The Metaethics of Nursing Codes of Ethics and Conduct

Nursing codes of ethics and conduct are features of professional practice across the world, and in the UK, the regulator has recently consulted on and published a new code. Initially part of a professionalising agenda, nursing codes have recently come to represent a managerialist and disciplinary agenda and nursing can no longer be regarded as a self-regulating profession.This paper argues that codes of ethics and codes of conduct are significantly different in form and function similar to the difference between ethics and law in everyday life. Some codes successfully integrate these two functions within the same document, while others, principally the UK Code, conflate them resulting in an ambiguous document unable to fulfil its functions effectively. The paper analyses the differences between ethical- codes and conduct-codes by discussing titles, authorship, level, scope for disagreement, consequences of transgression, language and finally and possibly most importantly agent-centeredness. It is argued that conduct codes cannot require nurses to be compassionate because compassion involves an emotional response. The concept of kindness provides a plausible alternative for conduct-codes as it is possible to understand it solely in terms of acts. But if kindness is required in conduct-codes, investigation and possible censure follows from its absence. Using examples it is argued that there are at last five possible accounts of the absence of kindness. As well as being potentially problematic for disciplinary panels, difficulty in understanding the features of blameworthy absence of kindness may challenge UK nurses who, following a recently introduced revalidation procedure, are required to reflect on their practice in relation to The Code. It is concluded that closer attention to metaethical concerns by code writers will better support the functions of their issuing organisations.

Approaching Models of Nursing from a Postmodernist Perspective

This paper explores some questions about the use of models of nursing. These questions make various assumptions about the nature of models of nursing, in general and in particular. Underlying these assumptions are various philosophical positions which are explored through an introduction to postmodernist approaches in philosophical criticism. To illustrate these approaches, a critique of the Roper et al. model is developed, and more general attitudes towards models of nursing are examined. It is suggested that postmodernism offers a challenge to many of the assumptions implicit in models of nursing, and that a greater awareness of these assumptions should lead to nursing care being better informed where such models are in use.

The Art of Nursing in a Postmodern Context

Notions of the "postmodern" pervade various fields of study, but have rarely been applied to the practice and theory of nursing. This paper uses some conceptions of the "postmodern" to remedy this. Though there are many contested usages of the term, here "postmodern" will be used broadly in a periodical sense to trace changes in society and culture from the "modernism" of the 18th and 19th centuries to current concerns about "postmodernism". How these changes have been reflected in nursing practice and nursing theory will be explored. The changing use of the term "modern" to describe up-to-date practice will be addressed in the course of this. It is suggested that contextualizing nursing as a social/cultural activity in this way offers perspectives which will help us untangle the conflicting agendas and issues which form the fabric of the social world in which current nursing takes place, enabling us to act more effectively in promoting our own professional agendas.

Poetry With People With Dementia: An Evaluation of a Two Year Project Engaging in Poetry Activities With Older People in Residential and Nursing Homes.

This paper is a summary of an evaluation of the first two years of a three year poetry project for older people with dementia. The project was set up with a poet in residence who mentored six poets to deliver poetry activities to older people and those with dementia in residential and care homes in Herefordshire. The project was developed and run by the Courtyards Hereford. The evaluation was undertake through the use of questionnaires that were given to staff and carers undertaking training workshops and the poets, staff and carers in the homes who facilitated the activities and finally by the residents who took part in the project. The main findings were that participants that responded to the questionnaire for staff and carers it had increased confidence and assisted them in gaining more knowledge about the residents, whilst for residents it had a number of positive effects including enhanced communication, increased self-esteem and enhanced self-worth whilst making them feel less isolated.

Towards the End of Life: an In-depth Exploration of the Role of Admiral Nursing in Dementia Care (Innovative Practice)

There are approximately 150 Admiral Nurses in the UK who work alongside other health and social care professionals to support people with dementia and their family carers. However, the stigma of the disease and the lack of recognition that dementia is a life limiting illness have led to neglect in addressing the end of life challenges. The small in-depth study reported here aimed to add to an extremely limited formal evidence base for the effectiveness of this approach and to develop a greater understanding of the range of knowledge and skills required of them in ensuring they are better able to support families in the later stages of the illness. Findings focus on the experiences of family carers, the impact of performing the Admiral Nurse role and the use of qualitative measures in this setting.