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

CHAPTER З

PRACTICES AND THE PRACTICE OF NURSING

Nursing is a complex occupation that continues to defy simple definition. In this nursing
shares similarities with other professional work (such as, teaching, medicine,
physiotherapy and so on) where a concern for human betterment is at the heart of
professional aspirations. It may be that this definitional problem is more acute for
nursing as other groups can point to some centrally important aspect of their practice: a
teacher’s central purpose is education; for a doctor it is diagnosis and prescription of
treatments; for a physiotherapist it is manipulating joints and muscles, chest
physiotherapy and so on. Nurses struggle to identify such centrally defining activities
for it is the case that nurses do many things: nurses educate; some nurses diagnose and
prescribe (at least in some instances); and many nurses undertake physiotherapy tasks.
Moreover nurses often undertake these ‘specialist’ activities in the absence of the
‘specialists’. That is to say, that nurses are the only group to provide a continuous 24-
hour presence for patients and consequently find themselves doing whatever needs
doing at times when ‘specialists’ are unavailable (although there are, of course, limits to
this and nurses are reminded in the NMC code of professional conduct (NMC 2004b)
about the need to practice only within their sphere of competence). In meeting the needs
of patients, nurses are the only group who are unable to define what they do as limited
to specific and particular roles. With the exception of those occasions when there are
reasons for a physiotherapist or occupational therapist to assess a patient’s ability to
self-care, whenever a patient needs assistance to go to the toilet it is a nurse who is will
be summoned. When a patient needs to have a wound redressed, the physiotherapist, the
doctor, the social worker will call on the nurse. Doctors, physiotherapists, social
workers, teachers, occupational therapists and others would not normally consider such
activities to be part of their role. Yet, outside of normal office hours, it is generally the
case that nurses are expected to do many of the things these other professionals would
do were they present. The reverse is rarely true.

Of course, these examples reflect only the stereotypical impression of nursing as a
hospital based and medically oriented activity. As intimated in the introduction, nursing
encompasses a wide range of activity in a bewildering variety of institutional and
community settings. This adds to the difficulty in getting to the nub (as it were) of
nursing. Nevertheless, some discussion about the nature of nursing is a necessary part of

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