The Fundamental Values In Nursing Profession

Values are frequently derived from a person’s culture, religion and ethnicity and normally the same within families and social groups. Values motivate and guide people’s behaviour, choices and decisions. The NMC Code (2015, has the objective of ‘Professional Staff and Quality Services’. Included in this code are the 4 P’s of practice; Prioritise People, Practice Effectively, Preserve Safety and Promote Professionalism. All four standards are fundamental in Nursing practice and are the professional values that should underpin any healthcare setting. Nurses can, however experience conflict when dealing with patients that values differ from their own, as well as ethical issues.

Values and beliefs are what are important to people, these turn to standards by which people live by and influence how they make decisions and choices. The Nursing and Midwifery Council has established standards of competence which are necessary for safe and effective practice. Included in the NMC Code (2015) are the four P’s of Practice, which all nurses and healthcare professionals must adhere to. All four standards are fundamental in practice to ensure patients feel empowered and respected. Empowerment is a state in which a patient possess a high degree of power and control over their illness.

Scrutiny of the NHS has led to a recognition of the need to reflect on culture and practice in revisiting the values which underpin practice. Central to the commitment to values in the NHS is the understanding that patients are at the core of decision making, not passive recipients of care of treatment. Evidence Based Practice means using the best available practice to guide care. This is conformed of research, theory and clinical decisions and judgment. Nurses need this research for the knowledge to provide good care, this is important in promoting professionalism and a good foundation of accountability. It has been argued that the force behind Evidence Based Practice has minimised the role that values have in care. Values based practice is an approach to healthcare which compliments evidence based. It is said that all opinions and views must be respected and should been seen as an opportunity to challenge and reflect on personal values and behaviours.

Evidence based practice has better clinical results on healing and treat the patient however values based practice is shown to have overall higher patient satisfactory. A five year study in hospitals units showed higher patient satisfaction where patient centered care had been implemented to those that had not.

Patient centered care involves family and friends in decisions and takes into account a person’s values and beliefs. It is an approach to healthcare which is grounded in partnering patients with families and built on concepts of dignity and respect. This concept is built on taking into account a patient’s values, beliefs, religion and not just taking into account the patient’s illness.

Advocacy refers to providing support for patients’ rights and their best interest. Advocacy allows the patients to be autonomous and ensure the nurses provides the client has access to all healthcare services that meet their needs meaning nursing and the patient are equally accountable and responsible for the outcome of care. In 2012 the Department of Health established a White Paper called Liberating the NHS: No Decision About me Without Me model this put in place for the basic foundation to ensure patients were included at all levels of the decision making process. However Langear et al (2001) identifies a person’s level of self-confidence may impact their willingness to participate in decisions this can lead to conflict when patients preference differs to what professionals think is the most effective treatment. Michaels et al (2008) states that tensions can arise if patients reject professional’s recommendation. A nurse’s values and beliefs can differ to a patients. Nurses tend to implement policy but can experience conflict when policy imperatives are not congruent with nursing values. A study by Fouriner,et al (2007) states that nurses became distressed by their failure to meet patient and resulting in them feeling ‘burnt out’ and classed this as ‘ moral distress’. Hemm and Heggen (2004) uses the story of the Good Samaritans to highlight the fact that nurses have a moral responsibility and a moral duty to society to care for the sick. Nurses daily come into conflicting views with their own. Abortion and euthanasia are two examples. The two contested concepts and ethical issues are based on values and not facts. In the debate over euthanasia with the outcome of a ‘Good Death’ is reflected in autonomy, if the patient has capacity to make their own choice then why should this be questioned. These ethical issues can sometimes impose on nurses morals and values however Blais and Hayes (2016), claim nurses have no right to impose their values on a client and nursing codes of ethics is to support clients right to information . Normat (2010) says ‘ Victim blaming of the ‘unpopular patient’ such as an alcoholic, drug addict ,or where their illness can be classed as ‘self-inflicted’ is not only bad practice from the nurse but shows they do not understand the social causes of that illness. Hemm and Heggen claim, that as a coping mechanism, nurses can start to become desensitised to people who are sick or in need and can lose their empathy and compassion, affecting their Prioritising People practice. Albert Bandura (1963) theory shows moral disengagement, dehumaning or blaming the victim, though nurses are ethically obligated to maintain a non-judgemental approach and attitude and to protects the clients right to confidentiality and resources. With the development of technology and medical advances nurses need to be comfortable when facing ethical issues such as euthanasia and abortion.

Nurses need to be able to implement the four P’s of practice to be able to provide a safe and effective care. The NMC code highlights the nurses role in advocacy to help individuals access relevant healthcare, information and support. Advocacy is a requirement that nurses should fulfill to patients who feel vulnerable or powerless. When a nurses values and beliefs differs to that of their patient can cause conflict however in a career such as Nursing, the nurse has to be an advocate and act as an interpreter between patient and doctor and put aside differences. The four P’s of nursing underpin the values and beliefs of healthcare practice. Nurses can acquire professional values during socialisation with other nurses, nursing experiences and peers. A nurse should be neutral and not ignore their own personal values but they need to be able to accept a client’s values in a non judgemental approach.