The Challenge of Accountability in Nursing

Abstract

The authors examine the literature on accountability in nursing and analyze the following questions: What is meant by accountability in nursing? To whom are nurses accountable? For what should nurses be held accountable? Finally, the implications of accountability for the nursing profession are explored. In order for nursing to grow and develop as a profession based on sound theoretical foundations, nurses need to examine what it means to be truly accountable. The authors point out that accountability is a complex issue that requires nurses to examine their practice relative to the needs of healthcare consumers, their relationships with other healthcare professional, and the increasingly critical role of nursing in the healthcare system.

The Relationship Between RN Job Satisfaction and Accountability

“…Nurses also have accountability to patients, themselves, and the public. Personal level of accountability is being accountable to one's self as an individual (Snowdon & Rajacich, 1993). O'Rourke (2003) emphasized nurse accountability to patients through determining the patient's condition and directing care activities in relation to a patient's changing status.…”

“…In fact, there is no agreed on definition (Snowdon & Rajacich, 1993). Maas (1989) defines individual accountability as answerability of the individual nurse to patients, peers, and the organization for the outcomes of her or his actions.…”

“…As a nurse it is necessary that one is not only accountable for his or her individual practice but is also accountable for ensuring that the practice of his or her colleagues meets the standard of care. This collective accountability could be at the unit level, within an organization, or across the care continuum (Snowdon & Rajacich, 1993;Specht, 1996).…”

“…O'Rourke (2003) emphasized nurse accountability to patients through determining the patient's condition and directing care activities in relation to a patient's changing status. Nurses are also accountable to the public, as a society that funds the health care system and as individuals who are served by nurses (Snowdon & Rajacich, 1993). Licensure ensures that individuals have met minimal standards of knowledge and competence to practice and is one method of accountability to society (Porter-O'Grady, 1990).…”

Autonomous or Automatons? an exploration through history of the concept of autonomy in midwifery in Scotland and New Zealand

“…10 The contemporary philosopher Brian Fay 11 (p. 77) suggests that collective autonomy involves 'a group of people determining on the basis of rational reflection the sorts of policies and practices it will follow and acting in accordance with them. ' Havighurst 12 suggests that in order to be classified as a profession such a collective autonomy must exist.…”