The nursing team is made up of many different people. Each has different skills, knowledge and competence. The person in charge of a patient's nursing care is usually a registered nurse. But nurses cannot perform every intervention or activity for every patient or client, so they have to delegate some tasks.
The principles of accountability and delegation apply to all members of the nursing team, including health care assistants, advanced practitioners, registered nurses and nursing students.
Health service providers are accountable to the criminal and civil courts to make sure their activities meet legal requirements. In addition, employees are accountable to their employer to follow their contract of duty. Registered practitioners are also accountable to regulatory bodies in terms of standards of practice and patient care. Registered nurses and midwives are professionally accountable to the Nursing and Midwifery Council (NMC).
The law imposes a duty of care on practitioners, whether they are HCAs, APs, students, registered nurses, doctors or others. The duty of care applies whether they are performing straightforward activities such as bathing patients or undertaking complex surgery.
All practitioners must ensure that they perform competently and that they don't work beyond their level of competence. They must inform a senior member of staff when they are unable to perform competently.
To be accountable, practitioners must:
Registered nurses have a duty of care and a legal liability to their patients. When delegating an activity, for example to an HCA or AP, they must ensure that it has been appropriately delegated.
The NMC code says registrants must be accountable for their decisions to delegate tasks and duties to other people.
It says they must:
Employers have responsibilities too. They must ensure their staff are trained and supervised properly until they are competent.
Employers accept vicarious liability for their employees. This means that if their employees are working within their sphere of competence and in connection with their employment, the employer is also accountable for their actions.
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