Nursing Essay Example | Topics and Well Written Essays - 3000 words

Nursing - Essay Example These changes coupled with the escalating complexities of the ever evolving healthcare delivery system and the changing socio-political market has further heightened the pressure on nurses to be more responsible and accountable for delivery of quality patient care (Lenburg, 1999; Savage & Lucy, 2004:9). As the healthcare environment becomes more demanding with the increasing complexity and changing patterns of healthcare delivery, and the development and evolution of the nursing practice in response to the increasing health needs of clients, nurses are faced with the increasing pressures of decision making (Accountability in Nursing and Midwifery, 1997). In all these changes, what stands the same is that the nurse must exercise discretion and judgment in the management and supervision of patient care, in accepting or rejecting responsibilities, seeking consultation and even in assigning responsibilities to others who may carry out nursing care. With this increasing level of responsibility in patient management and care, the demand for nurses to be accountable for their decisions, judgment of discretion becomes more crucial for evaluating and improving quality of care. The Nursing and Midwifery Council (NMC) A-Z Advise sheet on Accountability states that "registered nurses have a responsibility to deliver safe and effective care based on current evidence, best practice, and where applicable, validated research." (NMC, 2006:1). While the NMC code of ethics also states that as a registered nurse, "you are personally accountable for your practice. This means that you are answerable for your actions and omissions, regardless of advice or directions from another professional." (NMC 2002) These policies hold grave implication for the nursing management of patient care. This paper therefore aims to look at the subject of accountability, in the light of the related concepts such as responsibility, autonomy and authority and how it affects the nurse delivery, supervision and management of patient care in the adult branch of nursing. For a start, let us take a look at what the term 'accountability' entails. According to Savage & Lucy (2004), although accountability is not a recent concept, it has however evolved over the last couple of decades from "a matter of regular reporting to an explanation of actions and outcomes and, more recently, a justification of the values informing actions and outcomes"(pg13). They argue that despite the fact that the use of the term is increasing in frequency in management and policy making circles, the term is becoming more vague as it now appears to refer to an increasing number of phenomena. However, within the nursing context, accountability has been described in different lights, by different authors. For instance, while the American association of Nurses (ANA) described nurse accountability as being Answerable to someone for something one has done. It means providing an explanation or rationale to oneself, to clients, to peers, to the nursing profession, and to society. In order to be accountable, nurses act under a code of ethical conduct that is grounded in the moral principles of fidelity and respect for the dignity, worth and self-determination of clients (Accountability in Nursing and Midwifery, 1997). The NMC considers accountability as being "fundamentally concerned with weighing up the interests of patients and clients in complex