From the nightingale’s oath to the nurse’s oath

What virtues should inform nurse practitioner (NP) practice?

This is an issue I’ve been combating for years. I think that NPs will answer this query otherwise, depending on their experiences, background, culture, and moral commitments. Some may disagree with the a part of the reply I ultimately arrived at. That’s okay. My goal shouldn’t be to manage a final oath to all parliamentary members, but to encourage reflection on the type of healthcare professionals we would like to turn into.

My journey into nursing has been quite personal.

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When my friend and I were nine years old, he died of relapsed lymphoma. He spoke concerning the compassion shown by nurses, doctors and other health care staff as they cared for him. After his death, I noticed that I desired to honor God and my friend by identifying with one of the vital trusted healing and caring professions – nursing. At my graduation ceremony, I swore to uphold the Nightingale Oath. This solidified my identity as a nurse.

Years later, after practicing pediatric critical care as each a nurse and an NP, I returned to the query: What moral vision should guide my NP practice?

Doctors have been looking into this for a very long time The Hippocratic Oath. Nurses have The Nightingale’s Oath. But NPs occupy a singular space. We concentrate on nursing, diagnosing, treating, prescribing, advising and promoting health. As I reflected on these responsibilities, I started to wonder if there have been virtues that deserved articulation from the attitude of NP practice itself.

At the identical time, I noticed that our role is different from the professions that first developed lots of the standard health care oaths. NPs come from a wide range of backgrounds, traditions, denominations, and viewpoints. For this reason, I don’t expect every IBO to agree with every element of the vision I ultimately develop. Nevertheless, I believe it’s price asking this query.

The seek for answers led me to delve into the history of nursing, the origins of the NP role and the place of the skilled oath in health care.

A brief history of nursing and nurses

My journey began by learning concerning the history of nursing. I learned that nursing grew out of caring for others in homes and communities before developing right into a science and a occupation. Throughout history, nurses have cared for others through relationships, service, and take care of the vulnerable.

I came upon that Florence Nightingale and Isabella Robb helped shape nursing right into a occupation defined not only by technical skill but additionally by character. Trustworthiness, confidentiality and dedication to the patient’s well-being became central and reflected the right nurse seen in The Nightingale’s Oath.

Much later, in 1965, a pediatric nurse Loretta Ford and pediatrician Henry Silver developed the NP role to expand access to care while maintaining the holistic orientation of nursing. NPs inherited responsibilities from each nursing and medicine, but our role has never developed a unifying oath that clearly connects our nursing roots with expanded clinical responsibilities.

Articulating the virtues that shape NP practice

As I read, I became increasingly more excited about the role of the skilled oath.

Codes of ethics are essential. They provide guidelines on skilled conduct and responsibility. But the oath serves a special purpose. The oath expresses the variety of skilled an individual desires to turn into.

This distinction stuck with me. In addition to skilled adherence, I wanted to precise the qualities that I imagine should shape my very own NP practice. I desired to remain firmly grounded in nursing while being aware of the responsibilities of diagnosing disease, prescribing treatment, coordinating care, promoting health, and performing clinical judgment.

My research led me to an idea internal morality of NP practice– by which I mean the moral obligations that arise from the practice of being an IBO yourself. While others may discover a wide range of commitments, I used to be drawn to ideals resembling healing, helping, serving the patient’s well-being, stopping harm, respect for dignity, truthfulness, humility, shared decision-making, and mentorship.

The Nurse’s Oath

The following is a major a part of my proposal The Nurse’s Oathpublished within the magazine Ethics and medicine, is my attempt to precise these commitments. In our health care system, increasingly driven by technology and efficiency, nations must not lose sight of the healing and caring relationship at the middle of care.

The Oath reminds us that our role as IBOs is ultimately one among service to vulnerable human beings. I offer this not as the ultimate word on NP identity, but as one NP’s try and answer the query: What virtues should shape NP practice?

“I solemnly swear to God, my patients and the interior morality of the practice of nursing that my goal shall be only to heal and help, to not harm, and when healing shouldn’t be possible, only to assist. Out of respect for dignity, I’ll promote the health of patients in harmony with the natural functions of the human body and I could have no intention of ending my life with my practice… To this end, I’ll maintain the trust of patients and other health care professionals and maintain the authenticity of our relationships of helping and healing beyond service for the great of the patient. I’ll educate my patients about disease processes and supply them with education on how they will proceed to live well to the very best of their ability. I won’t take any medications or therapeutic agents that affect the care of patients and I won’t prescribe or administer therapies that won’t provide physical, mental or financial relief to my patients, but I’ll moderately not take part in practices wherein I even have no specialized knowledge, but moderately I’ll use the knowledge of a certified person to coach and mentor young people on this occupation, I’ll leave this noble practice to those that will uphold these goals inherent in the interior morality of nursing practice.

Readers’ views on the proposed IBO commitment are welcome.

Author: Jesse Michael Kay, assistant professor of pediatrics within the Department of Critical Care Medicine at Baylor College of Medicine and a critical care nurse and group ethics consultant at Texas Children’s Hospital