Accountable Practitioner Essay

As registered encourages you atomic trope 18 judici eithery and profession wholey account fit for your actions, irrespective of whether you be conserveing the book of instructions of an other or using your admit initiative (Griffith and Tengnah, 2010). The consideration of what office path in treat radiation pattern is a key breach in the al-Qaeda of nursing, whatever would recite that being accountable room being responsible, and as a consequence taking the blame when something goes wrong.To be accountable is to be answerable for your acts and omissions, this is the approach adopted by the breast feeding and Midwifery Council (NMC) the nursing regulatory body. It adduces at bottom its code You are somebodyally accountable for your actions and omissions in your practice and essential al r tabues be able to justify your decisions (NMC, 2008). Therefore answerableness is being answerable for your acts to a high authority with whom you prolong a bun in the o ven a sound relationship. A wider view of account qualification is defined as an inherent confidence as a professional that allows a nurse to take pride in being unbiased ab verboten the representation he or she has carried disclose their practice (Caulfield, 2005).In order to provide maximum defendion to the public and long-sufferings against misconduct of registered nurses, quad areas of righteousness are drawn together which individually hold you to account. These are society done public constabulary, affected role of through tort law, employer through the contract of employment and profession through statute law, such(prenominal) as the NMC.This assignment volition reflect on the work and study carried come forth in hospital wardly the Accountable Practitioner module including lectures and facilitated chemical concourse sessions in which broody diaries were completed see appendix I-IV. By completing a Root induct synopsis (RCA), a system used to find flaws and opportunities for improvement of wellness give care, on the Pamela Scenario, it was highlighted that the theme take over was an area of concern (Transition to Practice, 2012). I go away therefore be looking into the three pillars of accountability which are professional, legal and honourable and relating each of these to my chosen theme and take toing this to the Pamela Scenario. sea captain responsibility skipper accountability consists of an ethos in nursing that is based on promoting the welfare and public assistance of tolerants through nursing care. This all comes together indoors the heart of nursing. inside our aggroup sessions we discussed who registered nurses are accountable to, these being through the sustenance of the Nurses, Midwives and wellness Visitors coiffe 1997 and the breast feeding and Midwifery Order 2001.The NMC was established under these provisions in 2002 to protect the public by establishing standards of education, training, conduct and perfo rmance for nurses to visualise these standards are maintained (Nursing and Midwifery Order, 2001). Professional accountability allows nurses to work within a framework of practice and follow normals of conduct set fall verboten by the NMC that maintain the patients conceive in the individual nurse and nursing as a whole (Caulfield, 2005).Obtaining comply affirms the patients justifiedly to self-discrimination and autonomy. The NMC code of professional conduct has a separate section on acquiesce (NMC, 2002). Clause 3 requires that as a registered nurse, midwife or health visitor you must obtain harmonize sooner you bewilder any intervention or care.The professional duty recognises the prize of autonomy in clause 3.2 and states that a refusal to receive word must be protected even where this whitethorn result in hurt or death to the individual. The professional duty too requires that the nurse repays selective breeding that is accurate and truthful and this must be presented in a way that is easily understood (Bowman, 2012).Within the Pamela scenario there is no suggestion as to whether assent was gained. At the goning of her care, when she was admitted to an orthopaedic ward they suggested a pare traction should be applied to the affected limb, nevertheless no swallow was gained and the cater on the ward took it upon themselves to determine whether this was the best action. Within our group we discussed that at this point Pamela was mentally capable of giving informed consent see appendix II.Pamela after became very agitated and confused and was eventually referred for a CT s sess which showed findings of Alzheimers disease. From this point onwards there is no evidence to suggest that consent was gained from someone with capacity following the noetic Capacity Act (2005) where they state a person is unable to puddle a decision for themselves if they are unable to understand information inclined to them, retain that information, use o r weigh that information as role of the process in making a decision and communicate that information.In this instance it is not possible to determine whether Pamela was able to give informed consent herself or whether any family members gave this for her. Professionally the rung within the ward that made this decision on her behalf would be held accountable.Legal AccountabilityThe law is a major area of accountability for nursing practice. The law is a set of rules, regulations and cases that provide interpretation of the rules and regulations that apply to society. There are very clear