In an article titled Promoting professional accountability and ownership: Nursing leaders set the tone for a culture of professional responsibility published by American Nurse Today authors Sherman, Rose O.; Cohn, Tanya M. examine and attempt to come up with their definition of professional accountability. The authors state,“Professional accountability is an internally driven mindset. It’s a commitment that you make to yourself and your career when you become a nurse to advance, grow, improve, and adapt to your work. It’s also a pledge to apply your talents, energies, and gifts to improve patient outcomes.” (Sherman, R. O., & Cohn, T. M. 2019 para. 5) The authors explained how professional accountability applies to nursing but focuses on the individual making themselves accountable. While holding oneself accountable as a nurse is very important it will be more effective if the each and every professional holds their counterparts accountable as well. This has the weight of the 3 plus million nurses each leaning on each other to maintain standards of care and act as a “professional” should. 

    Application of professional accountability in clinical expertise occurs on a regular basis as the nurse is working. How this is happening is due to the fact the nurses are continually expanding their clinical experience with each and every patient they care for. Through detailed systematic assessments they are utilizing a clinical skill and will often refer to professional resources to learn more and ensure they are providing the best level of care possible. They will often utilize more experienced nurses for advice. The nurse will also apply professional accountability in the clinical setting in regard to the nursing process usually by communicating with others in the Interdisciplinary Team (IDT) on the plan of care. The nurse is continually applying the nursing process, but it is verbalized to the IDT and usually the charge nurse during the shift. This is a demonstration of professional accountability because the members of the IDT are expecting the nurse present the nursing process to them so they can have input. This expectation of others is the accountability part. Another area of professional accountability is in evidence-based practice (EBP). The general public and the profession expect that nurses are utilizing current EBP in their care for others as this allows for better patient outcomes and is the standard of care. The nurse is held to this standard and is accountable by the other nurses that will care for the client. An example would be a client admitted to the hospital for a surgical procedure will potential have multiple nurses caring for them during their stay in the hospital. Every nurse that cares for the same client need to have continuity and consistency in their care and this is established by standards of care and EBP.

 

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2 postsRe: Topic 4 DQ 2

To be professionally accountable in nursing is necessary and vital for patient care and safety. According to The American Nurses Association Code of Ethics, the definition of accountability “ is to be answerable to oneself and others for one’s own actions.”
The nurse has to ensure that while delivering care, accountability is owed to themselves and the client, the client’s family, colleagues, the workplace and the profession.

An example of professional accountability is during the admission process of a client to a psychiatric unit for the first time. The client is involuntary and is not sure what this status means for them. With professional accountability, the nurse explains the involuntary status and also ensures that the family understands what this status is in a psychiatric facility. Due to the fact that the hospital is a teaching facility and nursing students are always present, each opportunity must be seen as a teaching moment, so nursing students can understand how professional accountability impacts the care of clients from the time of admission.

A senior nurse knows that establishing a therapeutic relationship allows the client to feel safe and being professionally accountable impacts both client and student especially during the assessment phase. Here the nursing process is key to clinical expertise and using the nursing process demonstrates that quality of care must start from the point of admission to discharge. This nursing process is kept in mind by a highly educated nurse who also uses evidence-based practice to deliver safe and effective care.

Evidence-based practice in professional accountability allows the nurse to have a better understanding of the practice and how accountability influences her to make decisions that fully impacts patient care.(Brower & Nemec,2017) An example of evidence-based practice in mental health is to form a client-centered plan of care to ensure all decisions are shared-decision making. The care team and the client seeking help with mental health issues come together to have client-centered care and self-directed care. 

With accountability to the client and self, the nurse is an advocate for the client and ensures that the latest evidence is used to drive change for better patient outcomes. ( Brower & Nemec, 2017).

Professional Accountability is one of the best ways for a nurse to self regulate, be conscious of the care and their impact when imparting knowledge to the future generation of nurses.

