Introduction
Conceptual Explanation of Each Core Value
There are different reasons why different individual make a choice of taking up nursing as a lifetime career. These reasons may range from financial gains, personal, love for people, professional, or even for job security. Nevertheless, every individual who make that choice of becoming a nurse enters into a lifetime commitment regardless of his or her reasons of becoming a nurse. Consequently, every nurse commits to observe and adhere to the five core values necessary for taking up a career in nursing. These core values include: human dignity, altruism, integrity, social justice, and autonomy each of which is discussed below.
According to the American Heritage Dictionary of The English Language (1992, p. 522), the term “dignity” is defined as the “quality or state of being worthy of esteem or respect” it logically follows that the phrase Human Dignity may be used to denote respect for the inherent worth and uniqueness of individuals and populations. When dignity correlates along with the word “human,” it depicts the concept that each individual man, women, or child (the person) of any race, culture, or ethnic background deserves unconditional respect. The value of human dignity is the ability to have mutual respect for one another as we live together in this world. One would want to remember the “Golden Rule” of treating others as you would want to be treated.
The concept of Altruism is used to depict a genuine concern for the welfare and well-being of others. As defined under the American Dictionary of The English Language, 1992, p. 56 altruism is an unselfish concern for the welfare of others. According to the American Nurses Association (2010), altruism is a core value of every nursing response to provide care to all who are in need regardless of their culture, social, or economic standing” (The American Nurses Association, 2010, p.5).
Altruism is therefore a commitment of every nurse to provide services to others in a selfless way even if it means risking their own safety and health. The welfare of the patient comes first in this line of duty. Chitty & Black (2011) contend that, “practitioners are motivated by service or altruism and consider their work meaningful as oppose to the money made” (Chitty & Black, 2011, p. 66-67). It therefore, follows that health care professionals such as nurses must be dedicated to the ideal of “altruism” to be able to work with the public and the sick patients (some contagious).
Another core value in nursing is the aspect of Integrity. This means acting in accordance with an appropriate code of ethics and accepted standards of practice. The American Heritage Dictionary (1992) defines integrity as the “steadfast adherence to a strict moral or ethical code” (The American Heritage Dictionary of The English Language, 1992, p. 938). Laabs (2011) elaborates that having moral integrity embodies characteristics such as: honesty, trustworthiness, and doing the right thing even when others disagree (Laabs, 2011, p. 433). In addition, a person with integrity “always tries their best to do the right thing, it is not always easy, especially when pressed by time, intimidated by others, not supported in their beliefs, …admitting when one has made a mistake, or has not lived up to one’s moral code and, then doing what one can to make amends” (Laabs, 2011, p. 433).
To put it in a simple way, integrity as a core value of nursing requires that nurses must act and behave ethically, fairly, and honestly in conducting the highest standards of professionalism at all times. Even more important, a nurse commented that, “a person with [moral integrity] will not take short-cuts just because no one else is watching” (Laabs, 2011, p. 434).
The fourth core value of nursing is Autonomy. This term basically means the right to self-determination. The word autonomy is derived from a Greek word Autonomia, which means the condition or quality of being autonomous; independence” (The American Heritage Dictionary of The English Language, 1992, p. 126). According to Varjus, et al. (2011), autonomy may be defined as: The ability to direct one’s own life and to make one’s own decisions… in referring to the profession of nursing, it means the privilege of self-governance and referring to the individual nurses, it means the ability of nurses to make some decisions within their own profession and their right and responsibility to act accordingly to shared standards of that profession.
In addition, Chitty & Black (2011) emphasizes that nursing actions are independent but physicians strongly makes the decisions and supervises many of the nursing activities while nurse practice acts in many states have a role in determining nurses’ actions when authorized by supervising physicians or hospital protocols
Social Justice is the fifth core value in the nursing profession. It means the act of upholding moral, legal, and humanistic principles” Social means “living together in communities, relating to communal living, or relating to society” (The American Heritage Dictionary of The English Language, 1992, p. 1710). Justice on the other hand means upholding of what is just, especially fair treatment and due reward in accordance with honor, standards, or the law (The American Heritage Dictionary of The English Language, 1992, p. 978). In short, social justice is about equality and fairness between human beings.
