Nurses: Accountability & Professional Responsibility

This assignment delves into the concept of accountability within the nursing profession. It emphasizes the importance of nurses taking responsibility for their actions and decisions, highlighting the ethical and legal ramifications of their practice. The discussion covers various aspects of professional responsibility, including scope of practice, patient safety, and collaboration with other healthcare professionals.

Running head: REGISTERED NURSES AND ACCOUNTABILITY 1
Should Registered Nurses be Held Accountable for Their Own Practice?
Student’s Name
Institutional Affiliation

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Introduction
Accountability means being answerable, liable, blame worth as well as possibility of
explaining about a certain action (Migrant, 2017). According to the definition by the American
Nurses Association’s code of ethics, accountability entails being answerable to one’s own and
others’ actions (Battie and Steelman, 2014). With regard to nurses, they may be held accountable
legally, ethically, and professionally for their actions, including omissions and inactions. On the
other hand, professional responsibility refers to the moral and ethical obligations that permeate
the nursing profession (Reid, n.d.). Accountability mainly entails competency, maintenance,
safeguarding of quality patient care, outcomes and heeding to profession standards at the same
time being answerable to those that are affected by one’s nursing actions (Ireland, 2017). In this
regard, nursing accountability is a complex but vital concept. Currently, accountability is a
principle relevant to all healthcare professionals.
As the Royal College of Registered Nursing (n.d.) outlines, providers of health service
are accountable to the criminal and civil courts. For RNS, they are accountable professionally to
the Nursing and Midwifery Council (NMC). However, in many healthcare settings professional
accountability has become an issue of concern. As Sherman (2013) claims, ethicists have
observed as most healthcare aspects change, individuals’ willingness to accept accountability and
responsibility has reduced. As such, the current paper seeks to explore the issue on whether RNs
should be held accountable for their own practice. Evidently, RNs should be held accountable for
their practice this keeps them in check to deliver quality care to patients, encourage them to meet
the set standards of care.

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For an RN to be deemed accountable, they must depict various aspects. They must have
the ability to carry out a certain intervention or activity, accept responsibility, and have the
authority to perform it, through delegation, protocols, and policies of the organization (Royal
College of Nursing, n.d.). According to the Australian Medicare Local Alliance (2013), RNs are
accountable for their actions and care they provide. Additionally, they are accountable for the
delegation of care decisions to another health care provider such as the EN. Also, RNs are
accountable for arriving at professional judgments regarding when an activity goes beyond their
scope of practice or their own capacity (Australian Medicare Local Alliance, 2013).
Roles of Registered Nurses
The role of a registered nurse ranges from performing physical examinations to taking
health history of patients (Aurora University, 2017). Registered nurses also provide health
promotion, counseling and education to clients (Charter College, 2017). Additionally,
registered nurses have other roles in the hospital to deal with the patients. They administer
medications, do wound care and other personalized interventions to clients (Aurora University,
2017).In order to know what is required of a particular client registered nurses interpret patient
information while making critical decisions about the needed actions (Registered Nurses, 2017).
The registered nurses are also in coordinating care in collaboration with other health care
professionals like doctors and enrolled nurses. They do this in order to ensure smooth running of
all the nursing activities in the particular health facilities.
Apart from direct care for the patients’ activities, registered nurses also engage in other
roles all of which contribute to the positive running of their overall responsibilities. For instance,

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the registered nurses are in charge of directing and supervising care delivered by other health
care officers like nurse helps and other practical licenses nurses and supervises the less-skilled
nurses or particular units (Charter College, 2017). The registered nurses also engage in
conducting research for improved practice support and the betterment of the patient outcomes
(Aurora University, 2017).
Areas of Accountability
There are several areas of accountability that RNs should be held accountable for. These
include accountability to the patient, employer, profession, and to the union (Philips, n.d.).
Foremost, RNs’ accountability is to the client where they hold out as individuals with special
training, knowledge, and skills necessary to provide the best care. As such RNs have a duty to
the client to offer standards of care that are reasonable and prudent. Compromising these
standards would be detrimental to the patient and one should be answerable to the consequences.
RNs’ accountability is also to their employer. As Philips (n.d.) outlines, as an employee, every
nurse has a responsibility to carry out their duties in the scope of employment as the employer
provides. As such, RNs are responsible for knowing their employment terms and work within
them, and to know the procedures and policies that govern their employment scope. Failing to
work within the defined scope may void the responsibility of the employer towards the RNs, thus
leaving them to bear the liability cost of their activities Philips (n.d.).
In addition to accountability to the client and employer, RNs are accountable to the
profession where they are expected to meet their profession’s standards (Philips, n.d.). In this
regard, RNs are required to carry out activities that are in the scope of their practice, and it is
their responsibility to maintain as well as update the standards. With regard to accountability to

