CHAPTER 1
Professional skills and
accountability
Tina Moore
Overview
The āduty of candourā is a professional and statutory requirement (Care Quality Commission [CQC]) that every healthcare professional must be open and honest with patients when something that goes wrong with their treatment or care causes, or has the potential to cause, harm or distress. They must refrain from preventing the escalation of concerns and encourage a learning culture by reporting errors.
The Nursing and Midwifery Council (2019b) state that healthcare professionals must:
ā¢ tell the patient (or, where appropriate, the patientās advocate, carer or family) when something has gone wrong
ā¢ apologise to the patient (or, where appropriate, the patientās advocate, carer or family)
ā¢ offer an appropriate remedy or support to put matters right (if possible)
ā¢ explain fully to the patient (or, where appropriate, the patientās advocate, carer or family) the short- and long-term effects of what has happened. (NMC, 2019b)
Link to Future Nurse Proficiencies (NMC 2018a)
Platform 1 Being an accountable profession: specifically 1.1, 1.5, 1.9, 1.17.
Expected knowledge
ā¢ Understanding of The Code: Professional Standards of Practice and Behaviour for Nurses, Midwives and Nursing Associates (NMC 2018b)
ā¢ Knowing the role of a student nurse
ā¢ An overview of a qualified nurse on the professional register
Introduction
Nursing practice demands that all nurses are competent and strive towards developing mastery in their chosen fields. This principle should also hold a genuine passion and vision for nursing, coupled with an endeavour towards excellence and quality. If a nurse fails to follow āThe Codeā (NMC 2018b), they may be reported to the NMC for an investigation into their āfitness to practiseā.
Accountability is an integral part of professional practice, requiring the nurse to explain and justify their actions and omissions in relation to care. Definitions of accountability reflect the expectation that justification should be evidence based.
Content
Professional skills | Accountability | Delegation |
Managing the clinical environment | Record keeping | Revalidation |
Learning outcomes
ā¢ Understand the term āduty of candourā and its implications for nurses
ā¢ Identify relevant professional standards
ā¢ Discuss the meaning of accountability and how this relates to the nurse
ā¢ Consider the principles of delegation
ā¢ Give a rationale and outline the processes in managing a ward or environment that delivers patient care
Key background
Today, we are experiencing the changes in role boundaries between nurses and other professional groups, particularly those in the medical field. In response the profession must continually be professionally accountable for expanding their clinical skill set and consistently implementing a high-quality evidence-based approach to clinical practice. Ongoing clinical competency development requires active participation to attain, maintain and develop further the skills necessary to provide outstanding care for the patient/service user population. This is to encourage patients to have confidence in the ability of nurses. Through this it is anticipated that occurrences that test our duty of candour will be reduced.
Over recent years the profession has seen a reduction in qualified staff and an increase in nursing associate roles/healthcare support workers. Nursing associates and healthcare support workers are undertaking many of the tasks usually done by registered nurses. Even between ānursesā, the boundaries of their roles have become unclear. This situation has also seen an increase in delegated duties from qualified nurses to those not or less qualified, including student nurses. This has presented further concerns and confusion for nurses around accountability issues relating to delegation.
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