Abstract
Becoming a mental health nurse and learning to reason: a personal view
As a student nurse in 2014, I am taught that I have a responsibility to be an ethical practitioner. I am taught to trust my instincts, and to blow the whistle should I have no alternative course of action, whether that is on placement or during my career. I am taught to question things I don’t agree with, be inquisitive, and be open about my practice. This is ingrained as an essential response to any given situation, and correctly so.
I am also taught about the Nursing and Midwifery code of conduct (2008), and how it contains guidelines for how I am to perform in a professional setting. From principles relating to the boundaries of therapeutic relationships with service users, to our professional opinions relating to illicit drug use. To my mind these two schools of thought have the potential to be contradictory, in that it is impossible to be both entirely true to your own ethical values, and also that of the code if they conflict. I also would suggest that certain cultural differences are not being taken into account by having a code of conduct, and that aligning my views with those presented in the code of conduct would be more likely to give me feelings of disempowerment and helplessness, rather than the confidence in self needed to positively influence peoples care.
So what do I follow?
I believe that most student nurses have a very strong sense of ethical principles, and follow these when they are in a work setting, however being taught the NMC code (2008) might be more likely to encourage students to think of ethical decision making as an act which must be governed by documentation, and referenced. Surely the most successful course of action would be to attempt to create ethical thinkers, who are taught not what to do in a situation of ethical ambiguity, but more how to think about what to do in these situations. This is of course a more difficult path to follow, since teaching someone to have ethical principles versus teaching someone to follow a code is equivalent to asking someone to undertake a long journey, guided by intuition instead of using a map. Of course not everybody would profess to be confident in making ethical decisions, this kind of decision-making ability takes practice through discussion, and learning to be willing to see situations from different perspectives, using different ideologies. It is not a quick process, especially when students are often hastily put into practice after arriving at university.
Perhaps it is fair to say that some are more accustomed than others naturally to take on these dilemmas, perhaps a broad range of students are catered for as well as possible. This said I certainly believe that to offer a deeper understanding of why particular action is right or wrong, young nurses must be encouraged to develop and hone their acute decision making skills in order to take them confidently into practice.
References:
Nursing and Midwifery code of conduct (2008) Standards of conduct performance and ethics for nurses and midwives [online] available from: http://www.nmc-uk.org/Documents/Standards/nmcTheCodeStandardsofConductPerformanceAndEthicsForNursesAndMidwives_LargePrintVersion.PDF [accessed 10 October 2014].
Biography
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