With all the concern about ethics today, little attention is paid to the way healthcare professionals treat one another. Nonetheless, the ethics of a profession delimit the role and scope of its activities and prescribe the nature of the relationship that should exist between its members and the lay public. A profession’s ethics also should establish the duties professionals owe to one another and the profession.
As nurses assume their professional identities, they are pledged to the work of understanding, interpreting, sharing, and expanding the profession’s knowledge; the equally disciplined work of critique and self-regulation; and developing and cultivating in themselves and their colleagues the character traits on which personal and professional excellence depend.
The ethical principles undergirding professional relationships derive from several sources:
- obligations and duties every human being has to another human being
- nurses’ obligation to help ensure and promote the public’s welfare (on both an individual and a societal level).
The third source is more difficult to summarize succinctly because it speaks to the nature of professionals’ mutual obligations to help one another and the profession to ensure competent care of individuals and populations—the handling of incompetent colleagues, freely sharing information and research that improves patient care, and determining where collegial loyalty begins and ends.
In terms of the sociology of the profession, the function of the professional relationship may be described as modeling, role modeling, and role internalization. The latter occurs when individuals begin to identify with their role models and internalize their behavioral patterns both consciously and unconsciously. Some have said nurses today have difficulty identifying with role models because there are so many levels and specialties in practice. If true, this creates a void for both nursing students and graduate nurses who need models of excellence. To some extent, deficits in role inculcation may relate to the educational model adopted by the nursing discipline. In misguided attempts to improve the educational status of nursing, students often have been “protected” from interaction, with the rationalization that such interaction smacks of the old apprenticeship model of education.
All experts were beginners or apprentices at one time who were guided and molded by master craftsmen. If nursing students remain apart from the mainstream of nurses’ work, they likely will develop allegiances to others whose work they know and admire. As a result, for many nurses, the professional bond in nursing is weak and may remain that way for their entire careers, because they don’t develop a professional identity. This, I believe, is the source of criticism of nurses who identify more with medical practice than nursing practice; it’s not so much what they learn, but from whom they learn. And certainly it is part of the reason many nurse managers identify more with management than with nursing.
Clearly, the structure of work in most facilities requires nurses to function interdependently—to recognize and trust their colleagues’ professional expertise. Mature recognition of their own capabilities and limits leads nurses to rely on and incorporate the knowledge, experiences, and research of other professionals in their own practice. To the extent that nurses recognize their interdependence, their commitment to common goals, the similarity of their fundamental knowledge base, and their indebtedness to the nurses who went before them, they will be willing to devote themselves to advancing their profession and promoting the growth of younger colleagues.
As a caring profession, nursing involves not only care for and of patients, but also care of and for nurses. Nurses may not fully appreciate the importance of intra-professional relationships if they focus their ethical concern solely on social and patients’ issues. Although challenging, nurses’ professional interdependence demands a special relationship among them: one worthy of ethical reflection.
Leah Curtin, RN, ScD(h), FAAN
Executive Editor, Professional Outreach
American Nurse Today