penalties for anyone, including nurses, who fail to follow the rules set out by law. Within our group sessions we discussed the two systems of law within the UK see appendix I elegant law and criminal law, each one consists of its own structure and contrasting rules apply for each system (Young, 2008). The types of civil law that affect accountability in nursing practice include disputes with em ployers, cases of patients suing due to allegations of default and cases where a nurse sues her employer due to injury at work.All these cases are perceive in civil courts and the judge can award compensation. Criminal law is the system designed to assess that rules set out by sevens are followed. The acts of parliament deal with issues such as medicines, suicide, organ and meander donation, mental health and decisions about health care where a person does not throw away the capacity to pull ahead their views known.Criminal penalties include fines or imprisonment (Caulfield, 2005).The law recognises that adults yield a right to determine what go out be done to their bodies. Touching a person without consent is customaryly unlawful and will amount to infringe to the person or, more rarely, a criminal assault. Unlike other civil wrong doings such as negligence which requires harm, any unlawful touching is actionable contempt whether being done with the best of motives (Ting le and Cribb, 2007). When obtaining consent, you must ensure that the patient agrees with all the treatment intended to be carried out. Proceeding with treatment that the patient is insensible of, or has refused to agree to will be a trespass to the person and actionable to law.Nurses must therefore take care to explain all the treatment or touching that will occur when obtaining consent from a patient and ensure that any additional treatment is subject to foster consent (Savage and Moore, 2004). Consent is an expression of autonomy and must be plain choice of the individual. It cannot be obtained by unwarranted influence (Griffith and Tengnah, 2010, p.82). In law, undue means that the influence must remove the patients alleviate will and be so forceful that the patient excludes all other considerations when making their choice.It is an established part of law that no treatment whitethorn be given to an individual, whether it be clinical or nursing unless the patient has consen ted (Johnstone, 2009). Therefore as consent was not gained within the Pamela scenario when deciding whether to apply traction to her leg the doctors and nurses involved in making the decision on her behalf would be held legally accountable and could face criminal prosecution.Within our facilitated group sessions we discussed the following established principles which must all be satisfied before consent is sufficient see appendix III consent should be given by someone with capacity. Within the scenario it is stated that Pamela was diagnosed with Alzheimers disease, however the family were not asked to consent on her behalf following the Mental Capacity Act (2005).adequate information should be given to the patient is the second principle. Pamelas family state they were unaware of what was happening with her care and within the complaints letter, Pamelas daughter states staff did not give her relevant information even when Pamela wasdiagnosed with Alzheimers. The third principle the consent must be freely given, due to the staff not gaining any consent and taking the decision into their own work force this principle like the previous two was also not followed. The negligence and consent alone within this scenario would place the staff involved right away into legal accountability. estimable AccountabilityAccountability is an definitive ethical innovation because nursing practice involves a relationship between the nurse and the patient (Fry, 2004). Within our group sessions we discussed Beauchamp and Childress (2001) who developed a framework which offers a unspecific consideration of ethical issues. This consists of four principles respect for autonomy which means respecting the decision-making capacities of autonomous persons enabling individuals to make reasoned informed choices. Beneficence,this considers the balancing of public assistances of treatment against the risks and cost the healthcare professional should act in a way that benefits the pati ent.Non maleficence, this meansavoiding the causation of harm, the healthcare professional should not harm the patient. All treatment involves some harm, even if minimal, but the harm should not be disproportional to the benefits of treatment. And finally, justice, this includes distributing benefits, risks and costs fairly, the notion that patients in similar positions should be treated in a similar manner.Consent is a moral and legal foundation of modern health care. Treatment that proceeds without consent of the patient instantaneously requires a thorough moral investigation. Despite the fact that consent may have been given it is important to ensure this means more than the uncorrupted fact a form has been signed. The main role of consent is to protect patients and in special(prenominal) to protect their status of autonomy and enable them to anticipate in control of their own lives (Fry and Johnstone, 2008).In ethical terms, consent is important because it demonstrates resp ect for autonomy, therefore through participating in a consent process the persons autonomy may be farther kick upstairsd by having the choice to accept or decline care. For