Central to the practice of professional nursing are the elements of accountability, autonomy, direct communication, and authority. The value that nursing work groups place on authority affects their level of acceptance of responsibility and accountability for clinical decision making. The authors examined the value that nurse managers and staff nurses on primary nursing and total patient care units place on authority/responsibility relationships. Results indicated that nurse managers and staff nurses on primary nursing units valued accountability, authority, and autonomy more than the nurse managers and staff nurses on total patient care units, a finding consistent with the professional practice model of primary nursing.

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