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Legal and professional responsibility of registered nurses

Question:

Should Registered Nurses Be Held Accountable Of Their Own Practice?

Registered Nurses are those nurses that have officially graduated from a nursing college, university or any other educational institution and have excelled in the national licensing exam. These nurses are meant to provide and set up care activities for the patients. Registered nurses are responsible for recovering patients. Additionally, they are responsible for educating patients and coordinating patient care schedules. Furthermore, the registered nurses have the responsibility to educate the public (non-patients) about any health condition and on various diseases and infections (Fisher, 2009). These nurses are mostly found in areas like the operations rooms, doctors’ offices, Intensive Care Units (ICU’s), clinics, patient recovery rooms, patient admission rooms and ambulatory care rooms. Accountability is the state of being responsible or liable for a certain action or result.

Accountability encourages individuals towards being responsible and answerable whenever they are involved in an action or when their actions causes certain results. On the other hand, responsibility is referred to as the obligation to carry out some tasks or duties by use certain professional knowledge and having the courage to be answerable for them. In that case, registered nurses are supposed to be accountable or rather responsible for their practices. Every employee who has a role and responsibility must have the courage to be accountable and answerable for all the activities they conduct and all the results that arise from those activities (McConnell et al, 2012). To be precise, registered nurses are usually trained to take care of hospital patients which basically means that they have to be accountable of what happens to the patients as a result of their professional practices (Goudreau et al, 2013). Therefore, it is important to note all health care providers are deemed accountable for their own practices by both the criminal and civil courts to ensure that all their practices are focused towards meeting their legal requirements and objectives. Furthermore, just as how general employees are accountable of their activities in the employer’s eyes, the registered nurses in Australia are also accountable to their regulatory organization (Nursing and Midwife Board of Australia previously called the Nursing and Midwife Council) who ensure that they abide to the rules and regulations governing their professional practice and patient care responsibility (Zahedi et al, 2013).

This discussion will provide a clear understanding on the reasons why the registered nurses should be held accountable of their own practices. The following are the reasons:

Importance of accountability for improving quality of care

The registered nurses must be accountable because it is actually their legal and professional responsibility to do so. When the nurses are trained, there main goal, objective and duty is solely to provide patient care in a health institution (Zahedi et al, 2013). By training them, they are equipped with immense knowledge, skills and expertise that is to be used when doing their jobs. Technically, the county’s laws (Australia) imposes a duty to all the health practitioners which is basically a duty to care on practitioners. These laws are imposed for all nurses whether HCA’s, Aps, students still in the program, doctors, registered nurses among others (Cashin et al, 2017). However, the registered nurses are also liable to adhering to the rules and regulations set aside by the NMBA which is the authoritative body in charge of registering nurses and giving the licenses. Therefore, it is the duty of each nurse to be accountable of any action that they take under those laws. If the action is within the laws grounds, then the responsible nurse for the action or result is supposed to take credit and if not according to the laws, the nurse responsible is supposed to shoulder the damages or danger caused by the results (Cashin et al, 2015). By setting up these laws, the nurses are aware of what they are supposed to do and what they are responsible for. On the other hand, the laws also offer protection to the regulatory organizations so that they are not entirely blamed for the nurses’ practices.

As mentioned earlier, registered nurses’ roles and responsibility, is to take care of the patients when doctors are not available. According to Sadeghi  et al, 2016, this means that they actually give medicine to the patients, change the patient’s beddings, give them food and other drinks, take them to visit the toilets, educate them on how to care for themselves, involve the patients in professional talks and other activities that the patients may need. In the grounds of taking care of the patients, the nurses are supposed to check on the patients on a regular basis, make observations when needed or when the doctor is not available, strategize on methods of making their health condition better to name just but a few activities that are supposed to be done by a registered nurse on duty. According to Hughes, 2008, all these activities are all related to a person’s health condition and life. This means that nurses are the ones to determine whether the patients will recover or not. Therefore, it is important for all nurses to be accountable of their own action/practice so that whenever a person’s life or health is in danger, they can be solely answerable for the results (Masso et al, 2014). Through this, the nursing practice will be given more though and value because of the fact that every nurse will be on their own. Additionally, the nurses will be ready to perform their best in their practices therefore providing the best care quality to the patients.

Nurses as caregivers and decision-makers

This is related to the improved quality care provision. The nurses that are placed in surgery rooms help the surgeons in operating on the patient. These practices give the nurses the opportunity to experience the operation activity and understand the care that the patient needs (Battie et al, 2015). The nurses placed in such scenarios get to understand these patients better because they have an idea of exactly what may have happened in the operation room, what medications that were used, what possible dangers that may affect the patients among other things (Mitchell, 2008). Therefore, these nurses are given the responsibility of taking care of these patients simply because they have more experience and information on their condition than any other. However, nurses should be accountable for their patients during their time of illness as well as when their during their recovery time, e.g. in the case of a surgery patient. When these nurses are deemed accountable for their actions, they give their best during the operational and after the operations (Battie et al, 2014). The nurses are allocated the responsibility to provide medication, observe the patients and make regular checkups on them. By doing all of these, the nurses will be determining the health condition and status of the patient especially towards their recovery process. Through this, the nurses will be ready to offer the best and improved safety and care to the patients no matter what.

