The key to accountability is clearly communicated expectations. We need to be careful not to assume that staff nurses know what is expected of them. We need to set clear expectations and communicate them, including the consequences of not meeting the expectations.
A nurse manager needs to clearly tell staff nurses what they are accountable for, gain their commitment to meet the expectation, and then hold them to that accountability. Having staff nurses repeat the expectation back to you in their own words is an effective tool to ensure that they understand what is expected of them and what they are committing to achieve.
Getting staff nurses to be consistently accountable is a nurse manager's challenge. Paying attention to the distinction between accountability and responsibility will help nurse managers determine what is happening and set commitments that can be kept. Remember the difference between responsibility and accountability:
- Responsibility: I have authority over things and they will respond to me.
- Accountability: I am committed to others to deliver and account for results by a given date.
-- Eileen Lavin Dohmann, MBA, RN, NEA-BC