EDUCATION MATTERS
Values: the heart of our professional Code Janet Scammell
‘In seeking to address all recent and any future criticism of nursing and its professional regulation, the current draft Code lacks cohesion, clear purpose and strong, authoritative identity.’ (RCN, 2014: 4)
1048
Indeed, there are 115 sub-clauses over 20 pages, giving the impression that we cannot be trusted to understand and abide by key principles but have to have what this means spelled out. Admittedly this is a draft, and the NMC has undertaken a comprehensive consultancy process to gain feedback before producing the final version, but comparable codes are shorter, for example the code for allied health and care professionals (Health & Care Professions Council, 2012). Nevertheless, no profession should dismiss the benefits of revisiting its core purpose and values, and so a review of our Code can only be constructive, given today’s healthcare environment. But any code, be it short and concise or long and detailed, is only a tool. What matters is whether the values embedded in our professional Code reflect our own personal values, for only if this is the case will we act according to those professional values. At this point it might be useful to remind ourselves of what is meant by this term. Values are principles or standards of behaviour; judgements about what is important in life (Oxford Dictionaries, 2014). Knowing the values of our profession not only reinforces what we expect of ourselves as practitioners, but also what we expect collectively of all nurses. Our personal values are part of who we are and, as such, they directly affect our behaviour. Judging by what our nursing students tell us when they start nursing, most of us probably become nurses because we thought our values reflect those of what we perceive a good nurse to be. For example, the values of compassion, integrity, competence and care are clearly embedded in our Code and most nurses would claim these as personal values. However, it is important to note that our values govern our priorities; while many values are learned early in life and are relatively stable, they can be influenced by daily interactions, including at work. For example, if we perceive competency as simply getting the job done accurately by a certain time, this fails to recognise the importance of the way the job is done. The result: incompetent care that lacks compassion. Most of us have excellent intentions but it is not always easy to do what
we say we will do, particularly if our priority (for example, to always give compassionate care) is not ‘rewarded’ in our work environment, or at least not allowed to take priority over getting the job done. It takes personal resilience to retain person-centred values even when others may not support us. The Code is a tool to argue for this but at the end of the day it is the resolve of the practitioner that will determine the outcome. In pre-registration nurse education, valuesbased curricula are now the norm and most include spending time asking students to talk about their beliefs regarding people and nursing. A few find this frustrating, as they want to get on with learning how to do things. Unless we encourage students to unpack their values about people and care, they may learn what to do but not appreciate the importance of how it is done. Patients expect us to be competent but they also expect that competence to be delivered in a compassionate way. Our professional Code supports excellent practice. We await the revisions following the NMC consultation exercise and hope for one that is user-friendly and fit for purpose. The professional Code will no doubt emphasise person-centred care, but such care is dependent on individuals valuing and prioritising humanised practices to ensure it happens. BJN
Francis R (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. http://www. midstaffspublicinquiry.com (accessed 7 October 2014) Health & Care Professions Council (2012) Standards of Conduct, Performance and Ethics. http://tinyurl.com/m2o4xfp (accessed 7 October 2014) Nursing and Midwifery Council (2014) Standards of conduct, performance and ethics for nurses and midwives (draft revised edition). http://tinyurl.com/ollsoee (accessed 7 October 2014) Oxford Dictionaries (2014) Definition of Value. http://tinyurl. com/m279hyw (accessed 7 October 2014) Royal College of Nursing (2014) Response to Nursing and Midwifery Council’s consultation on a draft revised code and our proposed approach to revalidation. http://tinyurl. com/pxkcu2y (accessed 7 October 2014)
Janet Scammell Associate Professor (Nursing) Bournemouth University
© 2014 MA Healthcare Ltd
O
ver the last couple of years those involved in health care in the UK have been shaken by reports of inadequate standards of care. Part of the fall-out from this has been the review of codes and standards for health professionals. The Nursing and Midwifery Council (NMC) recently revised the Code (standards of conduct, performance and ethics for nurses and midwives) (NMC, 2014) but feedback from the recent consultation on the draft revised edition indicated that it was perceived to be overly lengthy and somewhat patronising (Royal College of Nursing (RCN), 2014). However, the Code is pivotal to guiding and promoting excellent standards of nursing and consequently forms a central plank of nurse education. So what is the purpose of a professional code and what should be at its heart? Professional codes are essentially about public protection and should embody the rights of users of health services to knowledgeable, competent and humane care and treatment. The nursing and midwifery Code defines our profession, setting out our core values and standards. This embodies a set of expectations about the way nurses should behave. As such, it is an essential guide for new nursing students to understand the conduct and ethics expected of members of the profession they aspire to enter. For those who are already practitioners, the Code serves as a touchstone for us to model our behaviour as well as to challenge others who fall short of standards laid out in the Code. But how detailed does this ‘guide’ need to be? Professional nursing in terms of registration has been around for almost 100 years and so we might assume that the ‘right’ standards are embedded in nursing culture, although the Francis report (2013) argues otherwise. Nonetheless the revised edition of the NMC Code is very detailed, so much so that:
British Journal of Nursing, 2014, Vol 23, No 19
British Journal of Nursing. Downloaded from magonlinelibrary.com by 130.194.020.173 on November 26, 2015. For personal use only. No other uses without permission. . All rights reserved.
