Standards can help ensure that the care you are responsible for is safe, effective and based on current evidence.

Standards are often referred to as many other things, among them:

  • protocols
  • guidelines
  • guidance
  • best practice statements
  • benchmarks.

Standards and guidance can be considered as a hierarchy:

standards and guidance for nurses

Accountability

All health care workers are expected to perform as competently and safely as they can in these circumstances. They must also inform a more senior member of staff, such as the registered nurse assigned to care for the individual and leading the team, or the nurse in charge of the shift, when they are unable to perform competently and/or safely.

Delegation

Due to the changing context and models of care evolving as a result of the pandemic, there may be more delegation required, and it may be taking place in a busy and challenging environment.  

Registered nurses are responsible for managing the nursing care and are accountable for the appropriate delegation and supervision of care provided by others in the team.

For more information go to: rcn.org.uk/professional-development/ accountability-and-delegation/accountability-and-delegationin- practice

As a registered nurse, it is expected that you will know and understand your responsibilities to ensure that:

  • regulatory standards and legal policies/protocols are adhered to
  • guidance, best practice and benchmarks inform your practice decisions and interventions.

It is important that you consider how you will react in a situation where you, your team or the situation causes you to question the standard or guidance that exists.

Do not be tempted to take a risk that could harm you, your team, your organisation and most importantly your patient.

Reflection

Document

Reflect on a situation in which you have or been involved with a difficulty or challenged decision. 

How did you use your clinical judgement?

How was the decision informed by knowledge and understanding?

How did standards and guidance influence the decision?

Did the final decision feel right? 

In particular, reflect on your intuition/instincts - do these influence your clinical judgement?

Raising concerns

The RCN has developed a guide to make it easier for you to assess whether a situation you’ve witnessed or experienced should be raised as a concern, and to support you through the process of reporting it.

Take me there

Duty of candour

It is entirely possible that you will make mistakes. If you do make a mistake, report it to your preceptor or the nurse in charge. It might be difficult, but putting patient safety and honesty first is vital.

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Patient safety and human factors 

Watch the short film about the case of Elaine Bromiley. This demonstrates the importance of candour and also of raising concerns that we can learn from our mistakes. Then visit the Raising Concerns page in Starting Out for our analysis.

Watch the film