlled pain, but his breakthrough doses increased today. Person: the CNA, who will be in and out of his room overnight.
What the guidelines and rules say: assessment of pain is an RN function and cannot be delegated. Observing and reporting what the patient says or shows can be.
Decision: conditional yes, for observing and reporting only. Condition: the CNA reports immediately if he says he is in pain, grimaces, guards, or cannot settle, and does not judge whether it is serious.
What the RN retains: pain assessment, the decision to give a breakthrough dose, and the call to the hospice physician if the pattern continues. Record: the instruction given to the CNA and each report received.
Reading the Four Together
In every case the task could be handed over or not, but the RN's assessment and evaluation stayed with her. What decided each case was the patient's stability, not the difficulty of the task: feeding is a simple task that could not be delegated today, while giving morphine is a higher-risk task that could be, to the right person under stated conditions.
References
Jarzyna, D., Jungquist, C. R., Pasero, C., Willens, J. S., Nisbet, A., Oakes, L., Dempsey, S. J., Santangelo, D., & Polomano, R. C. (2011). American Society for Pain Management Nursing guidelines on monitoring for opioid-induced sedation and respiratory depression. Pain Management Nursing, 12(3), 118-145. https://doi.org/10.1016/j.pmn.2011.06.008
National Council of State Boards of Nursing & American Nurses Association. (2016). National guidelines for nursing delegation. Journal of Nursing Regulation, 7(1), 5-14. https://doi.org/10.1016/S2155-8256(16)31035-3
Wisconsin Board of Nursing. (2025). Standards of practice for registered nurses and licensed practical nurses (Wis. Admin. Code ch. N 6). Wisconsin Legislature. https://docs.legis.wisconsin.gov/code/admin_code/n/6
NSG 126 Unit 6 instructions, in plain terms
Unit 6 asks you to record delegation decisions for several situations. Expect to describe the setting, then for each case state the situation, the decision, the reasoning against delegation criteria and what the RN keeps. Many versions ask how many cases to include and whether to use a specific state's rules. Check whether your section names the guidelines. The same task can be delegable in one situation and not another, so explain what changed. Conditional decisions need the conditions stated, such as reporting triggers. Assessment, planning and evaluation stay with the RN. Hospice and end-of-life settings raise questions about comfort care and medication that test the criteria well.
Inside the NSG 126 Unit 6 example
The record opens with the unit, the staff on the shift and the guidelines used. Each case follows the same pattern: situation, decision, reasoning and what the RN keeps. Case 1 shows a routine comfort task safely delegated with directions. Case 2 shows a task held back because a change in swallowing requires assessment. Case 3 shows medication assigned to an LPN within state scope with stated limits. Case 4 shows monitoring delegated with exact reporting triggers. The final section draws the common thread that assessment and evaluation never moved. The consistent format lets a reader compare cases and see why each decision differed. Directions for each delegated task include what to report and by when.
Where the points sit in the NSG 126 Unit 6 rubric
Herzing's rubric for a delegation record typically covers the setting, application of delegation criteria, accuracy of each decision, conditions for conditional decisions, what the RN keeps and synthesis. Each decision is checked against the five rights and state scope, which is where most errors appear. Setting points reward staff roles and skill mix. Condition criteria look for specific limits and reporting triggers. RN responsibilities earn credit when assessment and evaluation are named. Synthesis points go to the pattern across cases. State rules, such as Wisconsin's N 6, are often credited when applied. The record relies on the NCSBN and ANA delegation guidelines.
NSG 126 Unit 6 help: mistakes that cost points
A Unit 6 delegation record often goes wrong by delegating assessment, such as evaluating a new swallowing problem, to an assistant. Another frequent problem is conditional decisions without stated conditions. The RN's continuing accountability for each handoff is sometimes left unstated. LPN scope is applied without checking state rules. Reporting triggers are vague, such as report any changes. Comfort care is treated as always delegable without checking the patient's stability. Synthesis is missing. Finally, explain what made each case different, because graders reward a record that shows the same criteria producing different decisions for good reasons. Another weak spot is forgetting the family, who often help with comfort care on a hospice unit and need clear guidance too.
Get a NSG 126 Unit 6 example written to your instructions
Send the Unit 6 instructions and the rubric from your NSG 126 classroom, along with the scenarios the assignment supplies. We write a custom example that describes each receiving person before deciding, cites the rules first, allows conditional answers with their conditions, and closes every case on what stayed behind. First custom sample free, back in 24 to 48 hours.
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NSG 126 Unit 6 questions, answered
Why does every case have to end on what stayed behind?
Because that is the idea the unit exists to install. Handing work to somebody else moves the doing and not the answering, and a graduate who has not absorbed that will make the mistake in their first month. Your instructions may word it as accountability or as responsibility; either way, the closing sentence of each case is where a reader looks for it.
Where do the rules for delegation come from?
Your state's practice act and board rules, plus whatever your classroom supplies, cited with the state named. Provisions differ between states in ways that change the answer to a case, so a record citing a general source without a jurisdiction cannot be checked. Where your program materials and a board document differ, follow the program materials and note the difference.
Should any of my cases end in a refusal?
At least one, unless your instructions say otherwise. A record in which every situation can be handed over reads as assembled to be easy, and it skips the reasoning that shows you can tell the difference. Write the refusal the same way as the others, with the rule cited and the reason stated, rather than as an exception at the end.
Where can I find a free NSG 126 Unit 6 sample paper?
Read the complete NSG 126 Unit 6 hospice delegation record here at no charge, four cases with decisions and what the RN keeps. A record for your own unit can be prepared on request.
Can a nursing assistant feed a patient with a new swallowing problem?
Not until the RN has assessed the change and a safe plan exists, since a new swallowing problem raises aspiration risk. This sample refuses that delegation and explains when it could be handed over.