“It's a Real Sink or Swim Environment”: A Qualitative Study of School Nurses Experiences of Developing Delegation Competence

Effective delegation is a critical component that significantly influences student outcomes, efficiency, and the overall interdisciplinary team dynamic. The aim of this study was to identify inhibitors and enablers of delegation in school nursing practice. This study used a descriptive qualitative research approach, using purposive sampling and data collected through a series of focus group interviews. Data were analyzed using a thematic analysis approach. The TranSPEC model was used as a framework to make sense of the data. The overarching theme was "It's a real sink or swim environment." Inhibiting themes were delegation complexity, moral distress, and being a novice school nurse. Enabling themes were acquisition of delegation skills, moral resilience, and being an experienced school nurse. Sub-themes were also identified. Multiple enablers to the delegation process were identified which present opportunities for school nurses, school administrators, and boards of nursing to enhance the safety of delegation.