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The concept of professional accountability as it pertains to nursing

Scenario

Nurse Lope is starting a busy shift in which she was finishing report on Mr. Johnson. During report, Nurse Jim who was finishing his shift also gave Nurse Lope a medicine cup containing three of Mr. Johnson’s unopened medications that he reported were recently retrieved from the medication dispenser. Nurse Lope was told that these were supposed to have been given 30 minutes ago and asked if she could give them during bedside hand-off. As Nurse Lope planned to stay in Mr. Johnson’s room to complete his vital signs and assessment, she agreed with this plan.

When she opened Mr. Johnson’s electronic medical record to administer these medications, she noticed that these medications were scheduled to be given 3 hours ago. Additionally, one of the medications had a barcode that was not scanning to Mr. Johnson’s chart. Nurse Lope proceeded to administer these medications so that she would not be late on the next round of medications, which included some of the same ones. It was later discovered that the medication that was not scanning was for another patient and should not have been given to Mr. Johnson.

Discussion Question

Outline the concept of professional accountability as it pertains to nursing. Examine the actions of Nurse Jim and Nurse Lope. Discuss how you would approach this scenario if you were in Jim’s and Lope’s position. Based on your analysis of how nurses demonstrate accountability in clinical practice, the nursing process, and evidence-based practice, explain how you would handle this situation if you were the nurse manager overseeing Jim and Lope.

Initial discussion question posts should be a minimum of 200 words and include at least two references cited using APA format. Responses to peers or faculty should be 100-150 words and include one reference. Refer to “RN-BSN Discussion Question Rubric” and “RN-BSN Participation Rubric,” located in Class Resources, to understand the expectations for initial discussion question posts and participation posts, respectively

Sample Answer

Professional accountability in nursing is the obligation to answer for one’s own actions and judgments. It encompasses adherence to professional standards, ethical principles, and legal guidelines. Nurses are accountable for providing safe, competent, and ethical care to patients.

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Analysis of the Scenario

Nurse Jim’s Actions: Nurse Jim demonstrated a lapse in professional accountability by transferring medication responsibility without proper documentation or verification. This action deviated from established medication administration protocols.

Nurse Lope’s Actions: Nurse Lope also exhibited a lapse in professional accountability by administering medications without verifying their accuracy and timeliness. Relying solely on verbal communication and failing to independently verify medication orders is a violation of safe medication practices.

Addressing the Scenario

If I were Nurse Jim: I would have ensured that the medications were properly documented in the electronic medical record before transferring responsibility. I would have verified the medication orders with the oncoming nurse and clarified any discrepancies.

If I were Nurse Lope: I would have refused to accept the medications without proper documentation and verification. I would have independently accessed the electronic medical record to confirm the medication orders and timing. If discrepancies were found, I would have immediately notified the nurse manager.

Role of the Nurse Manager

As the nurse manager, I would initiate a thorough investigation to determine the root causes of the medication error. Key steps would include:

Reviewing the incident report: A detailed analysis of the incident to identify contributing factors.
Interviewing involved staff: Gathering information from Nurse Jim and Nurse Lope to understand their perspectives.
Assessing the unit’s medication administration protocols: Identifying any gaps or weaknesses in the system.
Providing education and training: Implementing mandatory education on medication administration, verification, and documentation.
Disciplinary action: If necessary, taking appropriate disciplinary action based on the severity of the error and the nurses’ accountability for their actions.

Conclusion

This case highlights the importance of professional accountability in preventing medication errors. Nurses must adhere to established protocols, verify information independently, and prioritize patient safety. Effective leadership and a culture of safety are essential in creating a culture of accountability within the nursing profession.

References:

American Nurses Association (ANA). (2015). Code of ethics for nurses with interpretive statements. Silver Spring, MD: Author.

Joint Commission. (2022). National patient safety goals. Oakbrook Terrace, IL: Author.

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