In a personal communication, January 24, 2012 by Stone a professor at Presbyterian School of Nursing, stated that “as nurses, we are the advocate (fight for patients’ rights, freedom of choice, and equality) for our patients; therefore we question doctors, nurse practitioners, and others about medication dosages etc. when it doesn’t seem right…we speak out for the patients at the bedside when they cannot speak for themselves.” In all, we would build a stronger community and world by “upholding moral, legal, and humanistic principles”.
It therefore goes without saying that at all times; nurses must strive to uphold the aforementioned five core values regardless of the circumstance that they may be faced with. In so doing nurses can be able to treat everyone equally and also be able to put the interest of other before his or hers. This is because the nursing profession is a lifetime commitment to serve others, and all patients as well as their loved ones hold on the commitment of the nurses to adhere to these values. Failure to uphold these values would then result to the public losing faith in the system of healthcare.
Conceptual Explanation of Additional Student Selected Professional Values
Caring
It is worth mentioning that nursing is a caring profession. This profession emphasis ices the importance of the caring as it encompasses the connection of nurses with empathy for people. The professional value of caring amongst nurses can only be achieved through the aptitude of nurses to uphold the five core values in the nursing profession; these core values include autonomy, altruism, human dignity, social justice, and integrity. It therefore follows that caring professional nurses have to integrate the aforementioned core values in their day-to-day clinical practice.
Caring as a foundation for relationship is one of the most important professional value as a novice student and as an experienced nurse. Caring is defined as “the provision of what is necessary for the health, welfare, maintenance, and protection of someone or something” (Oxford Dictionaries, 2012). Furthermore, Suliman, et al. (2009) describes caring as a foundation for relationship upon using Watson’s theory on human caring relationships in suggesting that caring is centered on helping the patient in achieving peace within in the mind, body, soul, and through a transpersonal caring relationship.
As Chitty & Black (2011) elaborates on caring, they state that “nurses are encouraged to share their genuine selves with patients while the patients’ spiritual strength is recognized, supported, and encouraged…which leads to development of trusting and accepting relationships which feelings are shared and confidence is inspired ” (Chitty & Black, 2011, p. 309). In all, caring is one of the significant reasons why novice students choose nursing as a career path.
According to Sulimen et al. (2009), there are several caring behaviors which nurses should observe at all times. These behaviors include: appreciating the patient as human beings, showing respect for the patient, being sensitive to the patient, talking with the patient, treating information confidentially, treating patient as an individual, and listening attentively to the patient. (Sulimen et al., 2009, p. 294).
Public Figures Exemplifying Core Values
A public figure who exemplifies these core values of altruism, autonomy, human dignity, integrity, and social justice would be my local pharmacist who dispenses prescription medications to patients. Pharmacists aid the general public in answering questions to medication dosages, over the counter products, and to promote health. Pharmacists work in the healthcare field as well and they collaborate with doctors, nurse practitioners, and other health interdisciplinary for the well-being of the patients.
In comparison with the health profession of nurses, the pharmacist profession embodies their own values and beliefs with similar core values that were established in 1852 (founded by the American Pharmaceutical Association). The American Pharmacist Association (APhA), which is the first and largest association of pharmacist in the United States (American Pharmacists Association, 2012). It is worth noting that even the American pharmacists have some code of ethics which they ought to uphold at all times and they are set out under their preamble. Some of these values include inter alia respect of the relationship between the pharmacist and the patient; the pharmacist must also ensure that patients get the right medication, uphold their trust, and committed to safeguard the welfare of the patients.
- The pharmacist must also ensure that patients get the right medication, uphold their trust, and committed to safeguard the welfare of the patients.
