Leadership and Management (3)

Role Accountability

• Definition: Accountability in nursing refers to being answerable for one’s actions and their impact on others.

• Core Accountabilities as per ANA Nursing Administration Scope and Standards of Practice (2016):

  • Role Qualifications and Competence: Adhering to educational and skill proficiency as a foundational requirement.

  • Health Advocacy: Supporting patient self-determination and advocating for the rights of all healthcare participants, including patients and providers.

  • Quality, Safety, and Risk Management: Ensuring a safe environment that fulfills ethical obligations and protects the organization from legal liability.

  • Clinical Care Delivery: Knowledge of healthcare settings to model effective care practices.

  • Healthy Work Environment: Creating an optimal work setting where staff feel respected and safe.

  • Resource Management Accountability: Strategic management of financial and human resources.

  • Legal and Regulatory Compliance: Maintaining compliance with various local, state, and federal requirements.

  • Networking and Collaboration: Building alliances and collaborating across a broad spectrum of influence.

Nursing Education and Career Pathway

• Licensed Practical Nurses (LPN): Education can be in the form of certificates, diplomas, or associate degrees.

• Registered Nurses (RN): Generally earn degrees through associate, diploma, or baccalaureate programs.

  • Importance of Baccalaureate Education: Essential due to the increasing complexity of nursing practice.

  • Associate Degree Programs: Vital for increasing accessibility for students with location or scheduling constraints.

  • Institute of Medicine Report (2010): Emphasizes a seamless progression in nursing education.

• Current Trends:

  • Increase in RN-BSN and distance learning programs.

  • 2010 IOM recommendation: At least 80% of nurses should have a BSN by 2020.

  • The 2016 IOM report acknowledged this goal as ambitious, citing an increase from 49% to 51% of RNs holding a BSN or higher.

Nurse Licensure and Scope of Practice

• Nurse Licensure Compact (NLC): Allows for multistate practice and streamlines licensure across states.

• Broader Regulatory Environment:

  • Each state defines its own nursing education, licensure, and practice laws.

  • Nurses need to understand the regulations for the state in which they practice.

• State Licensing Authority: Boards can issue, suspend, or revoke nursing licenses based on various criteria, including legal violations and professional negligence.

Professional Development in Nursing

• Ongoing Learning: The evolution of nursing through continuous professional development is emphasized, with the Enhanced Nurse Licensure Compact (eNLC) aiming for consistent licensing standards.

• Recognition Programs:

  • Magnet Recognition: Awarded by the American Nurses Credentialing Center to facilities demonstrating high-quality care and exemplary nursing practices.

  • Pathway to Excellence: Facilities creating a supportive work environment under specific standards receive recognition.

Legal Aspects of Nursing Practice

• Understanding Legal Responsibilities:

  • Knowledge of pertinent laws aids in protecting client rights and minimizing legal risks.

• Criminal vs. Civil Laws:

  • Criminal law involves government relations; civil law protects individual rights.

  • Torts in nursing care can be categorized as unintentional (negligence, malpractice) or intentional (assault, battery).

Nurse Advocacy and Professional Voice

• Importance of Advocacy:

  • Professional advocacy includes active participation in the political process and addressing health legislation impacts.

• Collective Action: Nurses must unite to have a greater influence in shaping healthcare policies.

  • Engaging in lobbying, education, and participatory mentorship in health policies allows nurses to shape the healthcare system.

Ethical Considerations in Nursing

• Nature of Ethical Practice:

  • Ethical principles such as autonomy, beneficence, fidelity, justice, and nonmaleficence guide nursing practice.

  • Conflict resolutions often require balancing ethical dilemmas against scientific data.

• Ethical Decision-Making Steps:

  1. Identify the ethical dilemma.

  2. Analyze possible options for resolution.

  3. Select and justify the option aligning with ethical principles.

  4. Evaluate outcomes post-implementation.

Impaired Coworkers and Substance Use

• Reporting Obligations: Nurses have a duty to report suspected substance misuse by colleagues to ensure patient safety.

• Board of Nursing Regulations: State boards may require treatment programs for nurses found with substance issues.

Mandatory Reporting Laws

• Situations Necessitating Reporting: Nurses are legally obliged to report suspected abuse, communicable diseases, and mistreatment of vulnerable individuals.

Professional Standards and Best Practices

• Standards of Care: Derived from established guidelines, these dictate the level of care expected from nursing professionals.

• Preventing Malpractice: Adherence to professional standards, effective communication, and comprehensive documentation are vital in safeguarding against legal issues.