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the union, RNs should be aware of the union’s policies’ and decisions that may affect them as
members and also their responsibilities towards the union. Thus, RNs should be aware of the
many accountability areas they should consider prior to engaging in any actions and activities
related to their profession.
Factors Affecting RN’s Practice
Different factors in the society affect the way RNs’ practice in varying ways. The culture
and beliefs of the RN is one of the factors that may affect how these professionals carry out their
roles and make decisions. Some cultural beliefs may contradict with the acceptable standards of
care. For instance, an RN’s culture may call for secrecy regarding revealing a patient’s serious
condition. On the other hand, it is the right of the patients to be informed of their conditions and
is supposed to make informed decisions. As such, if the RNs are unable to set aside their beliefs
and act as per their professional standards they may be held accountable for their actions,
similarly, personality of the RNs may impact on their practice in terms of the way they deal with
human relations and their values and moral standpoints. As such, personality affects decision
making and determines how health professionals react to issues. Additionally, RN’s own
experience may also impact on their practice. More experienced nurses may be in a better
position to address certain issues as opposed to newly recruited professionals. For instance, an
experienced RN may be able to make a more accurate diagnosis. On the other hand, a nurse that
is new in the profession may be at a better position to implement evidence-based practice as
opposed to one that has been on the nursing industry for long. This is because it may take a while
for the more experienced nurse to adopt to change and integrate the innovative practice in their
nursing. Additionally, the one that has been in the nursing practice may be more experienced in
other areas but may lack the evidence-based skills, knowledge, and experience. In this regard, it

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is important for RNs to be able to integrate values, ethics, and professionalism when making
decisions and providing care, and be flexible. As such, different factors affect RN’s practice.
Benefits of Accountability
Accountability of RNs presents with certain benefits. As Rachel (2012) states,
accountability is an energizing drive in any organization that allows healthcare professionals to
fulfill their goals easily. Every care provider builds credibility by holding each other
accountable. On the contrary, where healthcare professionals lack accountability, they present
excuses for not fulfilling their objectives (Rachel, 2012). Additionally, accountability of nurses
allows for continuity of care. For instance, perioperative nurses are accountable when they
provide care after surgery since hand overs are an important component of the safety of the
patient that ensures that care givers are given sufficient information regarding the patient. As a
consequence, patients receive high quality and safe care after surgery (Battie and Steelman,
2014). Accountability also ensures that nurses advocate for patients by acting on their behalf
when they are incapable of communicating their needs. This ensures that patients are satisfied
with the care they receive and they develop a sense of trust towards the care providers. What is
more, it is through accountability that lifelong learning is exercised where nurses are accountable
for learning continually on using best and current evidence in providing care. Lifelong learning
thus allows utilization of evidence based care, which has been shown to improve patient
outcomes and promote health (Battie and Steelman, 2014). These positive outcomes arise from
the quality care offered by responsible nurses. Thus, accountability presents with many
advantages that cannot be guaranteed in its absence.

