Clinical Responsibility: The Mental Health Nursing Perspective

Abstract

This study sought to identify mental health nurses’ perceptions of clinical responsibility. Clinical responsibility refers to the tasks and skills that professional bodies, employers and the court of law can legitimately demand from a health professional and accountability refers to the mechanism in which if a practitioner fails to exercise their responsibilities that disciplinary action can occur. Current standards and guidelines only provide limited information to nurses about the topic. Further to this public inquiries have identified issues in regards to health professionals’ understanding of their clinical responsibilities. A descriptive qualitative design was used to explore the mental health nursing perspective of clinical responsibility. Participants were sampled from the local mental health nursing population and semi-structured interviews were used as the means of data collection. Transcriptions were thematically analysed which produced three major themes; patient responsibility, medical responsibility, and conflicting nursing responsibility. The consumer discourse, the medical discourse and risk management discourse were all considered as competing factors relevant to mental health nursing responsibility which set up a conflicting position in which the nurses perceived their own responsibility. These findings highlighted the challenge for nurses of balancing competing discourses related to clinical responsibility in practice. It is critical that mental health nurses have an awareness of societal and organisational factors that influence practice and decision making. This knowledge will better inform decisions in practice so that they are less likely to be based on misconceptions of accountability.