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Accountability, autonomy and delegation in nursing - Essay Example

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Nursing is a professional practice that deals with helping people in achieving and maintaining good health thus normal body functioning. The profession is entirely on nurse giving services to the human race. Nurses are guided by some code of ethics which they must abide to in order to perform their duties as required…
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Accountability, autonomy and delegation in nursing
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Extract of sample "Accountability, autonomy and delegation in nursing"

Nursing Criteria Nursing is a professional practice that deals with helping people in achieving and maintaining good health thus normal body functioning. The profession is entirely on nurse giving services to the human race. Nurses are guided by some code of ethics which they must abide to in order to perform their duties as required. The practice authority is based on social agreement outlining the practice responsibility expectations to enter the profession one must go through the territorial and national nursing boards all of which are administered and defined by the law thus defining a scope of practice. Nurses are therefore expected to be have Accountability, Autonomy and proper delegation in the nursing field the nursing field .these criteria will be discussed below; Autonomy means self independence, self governance and ability to practice self control. In nursing it means the idea of giving health professional (nurses) formal authorities in making independent decision concerning patient care. Autonomy is a key and central idea in the health care field of the modern world. It applies to the nurses as it allows them to exercise equitable control and judgment over nursing professional.(MacDonald ,2002) In the modern World nurses have some set professional standards that guide them in their work and which they all must adhere to. The standards clearly indicate the right way on how things can be done under the profession and also the wrong things which ought not to be done. Like any other profession nurses have that freedom of practicing professional judgment and setting their own standards of performance and employing the members and patients. (MacDonald ,2002) Professional autonomy will therefore give some justification as to why nurses act as per their own judgment (profession) rather than waiting to be guided by the physicians what to do. In this case the nursing profession will not been subordinate to the medical expertise but it will rather be independent of the medical expertise. Though the nurses will be retaining a scope of autonomy judgment on how the orders are carried out. It is very possible that nurses will know some things which are not known by their physicians. Thus is because nurses undergo some formal training that enables them to gain wide range of experience in some areas as under the profession for example nurses will understand and perform sterile dressing procedures perfectly than the physician will do will this regard wherever a physicians orders the nurse to do something that is in conflict with the professional autonomy of the nursing expertise than the autonomy dictates that the nurses has a right to object the fulfilment of such orders. (MacDonald ,2002) Accountability defined on the black's law dictionary in the state of being responsible or answerable to your deeds. Nurses in the nursing profession are required to be answerable to the physicians, patients and nursing board. They should be held responsible in any thing done under their profession hence answerable. Accountability ensures that professionals' ethical, acceptable and legal nursing conducts are maintained by the nurses. Nurses are therefore expected to show accountability in their profession as ling as they are engaged in it. They should perform their duties with regard to the acceptance nursing care and the acceptable nursing care and the set out standards a thing that will demonstrate higher accountability on the nurse own actions.(Hage ,2000) Accountability goes hand in hand with liability. (Hage ,2000) The black's law dictionary defines liability as a condition of being potentially subject to an obligation. The nurse profession carries moment's duties and obligation which guides the nurse on what to do. Nurses should therefore be held liable for anything that happened under his docket and should be held responsible for example. (Hage ,2000) A nurse should follow the procedures and policies as laid down by his employer and should follow the procedures and policies and procedures. A nurse should practice all the nursing care standards as that demonstrate failure to practice the standards of care lead him/her to some civil suit which may be raised by the patient or even an employer most of this actions are as a result of negligence and can contribute to the nurse serving a jail term suite he/she must be held accountable for what she did outside the professions code of ethics. (Hage ,2000) The federal or local prosecutors can also raise a criminal case against the nurse. The nurse should be held accountable and liable should the state or the federal prosecutor fined him guilty. (Hall ,2005). Lastly, the nurse should be accountable and considerable to the board of nursing investigators should they find him guilty for violating the rules and guidelines under the nursing profession. He should therefore carry the disciplinary actions that the administration may deal necessarily for his/her violation of rules. Should nurses delegate duties to other people then the principle of accountability entails then the concerned nurse should be held answerable for the actions and inactions of himself and delegated for the nurse should understand all the principles of delegation and be careful when implementing them so as to avoid a case of risking her license as a result of incorrect delegation. (Hall, 2005) Delegation is that act of a nurse assigning his duties to some unlicensed assistive personnel to carry out the duties on his/her behalf. Even after transferring the authority of performing a given task in a given situation the nurse is left with the accountability of the delegations.