- The pharmacists should also observe patient pharmacist confidentiality
- He must also uphold the dignity and autonomy of the patients.
- In his professional relationship a pharmacist should uphold the core values of integrity as well as honesty.
- Professional proficiency must also be observed at all times.
- They should also show respect to the abilities and values of other health practitioners and fellow pharmacist.
- They must be ready to sever all persons in need of their services at all times
- It is the responsibility of every pharmacist to uphold social justice in his professional services.
The American Pharmacists Association’s (APhA) is very similar to the American Nurse Association’s (ANA) core values of nursing. There are several professional core values that are shared by both the nursing and pharmacists professions such as altruism, autonomy, human dignity, integrity, and social justice. Both work in the health care industry and they work to promote health and well-being of the patient. Often a time, they collaborate with each other to bring all of these five core values together as one.
Life Experience of Core Values (Include Cultural Impact Perceptions)
Autonomy– “The right to self-determination”
Life experiences of autonomy, as a teenager is a duty and not an option in my culture, especially being the eldest girl. I had the responsibility of making decisions on my own, monitoring my siblings as they do their homework, bathing them, and cooking for them. Being the eldest amongst my siblings, every decision made is always looked at with consequences; therefore, one would have to make decisions wisely. As a daughter, one would have to take care of the younger siblings and to help clean and cook around the house. Housekeeping chores are given to the oldest and to the girls. Boys are considered much more important in the family and so they do not have to do anything.
Additionally, in the Hmong culture, we emphasize a more collective approach to decision making which involves the eldest to the extended family members. For instance, if my parents wanted a divorce, both would have to consult the elders to come together and talk about issues. Decision making in this situation is based on the elder’s ruling. The majority of elders will the parties to reconcile and eliminate the chances of a divorce. In all, autonomy in the Hmong ethnic background particularly in decision making is complicated especially among the young generation which is accustomed to the Western’s way of life and decision makings.
Human Dignity — “respect for the inherent worth and uniqueness of individual care”
There are instances where life experience of human dignity would arise such as an opportunity to feed the poor through a church program. In such instances, the Hmong United Methodist Church youth members have the opportunity to make sandwiches and to feed the less fortunate at the Uptown Shelter. This life experience was an eye-opener for me as a young adult. The act of feeding the poor and to serve those in need is an experience that is geared toward achieving human dignity across all social and cultural status and respect for one another regardless of race, color, and sex. In the end, we are all human beings in search of something-love, respect, shelter, self-esteem (using Maslow’s Basic needs).
Altruism–“a concern for the welfare and well-being of others”
The aspect of altruism cut across all aspects of human life from work place, school, or even in the family. In the Hmong culture, the oldest son in the family is the one who is responsible for looking after the elderly parents but since we live in American where the cultural setting is different, some of these traditional practices are not strictly followed. That notwithstanding the Hmong culture emphasizes the responsibility of the children to their parent or the elderly in the society which is clear indication altruism.
Consequently, care and respect for the elders by the young generation is highly emphasized and practiced in the Hmong culture. Altruism may also be reflected through voluntary work such teaching young children in their elementary education. My work experiences include working as a pharmacy technician, phlebotomist, nursing assistant, and a nursing student (clinical) at Presbyterian School of Nursing. All of the above work experiences involve the core value of altruism.
Clinical Examples of Core Values
Human dignity
An example of human dignity in nursing is treating all persons with equal respect and giving them adequate care regardless of their social status, race, sex, color or religious and political affiliations. All patients must be treated as one would treat his or her loved ones. Another example of this core value is knocking on the patient’s door before entering the patient’s room. Even when they are not well or cannot answer, one should preserve the patient’s dignity. We have to respect our patient all the time because the space has become their home or their environment.
