Put simply, ‘accountability’ is about taking responsibility for your actions, always ensuring you are competent to do the activity you’ve been asked to perform, and always putting patients’/clients’ interests first.
What it means in practice is that whatever you do in your work as a health care assistant, you should be able to justify it as a sensible course of action. This means that whatever you do:
- you should know why you’re doing it
- you should have been properly trained and assessed as being competent to do it
- you should be doing it as part of an agreed plan of care for the patient/client.
Even though you’ll always be working under the supervision of a registered member of staff who’s accountable for the overall care given by the team, you’re still accountable for what you do as part of the team.
You’re accountable to your patients/clients, to whom you owe what is called a ‘duty of care’. In health care, there will be times when your actions could cause harm to a patient/client if not carried out in a careful and competent way. There are also times when your failure to do something that a health care assistant would normally be expected to do – what is called an ‘omission’ – could also cause a patient/client harm. Health care assistants are legally accountable to patients/clients for any errors they make, or any acts they fail to take, that cause them harm, and patients/clients are entitled to pursue the case through the civil law. In very extreme cases, where a patient/client has died or suffered serious harm due to an error or omission, the case might be pursued through the criminal courts.
You’re also accountable to your employer, who must set out in your contract of employment the duties you’ll be expected to perform. You then become accountable to the employer for safely and effectively carrying out those duties, and failure to do so can result in disciplinary action. Your employer has accountability to you as well, however, and the RCN has suggested that employers must support you to carry out your duties safely and effectively by:
- making your duties clear and ensuring you have the right training to carry them out safely and effectively
- making the boundaries of your role very clear
- providing agreed protocols to guide care delivery
- ensuring you have adequate support and supervision in your role
- offering you opportunities to develop in your role
- making issues around delegation clear.
Accountability also means complying with the code of conduct for health care workers that applies to you in your country and any codes your organisation has in place – ask your manager or supervisor to advise you on what codes apply to you, then study them to make sure you comply.
ACCOUNTABILITY IN NURSING PROFESSION
Accountability refers to answerability, liability, blameworthiness as well as the prospect of account-giving. In nursing profession therefore, accountability as stated within the code of ethics explains what nurses are entitled to and the consequences of their actions. In this case, patients are aware of their decisions to take legal actions against individual professionals. A nurse is held responsible for all actions where if anything is not right, the nurse in question will be approached for the purpose of finding possible solutions for problems if need be and handling the situation in general. When nurses perform various actions, they take responsibility for those tasks as well as their outcomes.
There are various categories of people to whom nurses are accountable to. These categories are: patients, employers, profession and the public. A nurse is accountable to the patient through a duty of being concerned which is underpinned by an obligation to support efficiency and safety and legal duty through civil decree. Accountability to the employer is defined by the indenture of employment and description of the job. The details in this case include what was agreed during the interview, the terms of employment and signed documents to show that the nurse has agreed to everything. Accountability to the profession is seen in terms of adhering to all set rules and regulations, upholding and improving competence and professional knowledge. It is also seen in terms of acknowledging the limitations in competence and knowledge and declining any responsibility unless one is able to perform it in a skilled manner and safe place.
For nurses to be accountable to their profession, they need to be accountable to themselves too. This is done by keeping a diary which is reflective. Keeping this diary is a way of accounting to one self’s actions and thoughts which helps in questioning and improving the quality of concern provided. There is need for recognizing and balancing a variety of points of view on what makes up adequate standards of care. This is to make certain that effective services are provided and that patients receive what they deserve. It is therefore the responsibility of every nurse to undertake all activities having in mind that there are consequences which are faced and dealt with individually. This helps to make them carry out their duties effectively in order to satisfy their clients and avoid getting into trouble which poses a risk to their professional position.