NMC Professional Accountability and Delegation 3 — Questions and Answers
Question 1: A patient asks a healthcare assistant for information about their diagnosis. The HCA is uncertain. What is the correct response?
- Provide the best answer they know
- Tell the patient the information is confidential
- Direct the patient to ask the responsible registered nurse (Correct answer)
- Look up the information online and relay it
Correct answer: Direct the patient to ask the responsible registered nurse
HCAs should refer clinical enquiries to a registered nurse, ensuring the patient receives accurate information within the correct scope of practice.
Question 2: A nurse is asked to countersign a student's documentation. What must the nurse verify before signing?
- That the documentation is neatly written
- That the student has been with the organisation for at least 6 months
- That the entry accurately reflects the care given and meets professional standards (Correct answer)
- That the ward manager approves the countersignature
Correct answer: That the entry accurately reflects the care given and meets professional standards
Countersigning documentation means the registered nurse is personally vouching for its accuracy; they must verify the content is correct and meets NMC record-keeping standards.
Question 3: What does 'vicarious liability' mean in the context of nursing delegation?
- A nurse can be sued personally for all clinical errors
- The employer is liable for negligent acts of employees acting within their role (Correct answer)
- The delegatee is solely liable for any errors made
- Liability is shared equally between all staff on a shift
Correct answer: The employer is liable for negligent acts of employees acting within their role
Vicarious liability holds employers responsible for employees' negligent acts committed within the course of their employment.
Question 4: A registered nurse is approached by a colleague asking her to sign off a procedure the colleague performed but that the nurse did not witness. What should the nurse do?
- Sign off as a professional courtesy
- Decline to countersign as she cannot verify what she did not witness (Correct answer)
- Ask the ward manager to sign instead
- Sign with a note saying 'not witnessed'
Correct answer: Decline to countersign as she cannot verify what she did not witness
The NMC Code requires nurses to only sign for what they can personally verify; countersigning unwitnessed procedures is dishonest and violates professional standards.
Question 5: Which scenario best demonstrates appropriate accountability when a delegation goes wrong?
- Blaming the delegatee and filing a complaint against them
- Acknowledging the error, reporting it, reflecting on the delegation decision, and taking corrective action (Correct answer)
- Concealing the error to protect the delegatee from disciplinary action
- Waiting to see if the patient is harmed before reporting
Correct answer: Acknowledging the error, reporting it, reflecting on the delegation decision, and taking corrective action
Professional accountability requires transparent error reporting, honest reflection on the delegation decision, and active steps to prevent recurrence.
Question 6: A nurse is off duty but is the only clinician available when a community emergency arises. Under NMC guidance, what should the nurse do?
- Decline involvement because she is off duty and uninsured
- Provide basic life-saving assistance within her competence while summoning emergency services (Correct answer)
- Wait for emergency services to arrive without intervening
- Perform any available clinical procedure regardless of her competence
Correct answer: Provide basic life-saving assistance within her competence while summoning emergency services
The NMC Code states that nurses must respond to emergencies when basic life-saving care is needed, acting within their competence until emergency services arrive.
Question 7: When a nurse takes on an expanded role (e.g., nurse prescriber), who is accountable for ensuring the nurse is competent in that role?
- Only the employer, through mandatory training
- Only the NMC, through revalidation requirements
- Both the nurse and the employer share this accountability (Correct answer)
- The medical director who approved the role expansion
Correct answer: Both the nurse and the employer share this accountability
Both the individual nurse and the employer have shared accountability: the nurse must not practise beyond their competence, and the employer must provide appropriate training and assessment.
NMC Professional Accountability and Delegation 3
A patient asks a healthcare assistant for information about their diagnosis.
The HCA is uncertain.
What is the correct response?