Nurses can use a variety of ways to demonstrate individual accountability; two methods are continued competency and professional development. Professional competency is an empowerment tool in that it enables the nurses to fulfil their responsibilities of care effectively. It is also, therefore, important to understand the factors that influence clinical competency (Memarian et al., 2007, 203-214).
Accountability and Ethics: The codes of nursing ethics have focused on accountability as a central moral concept and value. Some national nursing organisations have identified accountability as the key standard of competent practice. The code of professional conduct calls for a high standard of professional behaviour from the nurses, regulating the nursing and midwifery practice in order to ensure standards and providing protection for the clients (Vanlaere and Gastmans, 2007, 758-766). Nursing, in essence, is a care system that springs from safe, caring, and competent and educated decision making, and nurse is a professional who is willing to accept personal and professional accountability for evidence-based practice guided by ethical principles (Wiseman, 2007).
Accountability: The code of professional conduct enumerates that the nurse is personally accountable for her practice. Literally, this means the nurse is responsible for actions and omissions, "regardless of advice or directions from another professional." This directly relates to the law of the land and is guided by the duty to deliver safe and competent care. Therefore, this also involves the responsibility of reporting. However, it must be mentioned that accountability for standards of practice is judged by the peers or fellow professionals, and only they are in a position to make decisions about the appropriateness or quality of service. Nursing diagnoses, the first taxonomy created in nursing, have fostered the development of autonomy and accountability in nursing and have helped to delineate the scope of practice. In that sense, professionalism and accountability are inherent in nursing practice (Jos and Tompkins, 2004, 255-281). The nursing profession has traditionally used three methods of assuring accountability to the public-licensure examination, continuing education, and certifications, all of which are avenues of professional development that ensures quality and standards of care. The idea of a standard of care evolves from this principle. Standards of care provide a ruler for measuring nursing actions, and therefore, maintenance of accountability promotes both personal and professional development. This behaviour would uphold the profession, and accountability also ensures that the nurse acts quickly to protect the patient and his rights within the limits of contemporary professional competency. Nurses are accountable to their clients and to their colleagues. When providing care to clients, nurses are responsible for their own actions, good and not so good (Griffith and Tengnah, 2005, 339-343).
The principle of autonomy has considerable merit and is supported by the Code of Ethics for Nurses. Following this ethical principle