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.

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.

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.

Promoting the 6Cs of Nursing in Patient Assessment

Recognising the deteriorating patient is an essential nursing skill, and structured frameworks should be in place to assist effective patient assessment. The aim of this article is to encourage nurses to consider how to promote the 6Cs of nursing within such assessment. The article provides an overview of the Patient Assessment and Clinical reasoning Tool designed to facilitate the development of clinical reasoning skills and effective communication with other healthcare professionals, therebyenhancing patientcentred care.