Accountability in Practice

Introduction

In this assignment I intend to critically analyse the developing role of the advanced nurse practitioner in relation to analysing the professional accountability when making clinical judgement.
The Royal College of Nursing informs us that ‘as a professional, you are personally accountable for actions and omissions in your practice, and must always be able to justify your decisions’ (NMC 2008)

Accountability can be defined as ‘required or expected to be able to justify actions, decisions or responsibilities’ (Oxford Dictionaries 2014).
In looking at this statement it can be broken down further into sections all which are imperative to the role of the nurse practitioner.
Required – it is officially compulsory or essential. This reiterates that we are under the code of conduction of our governing body – the Nursing and Midwifery Council (NMC).
Expected – a requirement to fulfil an expectation or is appropriate under the circumstances.
Justify – being able to prove to be right or reasonable.
Action – something that we do or perform.
Decision – it is a resolution or conclusion reached after consideration.
Responsibility – the moral obligation to behave correctly.
All these are a requirement for any health professional in delivering a high standard of care but what is required to obtain this?
Pulse magazine (2013) reported that the number of vacancies in general practice for Doctors had risen from 4.2% in 2011 to 7.9% in January 2013 and that GP surgeries were spending almost 20 per cent more on locum doctors each year. There is an older population of general practitioners and as these retire, many are not being replaced by younger doctors, probably more due to good locum rates of pay and also lack of responsibility except for the patient that they see. This is reiterated by Dr Ruth Hussey (2014) stating that there was poor response to recruitment.
Unlike secondary care, General Practitioners have a responsibility for making sure their staffing levels are sufficient to meet the needs of their patients, and this is part of their contract with the Local Health Boards. The criteria under which General Practitioners’ obtain monies for their surgery change each year and has become increasingly reduced. Instead of paying locum’s they have started to employ advanced nurse practitioners to fulfill those roles.

REQUIRED.
What is required of us as nurses? The NMC (2008) inform us that it trust and respect; to treat people with consideration and dignity; not to discriminate and act as their advocate, maintain their confidence, listen and respond to their concerns, good communication, and gain consent for treatments and procedures but whilst doing all this, main professional boundaries.
Not only do the NMC (2008) describe in our code of conduct how they want us to treat our patients but how they want us to treat our colleagues. They want us to share information, work effectively as part of a team, delegate efficiently and manage risk.
Furthermore they look at how we need to perform. To looking at best evidence and practice; keep skills and knowledge up to date; maintaining clear and precise documentation. Besides this, we must be open, honest and act with integrity; be impartial and be able to deal with problems, whilst upholding our professional reputation. Now included as from July 2014, we are required to have professional indemnity insurance.
That is a lot to ask and a lot to think about when dealing with patients and colleagues; it also questions a lot about us.
Competencies for Advanced nurse practitioners initially came from the NHS Knowledge and Skills Framework (2004) which outlined standards of clinical outcomes and the need to audit fitness to practice at this level in response to meeting the health needs and demands of the changing population and their expectations. NHS Wales informs us that Advanced Practitioners has become the driving force behind the need to address