Running head: LEADER ACCOUNTABILITY

Accountability of the Nurse Leader

Melissa Diebel
Ferris State University

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Abstract
The purpose of this paper is to provide an overview of the knowledge needed for effective
leadership on legal and risk management needs in the healthcare profession. Nursing
administrators are responsible for handling daily operations, advocating for staff, promoting
quality of patient care based on the nursing standards of practice, as well as encouraging staff to
continue their education for professional development. Obtaining the appropriate education and
work experiences to effectively manage others is critical today to managing healthcare reform.
New leadership styles, information technologies, lean methodologies, and abilities to empower
and influence staff to make decisions towards continuous improvements and quality of patient
care.

Keywords: administration, ethics, framework, leadership, knowledge, legal, risks

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Accountability of the Nurse Leader
Knowledge Accountability
Nursing administrators are expected to have a great deal of knowledge as role models for
continuous improvement and lifelong learning (ANA, 2009). The level of education expected
for administrators include graduate-level degrees, and doctoral level for those holding executive
healthcare positions (ANA, 2009). Other educational requirements needed to enter the nursing
profession as a registered nurse include a two year associate degree. Many nursing leaders feel a
four year bachelor degree would better prepare nurses into practice (ANA, 2009). Qualifying to
become an registered nurse (RN) requires taking the National Council Licensure Examination
(NCLEX) to obtain licensing in the state (Grant & Ballard, 2011).
According to American Nurses Association (ANA, 2010), Nursing administrators shape the
environment in which nurses practice and teach and consumers receive health care, with the goal
of inspiring those around them to reach for excellence in their practice (p. 5.). Nursing
administrators should also understand the ethics and laws that provide the framework of the
healthcare profession. Florence Nightingale initiated these perspectives through her pledge
written in 1893 (Grant & Ballard, 2011). As a leader, the importance of understanding the ethical
and legal guidelines will allow an administrator to guide their staff and organization
appropriately reducing the risks of ethical and legal issues. Advanced knowledge in these areas
will contribute to effective leadership as followers will need appropriate guidance in practice.
Legal Issues
Being a leader requires the knowledge of the legal framework in the nursing practice. As
Grant & Ballard (2011) explained the importance for administrators to understand how the
nursing practice is defined by the Nurse Practice Act (NPA), as well as the appropriate licensing
recognitions through the Nurse Licensure Compact (NLC), and National Council of State Boards

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of Nursing (NCSBN). Administrators should be familiar with the Code of Ethics for Nurses with
Interpretive Statements for Nurses published by the ANA (2001). This code of ethics sets the
parameters for nursing practice by explaining the obligations assumed by the nursing
professional (Grant & Ballard, 2011). Administrators need to be familiar with the Occupational
Safety and Health Act (OSHA), workers compensation programs, and the ethical obligations
with wrongful discharge (Grant & Ballard, 2011). Healthcare today has a great need to be
involved with advocating for what is best for the population. Understanding how to advocate
through the branches of government to promote important laws and regulations for the industry
is also an important role of an administrator. For example, the promotion of senate bill 2, is
important for Advance Practice Nursing (APN) in the state of Michigan. As members of the
healthcare profession, we all need to pull together in the state of Michigan to write our
congressman to promote passing this bill to empower APNs to practice at their full potential.
Understanding the governmental processes is important for advocating change in the healthcare
industry.
Risk Management
Administrators also have the responsibility of understanding risk. Having the knowledge of
loss prevention and reduction, financial risk, and managing claims (Roussel, 2013). Reducing
risks of injuries to staff, patients and visitors are important aspects of a risk management plan
(Grant & Ballard, 2011). Understanding how to identify risks through the organization and
develop a risk management plan supporting staff members of malpractice, litigation, entering
contracts, and an overall understanding of the employee selection and dismissal process also
leads to risk within the organization. Enforcing staff members to stick with the facts during
documenting and providing information for reports. As an administrator, identifying and

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reducing possible risks throughout the organization is another very important responsibility for
protecting individuals, as well as the organization from personal harm or financial implications.
Conclusion
In conclusion the need for continued education will provide the knowledge for nursing
administrators to guide staff members and organizations appropriately through many obstacles
the healthcare industry faces. Leaders are accountable for properly guiding staff and
organizations within the ethical and legal framework of the healthcare industry. The importance
of knowledge through ethics, legalities, potential risks and health promotion through advocacy
become the core characteristics supporting continuous improvement, high quality patient care,
and safety in the healthcare industry.

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References
American Nurses Association. (2009). Nursing: Scope and Standards for Nurse Administrators.
Washington, D.C.: American Nurses Association.
American Nurses Association. (2010). Nursing: Scope and Standards of Practice. (2nd Ed.).
Silver Spring, MD: Nuresebooks.org.
Grant, P.D., & Ballard, D. C. (2011). Law for Nurse Leaders: A Comprehensive Reference. New
York : Springer Publishing Co.
Roussel, L. (2013). Management and leadership for nurse administrators (6th Ed.). Sudbury,
MA : Jones & Bartlett Publishers