Abstract
M.Cur. (General Intensive Nursing)
In South Africa, where the nurse is seen as an independent practitioner, she must take continuously accountability and responsibility for her actions. Only she can decide whether she is legally able, or knowledgeable and competent enough to accept a prescription or direction from a doctor. Once she has indicated acceptance, she has made an independent decision and accepts full responsibility and accountability for her decisions and actions.
Accountability means that the nurse must be able to give a reason for her actions and or omissions. It is very important that she has enough knowledge of the effects, side-effects, indications and contra-indications of the medications that are prescribed by the doctor before she administers it. Knowledge of medications and the Nursing Act with related regulations that directs her practice, are very important to the nurse to ensure a high standard of nursing care. The nurse working in an intensive care unit must often
make decisions in a crisis situation in connection with her legal accountability. So much more in the private sector where the intensive care nurse must .often rely on her own judgement and knowledge because a doctor is not always available.
Two questions evolving from this is what is the nurse's responsibility with in the legal framework of medication administration in a intensive care unit and do nurses have enough knowledge of selected medications? These two questions have been answered by evaluation of the doctor's prescriptions and nursing actions, with the help of prelisted control lists and a questionnaire The results of the study showed that the doctor's prescriptions were not legally correct and nurse's actions and knowledge of the selected medications were not up to the expected standard in the chosen unit. Two recommendations evolving from this study are that inservice training to increase knowledge of medications that are frequently used in the unit should be presented monthly and that more time must be spent on pharmacology during the training of the intensive care nurse.