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Nursing Roles Affect Accountability And Delegation

Currently, a lot of responsibilities have been granted to the healthcare support staff as a way that NHS is using to cover for the ever-rising demand associated with healthcare service.  The NHS is also giving nurses a lot of responsibilities as a means of saving money (Harris, 2017). However, the current situation where nursing support roles are emerging makes the roles of qualified nurses to be unclear (Kendall-Raynor, 2019). It is because the roles that were first associated with registered nurses are performed by unregistered healthcare workers. Therefore, it brings the question regarding the accountability and responsibility of healthcare staff (Howard, 2018). Therefore, the paper is discussing registered nurses associated with accountability and delegation. Besides, the paper will also cover key aspects that arise for other healthcare workers such as Assistant in Nursing (AINs), Enrolled Nurse (ENs), and Registered Nurse (RNs).

Accountability and delegation roles of registered nurses

A simple definition of accountability is a willingness to embrace and accept responsibilities in the workplace (Howard, 2018). Besides, registered nurses also are accountable to their employers, regulatory body, Nursing Midwifery Council, and the nursing profession. Moreover, Nursing Midwifery Council’s code stipulates that all registered and qualified nurses must be held accountable for their actions and decision (Harris, 2017). Moreover, registered nurses are also accountable for the decisions they make as well as the tasks that they delegate.

Besides, four pillars of registered nurses’ accountability have been identified since the year 2001 (Howard, 2018). These pillars include professional accountability, legal accountability, and employee accountability, ethical accountability. Under professional accountability, registered nurses are held accountable for all the decisions and actions they execute while discharging their duties. Moreover, registered nurses should abide by the rules and regulations that govern their operations under legal accountability (Howard, 2018). Additionally, nurses should also understand that they are liable to criminal law and civil law. Furthermore, registered nurses should also execute their duties ethically while upholding the integrity of those they serve under ethical accountability (Harris, 2017). Additionally, registered nurses should understand that they are employees with clear duties and responsibilities accorded to them under employment accountability and should honor the signed contract.

As for delegation, registered nurses are allowed to delegate duties by asking support staff to perform certain tasks on their behalves (Harris, 2017). However, Nursing Midwifery Council has clear guidelines for delegation. Such guidelines include making sure that the individual delegating the duty can effectively perform the instruction (Kendall-Raynor, 2019). Also, the person delegating the task should make sure that the outcome of the delegated task meets the expected standards. Moreover, before delegating, the concerned person should make sure that the delegated individual is not only supported but also supervised (Howard, 2018). Furthermore, the person delegating has full responsibility for the actions of the person that to whom the duty is assigned.

Moreover, NMC has also provided guidelines that outline the delegation principle (Howard, 2018). According to the delegation, principle workload should be shared appropriately to avoid both under load as well as an overload of the support healthcare workers. Another delegation principle focuses on serving the interest of the patients by ensuring that all members of the team deliver quality service delivery (Kendall-Raynor, 2019). Furthermore, building rapport and support among the healthcare worker as a way of developing precision and purpose is another principle associated with delegation (Howard, 2018). Therefore, the overall purpose of the delegation principle is to ensure that delegation is undertaken appropriately.

Registered Nurse and other health care support staffs

Registered nurses can work in different areas of the hospital setup. Such areas include intensive care unit where patients require more attention or outpatient unit that requires little attention (Kendall-Raynor, 2019). However, registered nurses operate in two approaches. The first approach is by dealing directly with the patients while another approach is collaborating with other healthcare support staff in helping the sick individuals. Examples of healthcare support workers that can support registered nurses include graduate Registered Nurse, Assistants in Nursing (AINs), Enrolled Nurse (ENs) (Howard, 2018).

However, what is apparent in all the above-mentioned support nurses is that they help the registered nurses in discharging their duties (Kendall-Raynor, 2019). It means that registered nurses are the supervisors that delegate their duties to the support nurses. However, before delegating the duties, the registered nurses should at all times keep in mind that they are liable for any damage or misconduct associated with the operations of the supporting nurse (Wilkinson, 2019). However, it is worth noting that the majority of supporting nurses are qualified and competent individuals that are capable of discharging their duties effectively (Howard, 2018). It means that minimum chances can arise that are associated with incompetency.

Besides, it is the responsibility of the registered nurse to monitor and ascertain that the support nurse is executing the duties both effectively and efficiently (Wilkinson, 2019). Any failure that is linked to the incompetency of the support nurse and results in fatalities can subject the registered nurse to various legal accountabilities such as civil law and criminal law. Besides, the nurse can also face a legal battle with not only the employer but also the nursing regulatory bodies associated with negligence of duties (Kendall-Raynor, 2019). Therefore, registered nurses should at all times supervise and monitor the progress and operations of the support team that they delegated the duties.

Graduate Registered Nurse, Assistant in Nursing (AINs), Enrolled Nurse (ENs) are trained health practitioners that can adequately offer healthcare services to the public (Harris, 2017). However, they are not yet registered. Therefore, they should be aware that their main role is to offer a supportive role to the registered nurses. Therefore, the support nursing team should know their roles and boundaries by not being overworked or taken advantage of by the registered nurses. However, they should not refuse duties when delegated by the registered nurse (Howard, 2018). At the same time, the nursing support team should accept only the roles that they can execute effectively to avoid being seen as incompetent.

            In conclusion the roles of registered nurses are diverse and difficult. Registered nurses alone cannot meet the high demand associated with healthcare provision. Therefore, registered nurses require the assistance of qualified healthcare support individuals such as graduate Registered Nurse, Assistants in Nursing (AINs), and Enrolled Nurse (ENs). It means that registered nurses delegate some of their duties to the nursing support team to help them in discharging their duties. However, as they delegate their duties to the relevant support team, the registered nurse should understand that they are accountable for any misconduct or damages made by the nursing support team.  Therefore, it is their responsibility to offer support and supervise the support team without overworking them. Besides, registered nurses should be knowledgeable of the four salient types of pillars of nursing accountability before embarking on the delegation of duties to nursing support staff.