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There are other advantages of accountability. As a nursing principle, accountability
enhances performance and increases competency (OPM, n.d.). This occurs when clarity on how
to accomplish tasks is offered to nurses and their roles and responsibilities are well defined. As
Sherman (2013) states, professional accountability is achieved through making certain nurses’
professional responsibilities and roles, as well as clarity on how to accomplish tasks. Also, when
nurses are provided with clear standards and metrics are set they guide the nurses’ actions,
ensuring that their performance is improved.
For accountability to be forged there are elements that should characterize RNs. Firstly,
there should be clarity as outlined by Rachel (2012). Here, the RNs should be guided by clear
and specific goals and expectations. The other element is commitment where an accountable RN
not only gives orders to their juniors but also listens, understands, and commit to achieving the
goal (Rachel, 2012). In this regard, RNs should be held accountable for their actions to ensure
proper advocacy for patients, allowing for continuity of adequate care for patients through out.
Shortcomings of Accountability
The aspect of accountability does not present with positivity only as it presents with some
shortcomings. For instance, RNs face the liability threat on a daily basis as they seek to be
accountable for all the four entities. Therefore, the aspect of accountability may add pressure to
the RNs as they try to act with accountability to the patients, employers, unions, and their
profession. Additionally, as stated by Savage and Moore, (2014), as nurses try to act with
accountability, they may feel pressured as they take on tasks such as documentation of their
activities, some of which take their time away from making it a priority to offer direct care to

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patients. What is more, pressure to act according to certain terms may increase errors and
inaccuracies and decrease the RN’s level of competency (Savage and Moore, 2014).
In addition to the accountability pressure that nurses have to put up with, there are other
situations that make it difficult for nurses to act with accountability. For instance, if a nurse is
working in a rural or remote area where the hospital fails to provide the necessary equipments
that meet the standards of care, nurses may face a dilemma as to whether to compromise the set
standards by the entities they are responsible for. In such a case, the issue of accountability poses
questions such as whether the nurse should be held accountable for not providing care as per the
set standards even when they are not provided with the necessary facilities.
Another controversial issue regarding accountability may arise from nurses’ collaborative
relationships with physicians and doctors. For instance, a nurse may receive erroneous
directions from the doctors or physician in charge regarding the type of medication to offer a
patient. Without their knowledge they may follow these orders and continue offering the wrong
medication to a patient. As such, questions as to whether this nurse should be held accountable
may arise. Notably, it is not the responsibility of a nurse to prescribe medication. Additionally,
RNs may find themselves acting in contrary to defined roles. For example, as already stated, it is
not up to nurses to make prescriptions. However, situations may force them to intervene when
doctors are not in the hospital and prescribe medications in case of an emergency. Again, should
they be held accountable for such acts even if they intervened to reduce risks to a patient? As
such, there are other such factors that may compromise RNs’ ability to implement the
accountability principle when they have to deal with issues such as understaffing, unqualified
college staff, inadequate equipment and resources, and security and safety.

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However, nurses should be able to uphold standards before acting while prioritizing
accountability. For instance, to avoid situations where the RNs will not meet the necessary
standards of their profession they can refuse to participate in such tasks. Rejecting such tasks
will reduce chances of uncertainties to the RNs thus maintaining the standards of their profession
and concerns relating to accountability. As a result, this will influence the wider health system to
maintain high standards of care.
Conclusion
Thus, accountability in nursing has become an issue of concern especially with the
changing healthcare world. However, it still remains to be an integral element of nursing practice
and helps to improve patient care, life-long learning, advocating for patients, and continuity of
care. As An preoperative RN, accountability may be advantageous since it ensures that patients
are prepared efficiently for operations, leading to smooth surgery process. I should be held
accountable for my actions since it will foster and motivate me to offer quality services.
Accountability in nursing has been shown to improve the quality of care and patient outcomes.
Additionally, it is through accountability as a principle that RNs are provided with guidelines
through which they can prioritize and ensure that patient’s well-being is prioritized and the
standards of care provided are acceptable. However, it also presents with detrimental impacts
where it adds pressure on RNs, decreasing the time they spend directly caring for the patients as
they act with accountability to other entities such as employers, and unions. Additionally, the
aspect of accountability exposes RNs to liability threat in their day-to-day activities as they have
to consider the entities they have to be accountable to, limiting the RNs’ competency and
accuracy. However, the benefits of accountability seem to outweigh the shortcomings. In this
regard, RNs should be held accountable for their own practice.

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References
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