Table 3.

Task delegation and shifting in practice based on our ward observations

Category of delegation	Task areas
Tasks that can never be delegated to someone other than a qualified professional	Ordering supplies and equipment from the stores and pharmacy Resuscitation of babies Final assessment of nursing students to qualify as nurses Referral of babies from one hospital to an often-higher care hospital
Delegated to student nurses undertaking clinical training attachments	Weighing babies Taking vital signs observations Giving intravenous fluids Filling the nursing Kardex (a summary of individual patient needs used by nurses to communicate important information on their patient and often updated at every shift change). Giving treatments—either oral, intra-muscular or intravenous
Delegated to mothers	Cup and NGT (naso-gastric tube) feeding of babies Filling amounts of milk fed to babies on feeding chart Top tailing (cleaning baby from head to toe)
Delegated to support staffa	Dusting and cleaning incubators Cup and NGT (naso-gastric tube) feeding of babies Top tailing (cleaning baby from head to toe)
Tasks sometimes done/left undone	Education Emotional support

^aLong-term casual employees often sub-contracted by the hospital to primarily provide cleaning services within the hospital although they are also often used to run errands within the different departments in the hospital