 Every registered nurse’s career is determined by how much experience, skills and knowledge they have. However, after the nurses have finished their training programs and are officially registered, they can only get experience by working in a hospital. Basically, it means that new registered nurses may not have enough experience but can get it from performing their duties to their patients in hospitals. However, as for the already experienced nurses, they can learn from their past nursing experiences. This is where the accountability aspect comes in. When nurses are accountable of their own practices, they get to learn more or better than when they are given examples of nurses who failed or who made certain mistakes (Ross et al, 2013). Generally, a person is capable of taking their own mistake into consideration more than one of a person whom they may not know or even heard of. Therefore, when nurses are accountable of their actions, they get to correct their mistakes more positively or faster than when they are given examples of the same mistakes made by a different person. Every experience is a lesson for a nurse, e.g. taking care of different kinds of patients with different health conditions. When a nurse becomes responsible for a patient’s death, they should be accountable of the death on their own and if a patient’s health condition improves drastically, the nurse responsible should be responsible of the improvement of their own. According to Krautscheid, 2014, the accountability will certainly be helpful especially when the results of a practice are negative. Hence, accountability serves as a person’s own form of lifelong learning experience to say the least.

Accountability as a form of lifelong learning experience

Registered nurses are educated individuals who have graduated from a nursing college or a university or any other learning institution offering nursing education services. However, in these educational institutions, the activities involved are just teaching, studying and being examines theoretically or rather there are no actual patients in the educational forums (Hernandez, 2016). When these nurses are registered and start working, the have to deal with real human being and worry about their lives. This means that they get the opportunity to tackle real health conditions being experienced by real humans. In that case, these nurses are given the chance to practice their profession in real life. They get to observe patients, check their health conditions, differentiating different medications to give a person suffering among other things. This means that they ought to be effective and efficient planners, smart decision makers, have strong communication skills, a good caregiver, among other things. They certainly need to increase their levels and strategies of making the right calls or decisions (Kako et al, 2008). Through all these activities and roles about caring another person’s life, improves the thinking capacity of a nurse which is a basic way of letting them learn new things in their profession and career (Gardner et al, 2016). For that reason, it is important to approve the aspect of accountability or nurses for their practices because through this, they will be able to actually learn more and improve their professional education by practicing it.

Conclusion

Registered nurses are those that have already passed through the nursing education institutions and passed the national examination for licensing. However, these nurses, especially those in Australia, should be able to be recognized by their specific regulatory bodies, in the case of Australia it’s the NMBA. It is also important for nurse to ensure that their roles and responsibilities and duties are tied to a patient’s life which means that every any registered nurse should make sure that they take care of the patient’s health condition because their life is technically on their hands. Therefore, this being the obvious reason for the nurses to be held accountable for their practices and actions, the other are: the fact that it is a way of enhancing improvement in the quality of the nursing practice, a way of improving the safety standards of the patients, it offers a chance for further learning and professional education for the nurses, it is a way of adhering to the legal standards of a country and nursing regulatory body and that it offers an opportunity to the nurse to have more experience in their practice. Therefore, yes, the nurses should be accountable for their own practices because it will definitely do more good than harm to the patients and the entire society.

References

Battié, R., & Steelman, V. M. (2014). Accountability in nursing practice: Why it is important for patient safety. Association of Operating Room Nurses. AORN Journal, 100(5), 537.

Battie, R., & Steelman, V. M. (2015). Accountability in nursing practice: Why it is important for patient safety. ACORN: The Journal of Perioperative Nursing in Australia, 28(4), 14.

Cashin, A., Buckley, T., Donoghue, J., Heartfield, M., Bryce, J., Cox, D., ...& Dunn, S. V. (2015). Development of the nurse practitioner standards for practice Australia. Policy, Politics, & Nursing Practice, 16(1-2), 27-37.

Cashin, A., Heartfield, M., Bryce, J., Devey, L., Buckley, T., Cox, D., ...& Fisher, M. (2017). Standards for practice for registered nurses in Australia. Collegian, 24(3), 255-266.

Fisher, P. (2009). Organizational effectiveness and capacity: the critical role of organizational health. Victoria (BC): Fisher & Associates Solutions Inc.

Gardner, G., Duffield, C., Doubrovsky, A., & Adams, M. (2016). Identifying advanced practice: A national survey of a nursing workforce. International journal of nursing studies, 55, 60-70.

Goudreau, K. A., & Smolenski, M. (Eds.). (2013). Health policy and advanced practice nursing: Impact and implications. Springer Publishing Company.

Hernandez, J. S. (2016). Coaching other physicians through difficult conversations. Physician Leadership Journal, 3(5), 40.

Hughes, R. G. (2008). Nurses at the “sharp end” of patient care.

Kako, M., & Rudge, T. (2008). Governing nursing: Curriculum as a rhetorical vehicle using South Australian nursing schools from the 1950s onwards as an illustrative case. Contemporary nurse, 30(2), 142-155.

Krautscheid, L. C. (2014). Defining professional nursing accountability: a literature review. Journal of Professional Nursing, 30(1), 43-47.

Masso, M., & Thompson, C. (2014). Nurse practitioners in NSW'Gaining Momentum': rapid review of the nurse practitioner literature.

McConnell, K. J., Delate, T., & Newlon, C. L. (2012). Impact of continuing professional development versus traditional continuing pharmacy education on learning behaviors. Journal of the American Pharmacists Association, 52(6), 742-752.

Mitchell, P. H. (2008). Defining patient safety and quality care.

Ross, K., Barr, J., & Stevens, J. (2013). Mandatory continuing professional development requirements: what does this mean for Australian nurses. BMC nursing, 12(1), 9.

Sadeghi, A., & Khamarnia, M. (2016). Professional Ethics in health management, Patients’ rights grounds. Medical Ethics Journal, 4(13), 13-26.

Zahedi, F., Sanjari, M., Aala, M., Peymani, M., Aramesh, K., Parsapour, A.,& Dastgerdi, M. V. (2013). The code of ethics for nurses. Iranian journal of public health, 42(Supple1), 1.

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