A hermeneutical study of professional accountability in nursing.

AIMS This paper presents findings from a hermeneutical study which sought to explore how registered nurses experienced and perceived their professional accountability in clinical settings. BACKGROUND Professional accountability encompasses the ideals and standards of nursing practice. Nurses are accountable for their actions under civil, criminal and contract law to their; employing organisation, their regulatory body and the patients for whom they care. DESIGN AND METHODS This paper reports on a Heideggerian hermeneutical study involving seven registered nurses, working in clinical practice in the National Health Service in the United Kingdom. The study adopted purposive sampling, collecting data by means of in-depth interviews. Data was analysed using the hermeneutic circle. COREQ checklist was used as a reporting guideline for this study. RESULTS The findings suggest that professional accountability in nursing practice is a complex phenomenon, which can be compromised by many factors which are historically, socially or politically driven. Participants experienced challenges through a lack of resources and poor managerial support, which comprised their ability to deliver high quality patient care. However, collegiality strongly impacted upon resilience and positively influenced their wellbeing. RELEVANCE TO CLINICAL PRACTICE Amid the challenges of the clinical workplace, a positive workplace culture with visible managerial support is a fundamental requirement in supporting professional accountability, development and retention of nurses. Findings highlight the view that leadership should be seen as a collective responsibility, which empowers staff to positively change the practice environment.