Nursing - The Most Trusting Profession of 2019

It is the seventeenth year in a row that nurses ranked higher than any other profession for the trust gained by their communities. In fact, Stone (2019) reports that “84% of respondents said they rated nurses ‘very high’ for honesty and ethical standards”. An ethical value that strongly influences the perception of trusted nurses, is their accountability. This is the ability to claim responsibility for their actions, as well as accept the consequences of them (Ray, 2017). Not only must professional nurses be accountable to themselves, but also their patients, employer, coworkers, and to the nursing profession (Ray, 2017).

Professional nurse accountability, as defined by The American Nursing Association’s Code of Ethics, is “being answerable to oneself and others for one's own actions” (Davis, 2017). Nursing is a very difficult and demanding profession. It requires interdisciplinary collaboration and the ability to multitask. To manage these demands safely and effectively, the nurse must first and foremost, take care of themselves.

Nurses are notorious for skipping bathroom breaks and meals, working long hours and neglecting their self-care for their patients (Ray, 2017).

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But, for nurses to provide the highest quality of care to their patients, they must make themselves a priority. When a nurse neglects themselves, it may lead to burnout, making them more likely to perform errors in patient care (Hoskins, 2013). Nurses must remain accountable for their mental and physical state of health and how their current state is affecting their ability to deliver quality patient care. By remaining self-aware and engaging in activities outside of work, nurses can reduce the likelihood or prolong the time before they will suffer from burnout (Ray, 2017).

Nurses must also remain accountable for the skills they are implementing (Davis, 2017). If a nurse is uncomfortable or does not feel proficient in a skill, he or she must seek education regarding said skill. The medical field is ever-evolving, it is the nurse’s responsibility to remain up to date on the care delivered in their practice. If they fail to do so and make an error, they must claim accountability for that error and any consequences that come along with it. Nurses have a professional duty to put their “patient’s health first” (Ray, 2017).

This includes providing direct patient care but also means advocating for patient care that is delivered appropriately and in the highest quality by their peers and all other disciplines (Ray, 2017). When a nurse witnesses patient care that is harmful or not in line with protocol, it is their responsibility to hold their coworker accountable for the mistakes made (Ray, 2017). This should be done in a way that minimizes conflict and may require involving a manager or supervisor. If a nurse decides to forgo intervening, they are essentially neglecting to advocate for their patient which is a primary goal of professional nursing. Intervening in potentially dangerous care, includes thinking critically about a physician’s orders and the parameters of these orders. If an order is incorrect or a physician wants a nurse to administer a medication that is not appropriate for that patient at that point in time, the nurse must remain accountable for advocating for the patient. The failure of a coworker to provide safe and high-quality care to a nurse’s patient, will not only put the patient’s health in jeopardy, but will also negatively reflect on that nurse’s accountability. It will put into question their ability to advocate for their patients and intervene in unsafe situations.

Being accountable to their coworkers includes when one nurse helps another with a patient that is not on their assignment. In this situation, each nurse must be accountable for their responsibilities. For example, if one nurse asks another to sign off on a blood transfusion with them, the secondary nurse is responsible for individually performing all checks required by protocol. If the secondary nurse fails to perform the checks, just signs off on the transfusion, and it results in a transfusion reaction, both nurses are equally responsible and must be accountable for their actions or lack thereof. The primary nurse was responsible for ensuring the checks were done properly by the secondary nurse. The secondary nurse was responsible for performing checks outlined by protocol. In this incident, both nurses will be held accountable to the patient, themselves, their coworker, their employer, and the facility. In addition to being accountable to themselves, their patients, and their peers, nurses must also be accountable to their employer and the facility they work at (Ray, 2017).

Nurses arguably spend the most time at the patient’s bedside. This means that the perception the patient and their family have about the unit and the facility, is highly based on the care that the nurse provides. Employers and facilities count on nurses to uphold the morals and values of the institution. They must be accountable to their employer and the place they work if they do not comply with this responsibility. In cases where nurses do not remain accountable in this way, termination of employment is a possibility. As Ray (2017) states, “everything you do reflects on your profession”. Each nurse is counting on one another to represent the profession of nursing with integrity, loyalty, and honor. A nurse “accepts responsibility to uphold the standards of their nursing association and accept that they represent all nurses when they make decisions and take certain actions” (Ray, 2017). Without these attributes, nurses would not consistently be voted the most trustworthy profession. Being accountable to the profession also means getting involved. This may include being part of developing health care policies as a representative of the profession or reviewing employee and facility regulations (Ray, 2017).

A nurse’s responsibility does not end at the bedside or in the patient’s chart. Without the dedication and accountability that nurses in the past have had, the reputation of the profession of nursing would not be what it is today. A nurses’ neglect to be accountable for any of these factors, could result in harm to the patient. Nursing is a truthful and honorable profession and a nurse’s primary priority is to provide the highest quality of patient care possible while remaining safe. As the Nursing and Midwifery Council states, “Everything you do – or fail to do – is your responsibility. You can’t blame anyone else – there is no get-out clause that you were ‘only following orders’” (“Professional Accountability”, 2017). This not only includes nurses being accountable to themselves, but also being accountable to their patients, their peers, employer, and to their profession (Ray, 2017). Being truthful is an important factor in being accountable. But, advocating for patients to receive the best possible care, is crucial. Nurses need to remain vigilant and always aware of interdisciplinary care provided and the influence it has on their patients.