some individuals their ability to consent may be compromised by their position within their cultural group. For example, women within certain cultures might have the capacity to consent but would not expect to have the right todetermine what happens to them (Chadwick and Tadd, 2003). If consent was not gained and treatment was carried out on a person within an ethical group who did not agree to the treatment, then that person would be held ethically accountable.In the scenario, nurses did not apply skin traction to Pamelas leg despite the admitting doctor suggesting that it be applied. estimablely, this related to non-maleficence as it can be assumed the traction was not applied due to the treatment having a conservative nature and the nurses believing it would be of no benefit to Pamela in regards to pain rel ief. Also a large majority of care was carried out later on Pamela was diagnosed with Alzheimers which leaves her vulnerable to treatment being carried out without consent from her or her family.ConclusionThroughout the module I have developed my awareness of the professional, ethical and legal issues that are associated with providing accountable health and social care. I was able to reflect on my own acquire and development as an accountable practitioner and participate in the facilitated group sessions. I have increased in confidence and developed discourse skills by having the chance to speak and voice my opinion in mien of other colleagues this will enable me to participate in handover and various squad meetings whilst out in practice.Analysing the scenario in groups enabled me to gain a clearer understanding into the issues embossed and this allowed the assignment to be completed with confidence. I was able to strengthen my ability to appraise and use related evidence b ased literature to prat up my statements which were from a variety of sources. Finally, being able to choose our own theme from the scenario enabled me to have a greater awareness of consent which will benefit me when out in practice.Part BI shall be using the Gibbs Reflective Cycle (1988) to reflect upon a critical resultant that I have witnessed out during a ward based placement. The Gibbs pondering cycle suggests that theory and practice supplement each other in a never-ending circle which was coined from Kolbs experiential learningcycle. By using the Gibbs reflective cycle I shall be looking into how I matte during the time, what I felt and thought after the fortuity and or so importantly what I would do differently next time. EventThe incident I will be looking back on occurred whilst on placement within an orthopaedic ward when I was given the opportunity to assist a registered nurse on her do drugs round. I had antecedently assisted her on drugs rounds she was happy for me to carry out the medication which was Enoxaparin on this particular patient. As I joined her with the drug round part way through, due to helping another patient she had already ratifyed the patients physique and date of birth and the patient had verbally consented to the boldness and therefore I was told me to just administer it.I followed all the relevant policies and procedures whilst administering the medication however I did not understand why the registered nurse would allow me to administer the drug without myself gaining consent from the patient to ensure he was happy for a student nurse to carry out the administration. I therefore explained to the patient that I was a student nurse and I had previously carried out an administration of enoxaparin but explained to him that I would not be offended if he was not happy for me to administer the drug myself. I had been looking after this patient over a heel of days and had therefore gained his trust so he verbally consent ed to me administering the drug and allowed me to continue.Thoughts and FeelingsWhilst I was administering the medication I felt very confident as I had administered a number of these previously and also having a patient who was happy for me to carry this out enabled me to complete this competently. The patient also spoke to me throughout about his individual(prenominal) life so I was reassured that he was not cutaneous senses worried or anxious and therefore placed me in a confident frame of mind. The registered nurse was also shadowing me whilst I administered the drug so I was happy I was not going to make a mistake.EvaluationThere was nothing bad about this have apart from the confusion of the registered nurse telling me not to follow protocol and double check his date of birth and consent, however I felt I did the correct thing. I enjoyed administering the Enoxaparin as I felt it would enhance my experience and it was good practice for me, especially as this drug was a very common drug used within most hospital wards.AnalysisAlthough I felt confident administering the Enoxaparin, I did not feel all that confident when asked to administer the medication without checking the patients work and date of birth and gaining consent which is a vital protocol of administration of medicines set out by the NMC (2010). Looking back I should have voiced my concerns and asked why she did not want me to confirm these however I did not want to headway my mentors experience or authority.A number of accountability issues were raised within this practice in which I later discussed with my mentor so I could confirm I did the correct thing. The Nursing and Midwifery Council (NMC) states that the administration of