I don’t know how to handle this Nursing question and need guidance.
1)Re: Topic 4 DQ 2
Professional nursing accountability refers to taking charge for someone’s else nursing actions, judgements, and errors relating to life- long learning, maintaining competency, as well as safeguarding the quality of patient care outcomes and nursing standards of profession (Semper, Halvorson, Hersh, Torres & Lillington, 2016). In nursing, profession accountability serves the purpose of resolving nursing problem, maintaining the high standards of care and ensuring the patients are not harmed. As nurses, we must be answerable for the decision and actions we make as well as the consequences coming with our actions. For instance, an RN is not responsible for the actions taken by others health care providers. Therefore, nurses are answerable for acting in circumstances where patient safety and health is being taken for granted.
Accountability involves promoting respect for nursing profession achieved by maintaining core competencies and conduct throughout the career (Westrick, 2017). Nurses can demonstrate accountability by being liable for their actions and consequences, since as a health care provider we are not only answerable to ourselves but also our patients, employers, as well as other nurses in the profession (Westrick, 2017). Accountability is important because it earns us prestige. Moreover, nurses are required to take blame for our actions as well as ensure their practice depend on nursing standards, guidelines and legislation provided by ANA.
Semper, J., Halvorson, B., Hersh, M., Torres, C., & Lillington, L. (2016). Clinical nurse specialists guide staff nurses to promote practice accountability through peer review. Clinical Nurse Specialist, 30(1), 19-27.
Westrick, S. J. (2017). Legal and Ethical Accountability for Nursing Errors: Disclosure and Apology.
2)Re: Topic 4 DQ 2
Nurses need to be accountable for our practice, “it’s vital that we maintain this level of trust in our profession with each and every healthcare encounter. This means being accountable for our practice, work environment, and patient safety” (Davis, 2017). As a nurse, you need be responsible for yourself and your actions. “Nurses can be held accountable when they, even mistakenly, violate NPA standards” (Bucceri, 2020). Professional accountability demands that as a nurse and human being I am honest and forthcoming with an error or near miss.
As a nurse I face challenges everyday and one of those challenges is to say up to date with education. It is my responsibility to implement evidence based practices at the bedside and treat my patients with a gold standard. One way I do this in my everyday practice is to initiate end tidal CO2 monitoring with sedated and intubated patients. The patient’s end tidal reading will immediately change when the endotracheal tube becomes dislodged or if you obtain ROSC during a code situation. This happens much faster than oxygen saturation monitoring which can take up to minutes to tell if a patient becomes hypoxic and even longer if the patient starts adequately ventilating. It is up to me to stay up to date with my education and certificates such as ACLS where you learn about end tidal readings and ROSC. By reading and studying this material I can be at the top of my game and treat my patients with the gold standards and with evidence based practice.
Another way that I treat my patients with evidence based practice is by getting an EKG done within 5 minutes of arrival to the ED. This is a metric we have set in our department that is looked at daily. By getting that EKG done within the first 5 minutes, we can initiate care to a facility with a cardiac cath lab if the patient presents with a STEMI.
Not only do you need professional accountibility when caring for patients but you also need professional accountability when dealing with your coworkers. A third example of showing professional accountability within my practice is with narcotic wastes. We have 15 minutes to waste narcotics with a witness. If this is not done on a regular basis I would have disciplinary implications. The gold standard in this is to remove temptation from narcotic abuse as health care professionals have a high drug abuse rate. The witnessed waste deters one from harboring narcotics for yourself, family members, or friends.
Bucceri Androus, A. (2020). How is the Scope of Practice Determined for a Nurse? Retrieved from https://www.registerednursing.org/answers/how-scop…
Davis, Charlotte BSN, RN, CCRN The importance of professional accountability, Nursing Made Incredibly Easy!: November/December 2017 – Volume 15 – Issue 6 – p 4 doi: 10.1097/01.NME.0000525557.44656.04
3)Topic 4 DQ 2
Professional accountability is a core aspect within clinical expertise. According to Sherman, professional accountability is defined as, “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, 2019).
Testing this commitment is a daily occurrence, particularly within the specialty of the emergency department. There are times when caring for patients can be stressful and overwhelming. For instance, sometimes patients raise their voice at staff, or demand certain treatments that have yet to be approved by providers. It is imperative that accountability remain intact during these times to prevent near misses, errors, or sentinel events.
One evidence-based practice that I treat my patients with is the work-up that ensues when an individual is suspected to have sepsis from an infective source. These patients need to have updated vital signs, a screening tool is utilized once laboratory values become available, and antibiotics and fluid resuscitation needs to be administered within a set timeline.
Along with having accountability for patients, we also need professional accountability with our co-workers. According to Sherman, “nurses are both “accountable and responsible for the quality of their practice.” This means that nurses must take ownership of their actions and hold themselves accountable not only individually but also as members of a collective team” (Sherman, 2019). The statement means a lot especially when working with 1 other RN and MD, we all need to have professional accountability and trust one another.
Sherman, R. O., & Cohn, T. M. (2019). Promoting professional accountability and ownership: Nursing leaders set the tone for a culture of professional responsibility. American Nurse Today, 14(2), 24–26.