What might surprise us is the idea that nurses must be courageous. Yet, given the
pressure on nurses to deliver care in an environment where there are finite resources
(and the general consensus is that there will always be more demands on nurses than
nurses can possibly deliver), the need for a nurse to be courageous is perhaps more
necessary than ever if only to ensure that those expectations alluded to above in respect
of being honest and just can be met. It takes courage to stand firm in one’s principles in
the face of the sometimes overwhelming forces of the institution with its emphasis on
the goods of effectiveness rather than the goods of excellence.
Indeed, the NMC code of professional conduct (NMC 2004b) requires each registered
nurse to act in ways that are consistent with the virtues of honesty, justice and courage.
The code states:
All patients and clients have a right to receive information about their condition
... Information should be accurate, truthful and presented in such a way as to
make it easily understood. (Clause 3.1)
You are personally accountable for ensuring that you promote and protect the
interests and dignity of patients, irrespective of gender, age, race, ability,
sexuality, economic status, lifestyle, culture and religious or political beliefs.
(Clause 2.2)
You are personally accountable for your practice. This means that you are
answerable for your actions and ommisions, regardless of advice or directions
from another professional (Clause 1.4)
Clause 3.1 clearly requires nurses to be honest, at least in relation to giving information
to patients about their condition. Clause 2.2 requires that nurses be just in allocating
care to patients so as to avoid discrimination between patients on anything but the basis
of clinical need. Clause 1.4 requires each nurse to take professional accountability for
her or his actions and omissions; this can take a great deal of courage when faced with
instructions from managers or more senior health care professionals to act in ways
inconsistent with the professional ideal of service. Indeed, acting in ways consistent
with these three quoted clauses of the NMC code of professional conduct can require
courage in the face of competing demands: being truthful to patients when more senior
staff demand that the patient not be told something about their condition is difficult in
the traditional hierarchy of health care; ensuring that a homeless persons or a ‘drunk’
gets the care they need when there is a general view that such patients are not worth
bothering with or are a waste of time or resources requires considerable self-assurance;
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