Discuss Accountability V/s Responsibility

Vidita Gandhi

* Discuss Accountability v/s Responsibility

These two words are RESPONSIBILITY and ACCOUNTABILITY. These two words are often used interchangeably, however, they are NOT interchangeable. Let me explain:

 Responsibility can be, and often is, shared. Many people are responsible to you in nursing like your supervisor, the rest of nurses, the people in your organization like nurse assistant, housekeeping, cooks, as it begins to develop, and, of course, your company, just to name a for. Every person in nursing is responsible for conducting themselves professionally in introducing the patients care. The goal to do correctly performing nursing care activities based on standard of practice. If LVNs administer medications, they are responsible for ensuring they meet their standards of practice, which include having the competencies to perform that function.

 Accountability, on the other hand, CANNOT be shared. We often hear the term "shared responsibility", but there is no such thing as "shared accountability". Some would call that term an oxymoron. One could define accountability as the "ultimate responsibility". Accountability is the readiness or preparedness to give an explanation or justification to relevant others (stakeholders) for one's judgments, intentions, acts and omissions when appropriately called upon to do so. The goal is to reliable and willing to recognize when nursing care is effective or ineffective. LVNs are accountable to their clients (the term clients includes patients and residents) and owe a legal duty of care to them.

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2. Accountability and responsibility

Nurses are well placed to take a lead in this process because they are involved in planning, managing and delivering patient care on a daily basis, no more so than in the community in relation to wound management. According to the NMC (2006), registrants have a responsibility to deliver safe and effective care based on current evidence, best practice and where applicable, validated research. They hold a position of responsibility in which they are relied upon by other people and have a range of accountability to the NMC (professional), contractual (employer) and to the law for their actions. However, Savage and Moore (2004) in their study found the meaning of the word accountability to be elusive and ambiguous, variously linked with retrospective analysis of practice, a way of apportioning blame but also as something that promotes good and good practice. The research suggested that accountability for making decisions appeared to rest with the person with the most expertise, however, practice protocols were seen as limiting the accountability of practice nurses in comparison to their practice partners.

Vidita Gandhi

Summarize the basic concepts of the nursing process

The nursing process is a process by which nurses deliver care to patients, supported by nursing models or philosophies. The nursing process was originally an adapted form of problem-solving and is classified as a deductive theory.

1. Assessment: A systemic, dynamic process by which the nurse, through interaction with the client, significant others, and health care providers, collects and analyzes data about the client. The nurse collects comprehensive data pertinent to the patient’s health or the situation. It depends on subjective and objective data. Subjective data are verbal statements provided by the patient, the data are secret until shared by the patient. Objective data are observable and measurable signs. For ex: “my chest hurts”---- BP 100/60, P 100, R 32, pt holds fist over sternum.

2. Diagnoses: It is the second step of the nursing process that gives u meaning to the data you collect and organize during assessment. It is a clinical judgement about individual, family or community responses to actual or potential health problems. Nursing diagnoses provide the basis for selection of nursing interventions to achieve outcomes for which the nurse is accountable, NANDA. When submit nursing diagnoses following four components: 1. nursing diagnosis title/label, 2. definition of the title/label, 3. contributing/etiologic/related factors, and 4. defining characteristics. e.g. risk for situational low self-esteem.

3. Planning: Planning is the third step of the nursing diagnoses, this step identify a set if diagnoses, set patient-centered goals and expected outcomes and prescribe nursing interventions. In agreement with the patient, the nurse addresses each of the problems identified in the planning phase. For each problem a measurable goal is set. For example, for the patient discussed above, the goal would be for the patient's skin to remain intact. The result is a nursing care plan.

4. Implementation: The methods by which the goal will be achieved is also recorded at this stage. The methods of implementation must be recorded in an explicit and tangible format in a way that the patient can understand should he wish to read it. Clarity is essential as it will aid communication between those tasked with carrying out patient care.

5. Evalution: The purpose of this stage is to evaluate progress toward the goals identified in the previous stages. If progress towards the goal is slow, or if regression has occurred, the nurse must change the plan of care accordingly. Conversely, if the goal has been achieved then the care can cease. New problems may be identified at this stage, and thus the process will start all over again. It is due to this stage that measurable goals must be set - failure to set measurable goals will result in poor evaluations.

Vidita Gandhi

Application of the Nursing Process exercise, give one example

1. When making the assignment for following day. Which of the following is the most appropriate assignment for the nursing assistant?

• A client requiring frequent vital signs following a cardiac catheterization.

• A client