Task delegation in emerging chronic diseases: Long COVID care as a paradigm - a cross-sectional study

BACKGROUND: Emerging chronic diseases like Long COVID challenge traditional care models, creating therapeutic voids that nurses spontaneously fill through informal task delegation. This study examines nursing roles delegated in Long COVID care and identifies implications for nursing administration. METHODS: A cross-sectional study was conducted among 362 nurses in France’s Rhône-Alpes region (December 2023-March 2024). An online questionnaire assessed Long COVID care roles and delegation patterns. RESULTS: Among participants, 39.8% (95% CI: 34.8–44.9%) had cared for Long COVID patients. Primary delegated roles included psychological support (86.8%, 95% CI: 80.0-91.8%), proximity care (72.9%), screening/detection (42.4%, 95% CI: 34.2–50.9%), and therapeutic education (70.8%). Nurses performing screening roles were significantly more likely to also perform coordination activities (OR = 3.87, 95% CI: 1.92–7.80, p < 0.001) and therapeutic education (OR = 5.63, 95% CI: 2.37–13.36, p < 0.001). Private practice nurses demonstrated significantly greater task appropriation. Despite the quasi-total absence of specific training (1.4%), 80.4% (95% CI: 73.1–86.3%) of nurses with Long COVID care experience declare themselves ready to formally assume coordination responsibilities for Long COVID patient pathways. CONCLUSIONS: Nurses spontaneously appropriate medical roles when confronting emerging diseases. Nursing administration must formalize this informal delegation through structured training and policy frameworks to optimize chronic disease management. The screening role assumed by nurses represents a significant evolution in diagnostic responsibilities distribution, requiring recognition and structured support.