Altruism
A clinical example of altruism as a core value of nursing may include nurses putting themselves in the way of patients who may be physically aggressive for purposes of safeguarding the wellbeing and safety of other staff and other patients. It can be also demonstrated through taking care of patients with contagious diseases such as TB, MRSA and others diseases like HIV. In addition, this value may be demonstrated through checking the safety of all patients when the nurse clocks in on duty. The student nurse should make sure that the bed is in the lowest position with the call bell at the patient’s side. The student nurse will evaluate the room to see if there are rugs or clutter in the room to prevent falls or injuries. These are an example of altruism because the patient’s welfare and safety is the priority of the student nurse when she starts her shift for the day.
Integrity
Some clinical example of integrity in the clinical setting is abiding by the hospital protocols and OSHA regulations. As a student nurse, one would want to follow aseptic technique when inserting a Foley Catheter even when the instructor is not around. A student nurse should wash his or her hands before getting into contact with any patient. This is upholding the core value of integrity. Taking care of patients belonging without misplacing or destroying them is also another clinical example of integrity in the nursing profession.
Autonomy
Nurses have the responsibility to give their patients all the facts and consequences of their health choices and give them the opportunity to decide the procedure they would want to take. This is an indication of autonomy in the nursing profession. As a student nurse in clinical, we are not licensed yet but we are allowed to have some decision making in the order of selecting patients in doing a health assessment and checking patient vitals. One could do it in any order but in a systematic way and chart it in the computer system so that the registered nurse could administer medications to patients accordingly.
Social Justice
An example of this core value in clinical would be when a student nurse stands up for a patient who may not be able to speak fluent in English. That patient may require a translator while the doctor is making his rounds to the unit. As a student nurse, one should immediately call to see if there is a translator available for the next doctor round before the patient is discharge. It is therefore the responsibility of the nurse to arrange for a translator to facilitate decrease the frustration of language barrier and increase a better understanding of the patient as a whole (culturally). Language barrier should therefore not be a reason to deny a patient his or her right to quality health care and that is where the exercise of the core value of social justice comes into play.
Summary and Reflection
Each person in the nursing program has various reasons of becoming a nurse. Some examples such as personal, job security, professional education (science), or just love to be around people. Each one of us has decided to take on this life long journey. In an effort to achieve the mission and vision of the nursing profession, every nurse commits to observe and adhere to the five core values necessary for taking up a career in nursing.
These core values include human dignity, altruism, integrity, social justice, and autonomy. Even though there are many other values that ought to be observed in the nursing profession, the aforementioned values form the basis of this profession and they should be upheld at all time regardless of the circumstances. Indeed, these core values help to guide novice students and practitioners in the nursing profession. It should also be noted that culture has a vital role to play in evaluating personal values and trying to reflect on the five core values of this paper.
The nursing career is a demanding profession and it is forever changing in a time of new technologies, but the core values of altruism, autonomy, caring, human dignity, integrity, and social justice will stand firm. These values cannot be separated from a truly professional nurse.
References
American heritage dictionary of the English language. (1992). Altruism. Social justice, human dignity, integrity, and autonomy. Boston, MA: Houghton Mifflin Company.
American Nurses Association. (2010). Nursing’s social policy statement: The essence of the profession. Silver Spring, MD: Nursebooks. Web.
American Pharmacists Association. (2012). Code of ethics for pharmacist. Web.
Chitty, K., & Black, B., (2011). Professional nursing: Concepts and challenges. St. Louis, MO: Saunders/Elsevier.
Laabs, C., (2011). Perceptions of moral integrity: Contradictions in need of explanation. Nursing Ethics, 18(3), 431-440. Web.
Oxford dictionaries. (2012). “Caring.” Oxford University Press. Web.
Suliman, W., et al., (2009). Applying Watson’s Nursing Theory to Assess Patient Perceptions of Being Cared for in a Multicultural Environment. Journal of Nursing Research (Taiwan Nurses Association), 17(4), 293-300.
Varjus, S., et al., (2011). Professional autonomy of nurses in hospital settings-a review of the literature. Scandinavian Journal of Caring Sciences, 25(1), 201-207. Web.