 

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The ability of the nurse to effectively advocate for the patient lies within the nurses competency of the situation at hand and the level of care needed by this patient. We must make sure that what is asked for by this patient is safe, and that this care can continue as they transition to the next level of care. If at all possible, we must engage a competent individual who will see to it that this care is carried out for the patient safety regardless of where they are transitioned to. We must give these patients a chance to participate in their care by educating them of their disease process, and recovery potential. They must be willing participants toward their recovery and hence improving their quality of life. We are to do all in our power to protect their rights and make every effort to eliminate errors. We must make sure their medication orders are without errors, and also see to it that they have all the resources they will need by helping them find outside resources. Their awareness of their community resources will greatly benefit them and help toward the improvement of their well beings.

Two days ago, I was involved in the care of an oncology patient. She was no longer able to speak and was becoming vividly altered in mentation. She had been alert and oriented in the previous week, but at the shift report on this day, I was informed that she had climbed out of bed and fallen. When I got to her, I discovered that her condition was becoming more acute and she was hallucinating and declining fast. I made the Charge nurse aware of her increasing anxiety and inability to stay in bed, requesting for a sitter to keep her safe, I was told that we had no resources and that I should consider using a posey restraint or ativan to settle her. My lady is 91 years old with acute alteration in the mental status due to her disease process, the last thing I wanted to do was to increase her anxiety with the posey, I did not want to end her life either by giving her ativan. She was severly anorexic and receiving PPN due to her NPO status. I went and stayed in her room and attempted to run to my other patients from there. I was finally able to consult with the shift coordinator who subsequently provided me with a sitter for this patient. She lasted the night with a 1:1 sitter, without exotic drugs and received the care she needed.

 

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Patients who are ill depend on nurses to help them return to an optimum healthy state.Utilizing the nursing process allows nurses to take an active role in a patient’s care.According to Oliveira and Tariman (2017), nurses spend more contact hours with the patient than any other member of the healthcare team. Therefore, nurses have an important role as a patient advocate.It is the duty of a nurse to speak up on behalf of a patient to protect their basic rights and safeguard their safety (Oliveira and Tariman, 2017). Advocating for patients may be difficult for some nurses because the patient may want or decline treatment and it is the nurse’s responsibility to make sure their wishes are met. Patient advocacy also entails speaking to other members of the healthcare team to maintain the best interests of the patient. Standing up for patient’s rights, no matter how difficult it is, is a nurse’s responsibility (Grand Canyon University, 2018). Barriers that nurses may encounter are lack of support from administrators, acuity of patients, not using evidence-based practice, lack of assertiveness or confidence (Oliveira and Tariman, 2017). It is important for nurses to remember that one must practice according to the guidelines set by the nursing practice act of their state and advocate for their patient within their scope and standards of practice.

In my experience as a labor and delivery nurse I have had several opportunities to advocate for my patients. In one instance I had a laboring patient who was very adamant that she did not want an epidural. She wanted to experience a labor with minimal interventions. When her physician came to evaluate her, he was upset that she did not have an epidural. He started to try to intimidate and scare her into getting one.There was no medical necessity for it and she looked at me and started to cry. I verbalized to the physician that she did not want an epidural and I was going to be sure that whatever her wishes were, we were going to respect them, no matter how inconvenient he felt it was for him, as long as there was no medical contraindication. My patient delivered with no epidural and was so thankful and appreciative that I helped her not get bullied into an unnecessary procedure when there was no medical indication for it.

 

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  Plagiarism is when we are using another person’s thoughts, idea, work, and effort without acknowledging it. When we do not use the name of the author or use the resource and material but don’t cite the source or author. We are then using someone else work as our own and this is being dishonest and cheat. This discredits us not only personally but professionally also we lose trust.

  When we properly cite the name of the author, quotation and a source of the reference then it helps us to prove that our research is substantial and is based on some evidence. This gives credibility to our work and proves our viewpoint. In the nursing profession keeping the integrity, reliability, confidentiality, and trust is the key. In order to maintain the academic integrity, we should use the resource properly by providing the name of the author, publication, book or article and also mentioning it in our references. Also should not copy someone work. I will try to ensure that I use the resources properly and ask for help if I need to.

 

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