What it means
The line a concern travels when it cannot be solved at one level. For a staff nurse it usually runs to the charge nurse, then the nurse manager or house supervisor, and on to higher leaders; for a medical issue it can run from the provider to the department chief. Every facility has a written policy for it.
For the nurse
Use the chain of command when a client's safety is at risk and the first person you raise it with does not act, for example when a provider does not respond to a serious change or insists on an unsafe order. Document who you contacted, when, and what they said.
Related terms
advocate
To speak up and act for a client's rights, safety and wishes; also, a person who does this.
delegate
To hand a specific nursing task to another trained person while the nurse stays responsible for the client.
incident report
A written record of an unexpected event in a health care setting that caused or could have caused harm.