The conduct of nurse managers, and health service managers more widely, has been subject to scrutiny and critique because of high-profile organisational failures in healthcare. This raises concerns about the practice of nursing management and the use of codes of professional and managerial conduct. Some responses to such failures seem to assume that codes of conduct will ensure or at least increase the likelihood that ethical management will be practised. Codes of conduct are general principles and rules of normative standards, (...) including ethical standards, and guides for action of agents in particular roles. Nurse managers seem to stride two roles. Contra some accounts of the roles of a professional (nurse) and that of a manager, it is claimed that there is no intrinsic incompatibility of the roles though there is always the possibility that it could become so and likewise for codes of conduct. Codes of conduct can be used to support nurse managers in making practical decisions via an ‘outside in’ approach with an emphasis on the use of principles and an ‘inside out’ approach with an emphasis on the agent’s character. It is claimed that both approaches are necessary, especially as guides to ethical action. However, neither is sufficient for action because judgement and choice will always be required (principles always underdetermine action) as will a conducive environment that positively influences good judgement by being supportive of the basic principles and values of healthcare institutions. The response to the Covid-19 pandemic has created a unique set of circumstances in which the practical judgement, including ethical judgement, of nurse managers at all levels is being tested. However, the pandemic could be a turning point because staff and institutions (temporarily) freed from managerialism have demonstrated excellent practice supportive of ethical and other practical decision making. Organisations need to learn from this post pandemic. (shrink)

This article presents the works of great Polish philosopher, Mieczysław Albert Krąpiec, whose creative output can be applied to professional nursing practice. Krąpiec's philosophical heritage is extensive and encompasses many philosophical fields: metaphysics, philosophical anthropology, philosophy of law, philosophy of culture, philosophy of politics and philosophy of language. Krąpiec created an original philosophical synthesis characterized by a realistic approach. In this paper, I present only one of several original philosophical concepts developed by Krąpiec: the theory of the person based on (...) seven essential characteristics, that is the ability for cognition, love, freedom, religion, legal subjectivity, completeness and dignity. I attempt to show how these personal characteristics correspond to various patient needs. I argue that the qualitative deficit of any personal characteristics indicated by Krąpiec corresponds to a patient's real need that must be satisfied. I also stress that the skilful diagnosing of all—not only selected—qualitative deficits of characteristics can be defined as holistic care in the nursing profession. (shrink)

This is lightly edited and referenced version of a presentation given at the 20th International Philosophy of Nursing conference in Quebec on 23rd August 2016. Philosophical texts are not given the same prominence in nurse education as their more valued younger sibling, primary research evidence, but they can influence practice through guidelines, codes and espoused values. John Stuart Mill’s harm principle, found in On Liberty, is not a universal law, and only a thoroughgoing libertarian would defend it as such, though (...) it, or its remnants, can be seen can be seen in policy documents. But its influence is weakening. Smoking bans in enclosed spaces were initially justified with other‐regarding considerations, but judgements from unsuccessful legal challenges from patients in UK psychiatric hospitals rely on preventing harm to the smoker, even when smoking outside, which does not harm others. In the wake of legislation, no‐smoking policies enacted by hospitals are becoming more aggressive, banning smoking both inside and outside, and extending the use of power gained through employment to prevent nurses assisting patients enjoy a lawful habit. Mill’s dictum has been subverted, and this speaks to the fundamental purpose of nursing. Should nurses collude and willingly exert their power for their version of the good of the patient? Or should they instead reaffirm values that support and facilitate life choices made by autonomous people? The paper supports the latter option, and this has wider application for nursing which can be illuminated, if not settled, by revisiting Mill and his famous dictum. (shrink)