Philosophical Perspectives on Trustworthiness and Open-mindedness as Professional Virtues for the Practice of Nursing: Implications for he Moral Education of Nurses

virtuous institutions, that is, institutions with arrangements that enable practitioners to
express rather than suppress the virtues.

As indicated earlier, those who practice as nurses often find themselves in situations
that are different from normal social conventions; or rather, practising nurses find
themselves working in environments where the normal patterns of acceptable moral
behaviour may be substantively different from those of everyday life and for which it
appears everyday life provides insufficient preparation. In everyday social situations
people are not usually confronted by others whose suffering is such that were it seen in
a horse, dog or cat would lead to those animals being ‘put down’. And what seems to be
acceptable moral behaviour in respect of non-human animals cannot be merely
transferred into the environment in which health care takes place. Thus, generally
speaking, when individuals begin to practise nursing they are unprepared to deal with
the sorts of dilemmas with which they will now be confronted. A general disposition to
be just, honest, courageous or trustworthy might provide a secure foundation in most
cases for moral actions in the everyday world and such everyday virtues might serve as
a basis for moral behaviour in the professional practice of nursing, but they will not
necessarily be sufficient to enable a nurse to act as a virtuous agent. It is often claimed
that nursing is a moral endeavour as almost every action a nurse can take there is an
alternative action omitted (Tschudin 1992, Sellman 1996), in part because there is
always more for a nurse to do than can be done in the time available. So for a nurse, to
prioritise her or his time requires a consideration of her or himself as a finite resource
the allocation of which equates with the identification of a greater value to one action,
or to one patient, rather than another. So while a nurse may wish to practice in a just
way, this may not be possible if the demands on the nurse are greater than her or his
capacity to respond to those demands. Clearly, there is a sense in which virtue for
nursing practice is different from general virtue. In the normal everyday world to act in
accord with general virtue allows for the fact that one already has made some value
judgements about one’s sphere of responsibility. Normally, it is to one’s family and
friends, and perhaps to one’s colleagues that one assumes specific obligations of general
virtue together with a general lack of vice to others. Whereas a nurse who wishes to
practice in accordance with the everyday virtues of truthfulness, courage and justice will
find her or himself faced with dilemmas posed by those very virtues precisely because
she or he is not normally able to select the boundaries of either the patients in her or his
care or the demands those patients will make.

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