Vital Notes for Nurses: Accountability

Helen Caulfield is a Solicitor and Policy Advisor at the RCN. She is a member of the Law Society Personal Injury Panel and a leading expert on regulation and health law effecting nursing.

Preface xiii

1 A Framework of Accountability for Nurses 1

Learning objectives 1

Introduction 1

A framework of accountability 2

The first pillar of accountability: professional accountability 4

The second pillar of accountability: ethical accountability 5

The third pillar of accountability: legal accountability 7

The fourth pillar of accountability: employment accountability 8

Conclusion 10

Useful websites 14

References 14

2 The First Pillar of Accountability: Professional Accountability 15

Learning objectives 15

Introduction 15

A classification of regulation in professional accountability 16

The function of regulation in professional accountability 18

Regulatory bodies for professional accountability 19

The Nursing and Midwifery Council 22

Other codes of conduct and guidance 27

The future of professional accountability 29

Useful websites 29

References 30

3 The Second Pillar of Accountability: Ethical Accountability 31

Learning objectives 31

Introduction 32

Autonomy 33

Paternalism 35

Utilitarianism 36

Equity 38

Best interests 39

Trust and truth 40

Acts and omissions 42

Application to accountability 44

Useful websites 44

References 45

4 The Third Pillar of Accountability: Legal Accountability 46

Learning objectives 46

Introduction 47

What is law? 48

Why is law important? 48

Where is law made? 50

How is law made? 51

Who are lawyers? 54

Types of law 55

European law and devolution in the UK 60

Application to accountability 61

Useful websites 62

References 62

5 The Fourth Pillar of Accountability: Employment Accountability 63

Learning objectives 63

Introduction 64

The employment relationship 64

Types of employment relationship 67

The contract of employment 69

Protocols and policies 70

Working Time Directive 71

Discrimination 71

Family rights 73

Unfair dismissal and redundancy 75

Health and safety 77

Application to accountability 78

Useful websites 79

References 79

6 Structures: The Health Service 81

Learning objectives 81

Introduction 81

The Health Service and devolution in the UK 82

Rights to treatment and resources 86

Quality standards 90

Application to accountability 94

Useful websites 95

References 95

7 Structures: Rights and Redress 97

Learning objectives 97

Introduction 97

Human rights 98

Redress in health care 103

Application to accountability 110

Useful websites 110

References 110

8 Concepts: Negligence 112

Learning objectives 112

Introduction 113

The first principle: duty of care 114

The second principle: breaking the duty of care 116

The third principle: causation 118

The fourth principle: compensation 119

Employers’ liability and indemnity insurance 121

Contributory negligence and time limits 122

Assault 123

Application to accountability 124

Useful website 125

References 125

9 Concepts: Consent 126

Learning objectives 126

Introduction 126

Why consent is important 127

The three principles of consent 130

Consent and young people 133

Consent and adults 136

Emergency treatment 138

Consent forms 139

Conclusion 139

Useful websites 140

References 140

10 Applications: Confidentiality 141

Learning objectives 141

Introduction 141

Legal accountability 143

Professional accountability 147

Ethical accountability 150

Employment accountability 152

Practical tips for protecting confidentiality in clinical relationships 154

Conclusion 155

Useful websites 155

References 155

11 Further Applications in Accountability 157

Learning objectives 157

Introduction 157

Abortion and conscientious objection 158

Scenario 159

Palliative care and gifts 164

Scenario 164

Conclusion 170

Useful websites 170

References 171

Index 173