Journal of Advanced Nursmg, 1990,15, 383-384
Editorial EXERCISING ACCOUNTABILITY IN NURSING, MIDWIFERY AND HEALTH VISITING
currently effective in the United Kingdom It reiterates that 'Each registered nurse, midwife and health visitor is accountable for his or her practice
The United Kingdom Central Council for Nursing, Midwifery and Health Visihng (UKCC), the regulatory Section B — the code of professional conduct and the body for nursing, midwifery and health visihng through- subject of accountabihty out the United Kingdom, has sent a document, containing important new advice to all registered nurses, midwives In unequivocal terms paragraph B3 emphasizes that the primacy of the interests of the public and the patient or and health visitors, enhtled Exercising Accountability The UKCC is charged with responsibihty for establish- client provide the first theme of the code It is established ing and improving standcirds of training and professional that, in determining his or her approach to professional conduct m the public interest The new document is con- practice, the individual nurse, midwife or health visitor cerned with standards of care and ethical matters It offers a should recognize that the interests of public and patient framework to assist nurses, midwives and health visitors to must predominate over those of practihoner and profession consider ethical aspects of professional practice In this way the point is made that the hallmark of a This IS the fourth document produced by the UKCC to profession is that it accepts the responsibility for regulating supplement the Code of Professional Conduct for the Nurse, itself, but m the public interest Midwife and Health Visitor, which contains the UKCC's definitive advice to its practitioners on matters of professional conduct Section C — concern in respect of the environment of Exercising Accountability asserts strongly the pnmacy of care the interests of patients, stating that 'the interests of the
paheni: or client are paramount' In addition to addressing
The importance of good systems of communication is
the subject of the accountability of professional practitioners in a general way, this important new document addresses
emphasized m paragraphs C2 and C3, as is the necessity of being open and honest about those matters in the practice setting which are contrary to the interests of patients
1 2 3 4 5
Concern in respect of the environment care Consent and truth Advocacy on behalf of patients and clients Collaboration and co-operation in care Objection to participation in care and treatment
Section D — consent and truth
in Exercising Accountability
This section of Exercising Accountability addresses two related aspects of practice that may not, m the past, have received the attention their importance deserves Paragraph D7 concludes by stressing that accountabihty can never be exercised by ignoring the nghts and interests of the patient or client That is a particularly important message
Section A — introduction
Section E — advocacy on behalf of patients or clients
Since this new document supplements and elaborates upon several clauses within the UKCC's Code of Professional Conduct, paragraph A2 of Exerasmg Accountability restates the nature and importance of that document Paragraph three indicates the reasons why this new document has been prepared and distnbuted to every nurse, midwife and health visitor whose registrahon is
The key message of this section is found m the final sentence of paragraph E4 which states that 'The Code of Professional Conduct envisages the role of patient or client advocate as an integral and essential aspect of good professional practice' What IS meant by advocacy is succinctly stated 'Advocacy is concerned with promoting and safeguarding
The document concludes with a list of seven principles against which to exercise accountability Attention is particularly drawn to the following passages
383
Editorial
the well-t>eing and interests of pahents and clients It is not concerned with conflict for its own sake'
to object to partiapation m particular forms of treatment, deemed to be 'harmful'
Section F — collaboration and co-operation in care
Section H — summary of the principles against which to exercise accountability
The importance of collaboration and co-operation between health care professionals and other carers to the delivery of good and comprehensive care is recognized clearly throughout this section Some of the matters that obstruct such collaborative and co-operative working are addressed, emphasis again being given to the need for the interests of the patient or client to remain paramount
Section G — objection to partiapation in treatment
Exerasmg Accountabihty concludes with a set of seven pnnciples This list begins with that principle which runs nght through the Code of Professional Conduct and all the sections of Exercising Accountability — that which states that 'The interests of the patient or client are paramount' It concludes by emphasizing the important pnnaple of justification Whatever the practitioner chooses to do or chooses not to do in the course of professional prachce, he or she must be able to justify the decision Such is the nature of true professioneil accountability
One of the pnncipal purposes of this section of Exercismg Accountabihty is to disabuse some practitioners of their References belief that there is a range of conditions ttwt justify refusal UKCC (1984) Code of Professional Conduct for the Nurse, Midwife to care for the patients presenting with those condihons and Health Visitor 2nd edn UKCC London There is no 'formula for being selective about the categones UKCC (1989) Exercising Accountability UKCC, London of patient or client for whom the practihoner will care' James P Smith The other mam purpose is to emphasize that there are OBE FRCN arcumstances in which it is legitimate for the practitioner
