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By Stephen Tilley, Roger Watson

Responsibility is a key quandary for nurses and midwives within the NHS this present day. expert accountability--being accountable for your activities and for the results of those actions--is a part of the framework of medical governance, which goals to supply high quality, reasonable, evidence-based care.The moment version of responsibility in Nursing and Midwifery addresses present matters and key issues in responsibility, concentrating on responsibility within the 4 major branches of nursing (adult, baby, studying disabilities and psychological health), in addition to in midwifery, neighborhood nursing, and nursing administration. In an more and more litigious society, the moral and felony implications of responsibility are transforming into and it's important that nurses comprehend the consequences for daily perform.

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182) 30 Accountability and Clinical Governance in Nursing However, accounting for the self raises different kinds of questions. How do these accounts serve to enable the individual to make sense of their world, including their sense of self in the world (Munro & Mouritson, 1996, p. 6)? How are these accounts developed and how are they linked to practices or technologies such as confession and examination? It is with these questions in mind that I turn to a discussion of the nature of accountability in the organisational and institutional context of the NHS and the clinical governance initiative.

First and foremost is the idea of personal accountability. This concept is taken to mean that the responsibility for patient care cannot be delegated to another person (either upward to senior staff or downward to unregistered staff). Ultimately each nurse must (or must be able to) answer for his/ her own actions. However, to whom they have to answer remains undefined: the NMC, colleagues, management or themselves. This ambiguity and the suggestion of a personal accountability based on a personal set of values imply a different understanding of accountability.

111). Accounts are forms of social action that accomplish attribution of or relief from responsibility for social action. e. make real and enable others to grasp – social acts (Tilley, 1995, p. 113). Within our theoretical framework this can be clearly seen as an example of an individual discourse of accountability. Accounts are not required by a structural hierarchy but are part of establishing and consolidating the self. Tilley’s dialogues show these accounts in actions and how the patient is taught to construct and transform him/herself, from the patient into the ‘healthy’ individual.

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