(Kennerly ,2000) Before delegating any duty the nurse should ensure that the assigned task is in the line with the knowledge, level of education, skills and judgment levels of the personnel to whom the task is assigned .this should include specifying the expected time frame for the compilation of the delegated task, the expected result and likely to occur. (Kennerly ,2000) According to Clifford (1998), delegation should be guided by the five rights which were published by the national council of state boards of nursing {NCSBN} these rights are as follows. 1. Right person - before delegating the nurse should ensure that he is assigning duties to the right personnel. The unlicensed assistive personnel should be competent people poising the right qualification for the entire organization. He should possess UAP's demonstrated and written skills. The selected personnel should know how to carry out a good data research, data reporting and representing the nurse fully in the patient's room. (Clifford ,1998) 2. Right direction and communication - duties and roles nurses should comprehend procedures and polices as stipulated by the nursing profession. They should then properly inform the unlicensed assistive personnel and educate them on each delegated duty in this case they should come up with a right schedule determining how the VAP'S should report to them and at what time. They should be free to ask questions those people to whom the task has been assigned, for example ask them whether they know how to perform some specified tasks, where they acquired the skills from, whether they have ever performed such tasks in the past and whether they have some documented experience with them. These questions will be very important in selecting the right person. (Clifford ,1998) 3. Right task - activities to be performed by nurses are determined by the nurse leaders. It is the nurses who then re-assign the task UAP's. Nurses should therefore assign those tasks that are proper as per the set guidelines. He should consider the UAP'S ability, the condition of the patient, how simple or complex the task is and the level of supervision required. (Clifford ,1998) 4. Right evaluation and supervision - It is the duty of the nurse to ensure that delegation works properly evaluation of the patient's results and the general tasks accomplishment. He should therefore assess direct and manage the UAP'S as the implement the assigned tasks. He should assist them where possible to make sure that duties are carried out to the expected standards. (Clifford ,1998) 5. Right circumstances - in his evaluation the nurse should consider the patients needs, the community expectations and the staffing needs. These will help him in realizing the right delegations procedures. (Clifford ,1998) References Benner P (1984). From Novice to Expert. Menlo Park, Calif: Addison Wesley; Blegen, M. (1993): Nurses' job satisfaction: a meta-analysis of related variables. Nurs Clifford J. (1998) Advancing Professional Nursing Practice. New York, NY: Springer Darbyshire, Philip and Gordon, Suzanne (2005). Exploring Popular Images and Reputations of Nurses and Nursing. In Daly, John, et al., (ed.) Professional Nursing: Concepts, Issues, and Challenges. pp. 69-92. New York: Springer Publishing Company. ISBN 0-8261 Freeman T. and O'Brien A.(1998) Factors influencing job satisfaction on specialty nursing units. Can J Nurs Adm. 1998; 11:25-51. Flexner A. (1999) Medical Education in the United States and Canada: A Report to the Carnegie Foundation for the Advancement of Teaming. Boston, Mass: Marymount . Hall L(2005). Indicators of nurse staffing and quality nursing work environments. In: Hall LM, ed. Quality Work Environments for Nurse and Patient Safety. Sudbury, Mass: Jones & Bartlett Kennerly S. (2000) Perceived worker autonomy: the foundation for shared governance. J Nurs Adm.;30:611-617. Kramer M, Schmalenberg C.(2003) Magnet hospital staff nurses describe clinical autonomy. Nurs Outlook.;51:13 -19. Institute of Medicine of the National Academies. Keeping Patients Safe: Transforming the Work Environment of Nurses. Washington, DC: The National Academies Press; 2004. Mrayyan M. (2003) Nurse Autonomy, nurse job satisfaction and client satisfaction with nursing care: their place in nursing data sets. Can J Nurs Leadersh. Moore, T. (1987): Managing the Nursing Shortage: A Guide to Recruitment and Retention. Rockville, Md: Aspen. MacDonald C. (2002) Nurse Autonomy as relational. Nurs Ethics.9:194-201. Hinshaw A.( 2002), Magnet Hospitals Revisited. Washington,DC: American Nurses Publishing. Hage J. (2000) Theories of Organizations: Forms, Process and Transformation. New York, NY: Wiley; Mundinger M.(2001) Autonomy in Nursing. Germantown, Md:Aspen Publishing;. RCN (2003) Defining nursing Retrieved October 2006 Strauss A. and Corbin, J. (1990): Basics of Qualitative Research: Grounded Theory Procedures and Techniques. Newbury Park, Calif: Sage; Read More
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