The Accountable Nurse Practitioner

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In this essay I intend to examine the issues surrounding nurses' accountability in relation to the scenario discussed, and to Adult nursing. From the group sessions and further reading I have broaden my understanding of what being an accountable practitioner involves. Nurses are highly responsible for their own actions and care they provide. Consequently they are professionally accountable to the Nursing and Midwifery Council, (NMC) as well as their employer, public, patient, families and to themselves. Nurses have to justify why specific care was given in a particular way, (Royal College of Nursing, 2008). And they are required to use their professional knowledge, judgement and skills to make decisions continually throughout their practice, to allow them to exercise best practice (NMC, 2008). Professional, ethical and legal issues are all incorporated into being an accountable practitioner and nurses must take these issues into account throughout their practice. However before exploring accountability further an understanding of the term must be addressed. Tingle, 1995 states it is a contested topic as the concept of accountability is indefinable and arguable. On the other hand Bergman, 1981, defines it as being able to be ‘counted on', however states it is a complex notion as there are varying ways a practitioner can be held accountable dependant on who they are accountable to at the time of the incident. In terms of health care McSherry and Pearce, 2002 explain that accountability relates to continual changing practice and the practitioner has a responsibility to ensure their practice is effective with an evidence base.

During nurse training students accept responsibility for their actions whilst on practice placement however it is the delegated professional who is held accountable for those interventions provided. This difference occurs because to be held accountable you need to have the extensive knowledge base of why interventions are carried out and this is what we as students are continually learning throughout our training. This is the role of the delegated professional to ensure that we are competent in the interventions we are providing to patients and they exercise the correct supervision to ensure this it is a safe learning environment. It is argued that a certain level of authority is required to be accountable as this allows the practitioner to act with a reasonable level of autonomy, (Burnard & Chapman, 1999). Student nurses are not fully autonomous as all decisions have to be agreed by the allocated mentor. Not until we become a registered nurse will we be able to make that transit to hold individual accountability. However, this individual accountability does not come without its stresses. As outlined by Gerrish, K, (2000) in her study which describes that very transition from student to newly qualified as shocking, because of the sudden shift to full accountability.

The element of accountability I will be focusing on in this assignment is standards of care. I have chosen standards of care, as this is one element that the accountable practitioner module intends to teach nursing students about. (University of Nottingham 2009) Black and Chitty (2007) tells me that standards of care guide and inform us on what it is a competent nurse would do in a similar situation. The Nursing and midwifery Council code of professional conduct (2008) dictates how one must maintain consistent high standards of care at all times, also informs us that one must do this by keeping knowledge and skills current with recent research. Basing actions on critiqued up-to date evidence, underpinning one's practice. However also highlights the importance of practicing under the boundary of one's own competency. The Department of Health (2008) expects from nurses a high standard of care and impose a strong view that these high standards will generate clinical effectiveness, and promote both patient safety and personal safety within...
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