unreasonable expectations of patients about what is and what is not within the scope of
a professional’s role to accomplish. Thome and Robinson illustrate this in their study of
patients with chronic illness who
.. .entered into health care relationships with an almost absolute trust in the
professionals who would provide care . This initial trust was based on the naive
assumption that answers to their health care problems would be forthcoming and
that the health care professional would be singularly dedicated to providing them
with those answers.
(Thome and Robinson 1988 p. 783)
What these patients found was that, in time and with an emergent understanding of the
health care system, their expectations of the health care professionals became more
realistic in terms of what the professionals could or could not offer, or, to put this
another way, became more realistic in terms of how far they could trust the health care
professional to look after their best interests. The situation is likely to be similar in other
professional relationships such as those between a teacher and a student.
In the same way that a nurse who finds she or he must betray the trust of a patient2, the
nurse teacher who finds she or he has betrayed students’ trust must make genuine
attempts at reparation. Admitting that one has broken a trust entails being honest, just
and courageous. It takes honesty to recognise the part one played in a breach of trust, it
takes an understanding of what justice requires to recognise that being untrustworthy
(even in a single instance) is to be unfair, and it takes courage to admit to one’s role in a
betrayal of trust. And because genuine attempts at a repair of broken trust require the
admission of fault, actions that aim at reparation illustrate the expression of those three
virtues. And the receptive student, that is, the student who aims to become trustworthy,
can Ieam from the nurse teacher not only how difficult it is to be trustworthy but also
how the virtuous person might go about recovering a lost trust in a virtuous way.
Similarly, the virtuous mentor will exemplify trastworthiness in the practice of nursing.
As illustrated in Chapter 4, dilemmas of tmstworthiness are more likely in clinical
practice precisely because the practitioner must answer to a number of different
individuals or groups. The way in which the professionalphronimos negotiates the
difficulties of being tmstworthy in everyday clinical practice will illustrate to the
willing student the relative importance the virtuous mentor places on competing
2 For example, the deliberate betrayal of the trust of children in the situation where a child needs but
refuses to accept an important and necessary treatment or procedure has been reported as a widespread
but apparently unproblematic fact of children’s nursing (Bircher 1999).
180