In American Nurse Today, Marcia M. Rachel explains that accountability in nursing must include obligation, willingness, intent, ownership and commitment as essential components. She states that only a combination of these elements create accountability, which creates one side of a coin along with responsibility.
Dr. Rachel explains obligation as a duty that comes with consequences. Willingness entails accepting by choice and without reluctance. She describes intent as the purpose that accompanies the plan. Ownership means having power or control over something and commitment encompasses a feeling of being emotionally compelled. Dr. Rachel further explains the difference between accountability and responsibility by defining responsibility as a requirement for the job performance. She states that responsibility encompasses the expectation of accountability, which means someone holds nurses answerable for the outcomes of their actions. Dr. Rachel acknowledges that clarity, commitment and consequences must also exist to create accountability. Clarity means the nurse has clear and specific goals and expectations. Commitment means the nurse stays with the task in order to reach an objective. Nurses must also design appropriate consequences as well as face consequences in such a way increases responsibilities and holds nurses accountable. Dr. Rachel claims accountability runs through the entire nursing practice in all settings and at all levels as an energizing force throughout an organization.