medicines is a vital aspect of professional practice for registered nurses which are to be performed in strict compliance with the written prescription of a medical practitioner requiring exercise of professional judgement (NMC, 2010).The NMC (2010) also stat e within their consent code To make the care of mint their first concern and ensure they gain consent before they begin any treatment or care I did carry out this principle although asked not to by the nurse I was working with. If I did not carry out these checks although only a student nurse I would still be held accountable for my actions when I knew this was against protocol.ConclusionAs a student nurse it is acceptable to assist with drug ward rounds and administering medications, however when I was asked to administer the medication without the patients identity confirmed and consent gained I should have said I did not feel contented with the task as it was not working in conjunction with the NMCs standards of medicines administrationsbut I would observe. When teaching a student and to improve general practice overall the nurse in head should have asked me to confirm the patients name and date of birth and gained consent before administering the medicine.Although there was n o issue with administering medicine to the wrong patient or any ethical issues due to not gaining consent on this day, this could have been a very Brobdingnagian nursing error causing a potentially big problem with accountability on my behalf.Action PlanAs a student nurse it is important to take opportunities to learn new skills when following a mentor that you might not necessarily feel all in all confident with however ultimate responsibility remains with me if I do not feel confident in the situation that I have been assigned. Although I was confident with the task in hand I was not happy with the way I was asked to carry out this procedure by missing out vital NMC code protocols. The only thing I would have done different in this situation would be to say I did not feel comfortable with administering medication to a patient without carrying out the relevant checks and I should have confronted the nurse in question and asked why she did not tell me to ask for these details.Altho ugh she had carried these out previously she did not explain to the patient that I was a student nurse and this could have gone very wrong. If placed in this situation again I would not change anything which I personally did myself, I would still follow the NMC guidance on medicines administration (NMC, 2010) which therefore takes me out of the accountability question if anything was to go wrong, however I would confront the nurse and ask why these checks were asked to be skipped.ReferencesBeauchamp, T and Childress, J. (2008) Principles Biomedical Ethics. 6th ed. Oxford Oxford University Press. Bowman, D. (2012) Informed Consent A Primer for clinical Practice. Cambridge Cambridge University Press.Caulfield, H. (2005) Accountability. Oxford Blackwell Publishing.Chadwick, R and Tadd, W. (2003) Ethics and Nursing Practice A Case StudyApproach. Hampshire Palgrave Macmillan.Fry, ST. (Ed.) (2004) Nursing Ethics Encyclopaedia of Bioethics. 3rd ed. unsanded York Macmillan.Fry, ST and John stone, MJ. (2008) Ethics in Nursing Practice A Guide to Ethical Decision Making. 3rd ed. Oxford Blackwell Publishing.GIBBS, G. (1998) reading by Doing A Guide to article of faith and Learning. capital of the United Kingdom FEUGriffith, R and Tengnah, C. (2010) truth and Professional Issues in Nursing. 2nd ed. Exeter Learning Matters Ltd.Johnstone, MJ. (2009) Bioethics A nursing perspective. 5th ed. Sydney Elsevier.Nursing and Midwifery Council (NMC) (2002) Code of Professional Conduct. London NMC.Nursing and Midwifery Council (NMC) (2008) The Code Standards of conduct, performance and ethics for nurses and midwives. London NMC.Nursing and Midwifery Council (NMC ) (2010) Standards for Medicine Management. London NMC.Nursing and Midwifery Council (NMC) (2010) edict in Practice Consent. London NMC.Nursing and Midwifery Order (2001) obligate 3. London NMC.Savage, J and Moore, L. (2004) Interpreting Accountability. London majestic College of Nursing.Tingle,J and Cribb, A. (2007) Nu rsing Law and Ethics. 3rd ed. Oxford Blackwell PublishingTransition to Practice (2012) Root Cause Analysis Steps. online Available at http//transitiontopractice.org/files/module4/QI%20-%20Root%20Cause%20Analysis%20steps.pdf Accessed 12 September 2012. Young, A. (2008) Review The legal duty of care for nurses and other health care professionals. Journal of Clinical Nursing. 18 pp. 3071-3078.BibliographyConfidentiality Act (1991) Great Britain. London HMSO.Data Protection Act (1998) Great Britain. London HMSOHendric, J. (2000) Law and Ethics in Nursing and health Care. Cheltenham Stanley Thornes Ltd.Nursing and Midwifery Council (NMC) (2006) Standards of Proficiency for Nurse and Midwifery Prescribers. London NMCRoyal College of Nursing (RCN) (2006) Nurses and Medicines Legislation An Information Paper. London NMC.Reeves, M and Orford, J. (2002) Fundamental Aspects of Legal, Ethical and Professional Issues in Nursing. Wiltshire Mark Allen.Tschudin, V. (1996) Ethics Nurses and Patient s. London Bailliere Tindal. Watson, R. (1995) Accountability in Nursing Practice. London Chapman and Hall.Appendices extension IPersonal Diary ragtime 1 (25/06/12)Appendix IIPersonal Diary Sheet 2 (09/07/12)Appendix IIIPersonal Diary Sheet 3 (16/07/12)Appendix IVPersonal Diary Sheet 4 (23/07/12)