A nurse delegates a task to an assistive personnel (AP) and the AP refuses to complete the assigned task. Which of the following actions should the nurse take?

Delegation in nursing involves assigning appropriate tasks to assistive personnel (AP) while maintaining accountability for patient care outcomes. Effective delegation requires communication, clarity of expectations, and mutual understanding of scope of practice. When an AP refuses an assignment, the nurse must assess the reason for refusal before taking further action. Open communication helps ensure patient safety while maintaining a functional and collaborative healthcare team. Rationale: A. Assigning the task to another AP may be appropriate only after understanding why the original AP refused the task. Without addressing the reason for refusal, the underlying issue may persist and compromise patient care or safety. The nurse must first clarify concerns before redistributing assignments. B. Performing the task on behalf of the AP may be necessary in urgent situations, but it is not the first action when refusal occurs. This approach bypasses problem-solving and does not address potential scope-of-practice concerns or knowledge gaps. The nurse should first explore the reason for refusal before assuming responsibility for the task. C. Reporting the AP to the risk manager is premature unless there is a pattern of unsafe behavior, negligence, or serious policy violation. A single refusal does not automatically indicate misconduct. The nurse should first engage in direct communication to determine whether the refusal is based on safety concerns or misunderstanding of the assignment. D. Discussing the AP’s concerns about performing the task is the appropriate first action because it promotes open communication and identifies the reason for refusal. The AP may lack training, feel the task is outside their scope, or have safety concerns. Addressing these issues supports safe delegation, teamwork, and appropriate resolution before escalating further action.