384
Editorial EXERCISING ACCOUNTABILITY IN NURSING, MIDWIFERY AND HEALTH VISITING
currently effective in the United Kingdom It reiterates that 'Each registered nurse, midwife and health visitor is accountable for his or her practice
The United Kingdom Central Council for Nursing, Midwifery and Health Visihng (UKCC), the regulatory Section B — the code of professional conduct and the body for nursing, midwifery and health visihng through- subject of accountabihty out the United Kingdom, has sent a document, containing important new advice to all registered nurses, midwives In unequivocal terms paragraph B3 emphasizes that the primacy of the interests of the public and the patient or and health visitors, enhtled Exercising Accountability The UKCC is charged with responsibihty for establish- client provide the first theme of the code It is established ing and improving standcirds of training and professional that, in determining his or her approach to professional conduct m the public interest The new document is con- practice, the individual nurse, midwife or health visitor cerned with standards of care and ethical matters It offers a should recognize that the interests of public and patient framework to assist nurses, midwives and health visitors to must predominate over those of practihoner and profession consider ethical aspects of professional practice In this way the point is made that the hallmark of a This IS the fourth document produced by the UKCC to profession is that it accepts the responsibility for regulating supplement the Code of Professional Conduct for the Nurse, itself, but m the public interest Midwife and Health Visitor, which contains the UKCC's definitive advice to its practitioners on matters of professional conduct Section C — concern in respect of the environment of Exercising Accountability asserts strongly the pnmacy of care the interests of patients, stating that 'the interests of the
paheni: or client are paramount' In addition to addressing
The importance of good systems of communication is
the subject of the accountability of professional practitioners in a general way, this important new document addresses
emphasized m paragraphs C2 and C3, as is the necessity of being open and honest about those matters in the practice setting which are contrary to the interests of patients
1 2 3 4 5
Concern in respect of the environment care Consent and truth Advocacy on behalf of patients and clients Collaboration and co-operation in care Objection to participation in care and treatment
Section D — consent and truth
in Exercising Accountability
This section of Exercising Accountability addresses two related aspects of practice that may not, m the past, have received the attention their importance deserves Paragraph D7 concludes by stressing that accountabihty can never be exercised by ignoring the nghts and interests of the patient or client That is a particularly important message
Section A — introduction
Section E — advocacy on behalf of patients or clients
Since this new document supplements and elaborates upon several clauses within the UKCC's Code of Professional Conduct, paragraph A2 of Exerasmg Accountability restates the nature and importance of that document Paragraph three indicates the reasons why this new document has been prepared and distnbuted to every nurse, midwife and health visitor whose registrahon is
The key message of this section is found m the final sentence of paragraph E4 which states that 'The Code of Professional Conduct envisages the role of patient or client advocate as an integral and essential aspect of good professional practice' What IS meant by advocacy is succinctly stated 'Advocacy is concerned with promoting and safeguarding
The document concludes with a list of seven principles against which to exercise accountability Attention is particularly drawn to the following passages
383
Editorial
the well-t>eing and interests of pahents and clients It is not concerned with conflict for its own sake'
to object to partiapation m particular forms of treatment, deemed to be 'harmful'
Section F — collaboration and co-operation in care
Section H — summary of the principles against which to exercise accountability
The importance of collaboration and co-operation between health care professionals and other carers to the delivery of good and comprehensive care is recognized clearly throughout this section Some of the matters that obstruct such collaborative and co-operative working are addressed, emphasis again being given to the need for the interests of the patient or client to remain paramount
Section G — objection to partiapation in treatment
Exerasmg Accountabihty concludes with a set of seven pnnciples This list begins with that principle which runs nght through the Code of Professional Conduct and all the sections of Exercising Accountability — that which states that 'The interests of the patient or client are paramount' It concludes by emphasizing the important pnnaple of justification Whatever the practitioner chooses to do or chooses not to do in the course of professional prachce, he or she must be able to justify the decision Such is the nature of true professioneil accountability
One of the pnncipal purposes of this section of Exercismg Accountabihty is to disabuse some practitioners of their References belief that there is a range of conditions ttwt justify refusal UKCC (1984) Code of Professional Conduct for the Nurse, Midwife to care for the patients presenting with those condihons and Health Visitor 2nd edn UKCC London There is no 'formula for being selective about the categones UKCC (1989) Exercising Accountability UKCC, London of patient or client for whom the practihoner will care' James P Smith The other mam purpose is to emphasize that there are OBE FRCN arcumstances in which it is legitimate for the practitioner
384
