Ethical, legal and professional accountability in emergency nursing practice: An ethnographic observational study

Abstract

IntroductionAccountability in nursing practice is a concept that influences quality care, decisionmaking, safety standards and staff values. Therefore, understanding accountability and how it affects nursing practice could improve patient care and nurses' working conditions. AimThe aim of this study was to find factors that influenced ethical, legal and professional accountability in emergency nursing practice. MethodsA qualitative ethnographic approach using participant observation through convenience sampling was employed as the data collection method, while ethnographic content analysis was used for data analysis. ResultsThe factors linked to nursing accountability found were classified into four main themes: daily dynamics, work environment evolution, customs and routines and bioethics principles' application. DiscussionThe long-term effect of chronic high workload and crowding, which affects nursing accountability, could promote burnout in a junior ED workforce. Changes in the nurses' working conditions need to be implemented to limit the workload to which an ED nurse is subjected to. ConclusionED nurses have to manage their accountability in difficult situations regularly, which followed patterns of four main themes across the majority of situations. Nonetheless, all those factors were influenced by nursing workload, an ever-present factor that was always considered by ED nurses during decision-making.

Understanding and measuring nurses’ professionalism: Development and validation of the Nurses’ Professionalism Inventory

“…For example, some previous scales (Finnbakk et al., 2015; Navabi et al., 2016) were focused only on action and not incorporating opinions other than nurses. Many previous studies focused on one aspect of professional standards such as accountability (Krautscheid, 2014; Rubio‐Navarro, Garcia‐Capilla, Torralba‐Madrid, & Rutty, 2019) or autonomy (Iranmanesh, Razban, Nejad, & Ghazanfari, 2014). This scale used self‐assessment to measure the beliefs that define individual behaviours and actions.…”

Decision-making in an emergency department: A nursing accountability model

“…Dependability and confirmability were established by following the Standards for Reporting Qualitative Research (SRQR) checklist, 20 providing a thorough description of the research steps taken and by presenting detailed records through publications 21,22 and public repositories. 23 –25 Furthermore, the researcher’s role in the field was integrated as a pivotal part of the analysis, as is common practice in ethnographic content analysis, enhancing reflexivity.…”

Routine of the unpredictable: workloads and health of urgent and emergency nursing workers

“…It is important to recover the nature of work in urgency and emergency, in which nursing professionals need to manage their responsibilities in critical situations. However, the high load that work imposes on them can influence their decision-making and, in the long term, promote their exhaustion (18) . Therefore, despite recognizing that there are workloads inherent to the nature of work, it should be considered that adverse conditions often enhance them.…”