Values: the heart of our professional Code Janet Scammell
‘In seeking to address all recent and any future criticism of nursing and its professional regulation, the current draft Code lacks cohesion, clear purpose and strong, authoritative identity.’ (RCN, 2014: 4)
1048
Indeed, there are 115 sub-clauses over 20 pages, giving the impression that we cannot be trusted to understand and abide by key principles but have to have what this means spelled out. Admittedly this is a draft, and the NMC has undertaken a comprehensive consultancy process to gain feedback before producing the final version, but comparable codes are shorter, for example the code for allied health and care professionals (Health & Care Professions Council, 2012). Nevertheless, no profession should dismiss the benefits of revisiting its core purpose and values, and so a review of our Code can only be constructive, given today’s healthcare environment. But any code, be it short and concise or long and detailed, is only a tool. What matters is whether the values embedded in our professional Code reflect our own personal values, for only if this is the case will we act according to those professional values. At this point it might be useful to remind ourselves of what is meant by this term. Values are principles or standards of behaviour; judgements about what is important in life (Oxford Dictionaries, 2014). Knowing the values of our profession not only reinforces what we expect of ourselves as practitioners, but also what we expect collectively of all nurses. Our personal values are part of who we are and, as such, they directly affect our behaviour. Judging by what our nursing students tell us when they start nursing, most of us probably become nurses because we thought our values reflect those of what we perceive a good nurse to be. For example, the values of compassion, integrity, competence and care are clearly embedded in our Code and most nurses would claim these as personal values. However, it is important to note that our values govern our priorities; while many values are learned early in life and are relatively stable, they can be influenced by daily interactions, including at work. For example, if we perceive competency as simply getting the job done accurately by a certain time, this fails to recognise the importance of the way the job is done. The result: incompetent care that lacks compassion. Most of us have excellent intentions but it is not always easy to do what
we say we will do, particularly if our priority (for example, to always give compassionate care) is not ‘rewarded’ in our work environment, or at least not allowed to take priority over getting the job done. It takes personal resilience to retain person-centred values even when others may not support us. The Code is a tool to argue for this but at the end of the day it is the resolve of the practitioner that will determine the outcome. In pre-registration nurse education, valuesbased curricula are now the norm and most include spending time asking students to talk about their beliefs regarding people and nursing. A few find this frustrating, as they want to get on with learning how to do things. Unless we encourage students to unpack their values about people and care, they may learn what to do but not appreciate the importance of how it is done. Patients expect us to be competent but they also expect that competence to be delivered in a compassionate way. Our professional Code supports excellent practice. We await the revisions following the NMC consultation exercise and hope for one that is user-friendly and fit for purpose. The professional Code will no doubt emphasise person-centred care, but such care is dependent on individuals valuing and prioritising humanised practices to ensure it happens. BJN
Francis R (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. http://www. midstaffspublicinquiry.com (accessed 7 October 2014) Health & Care Professions Council (2012) Standards of Conduct, Performance and Ethics. http://tinyurl.com/m2o4xfp (accessed 7 October 2014) Nursing and Midwifery Council (2014) Standards of conduct, performance and ethics for nurses and midwives (draft revised edition). http://tinyurl.com/ollsoee (accessed 7 October 2014) Oxford Dictionaries (2014) Definition of Value. http://tinyurl. com/m279hyw (accessed 7 October 2014) Royal College of Nursing (2014) Response to Nursing and Midwifery Council’s consultation on a draft revised code and our proposed approach to revalidation. http://tinyurl. com/pxkcu2y (accessed 7 October 2014)
Janet Scammell Associate Professor (Nursing) Bournemouth University
© 2014 MA Healthcare Ltd
O
ver the last couple of years those involved in health care in the UK have been shaken by reports of inadequate standards of care. Part of the fall-out from this has been the review of codes and standards for health professionals. The Nursing and Midwifery Council (NMC) recently revised the Code (standards of conduct, performance and ethics for nurses and midwives) (NMC, 2014) but feedback from the recent consultation on the draft revised edition indicated that it was perceived to be overly lengthy and somewhat patronising (Royal College of Nursing (RCN), 2014). However, the Code is pivotal to guiding and promoting excellent standards of nursing and consequently forms a central plank of nurse education. So what is the purpose of a professional code and what should be at its heart? Professional codes are essentially about public protection and should embody the rights of users of health services to knowledgeable, competent and humane care and treatment. The nursing and midwifery Code defines our profession, setting out our core values and standards. This embodies a set of expectations about the way nurses should behave. As such, it is an essential guide for new nursing students to understand the conduct and ethics expected of members of the profession they aspire to enter. For those who are already practitioners, the Code serves as a touchstone for us to model our behaviour as well as to challenge others who fall short of standards laid out in the Code. But how detailed does this ‘guide’ need to be? Professional nursing in terms of registration has been around for almost 100 years and so we might assume that the ‘right’ standards are embedded in nursing culture, although the Francis report (2013) argues otherwise. Nonetheless the revised edition of the NMC Code is very detailed, so much so that:
British Journal of Nursing, 2014, Vol 23, No 19
British Journal of Nursing. Downloaded from magonlinelibrary.com by 130.194.020.173 on November 26, 2015. For personal use only. No other uses without permission. . All rights reserved.
