Integrity and Mental Health Nursing: Factors to Consider

Abstract

Integrity is interpreted as a holistic phenomenon that incorporates personal characteristics, cognition, interpersonal awareness, and practical enactment-ultimately relating to matters society deems worthwhile. This approach enables integrity to be understood as both a personal morality and a social (group) morality. Mental health nurses embedded in a hierarchical bureaucratic organisation may act according to their personal morality and display moral strength in many situations; however, if the social morality of the group is at variance with their convictions, as individuals their capacity to be courageous and enact integrity will be tested. A likely consequence will be that those with the most cherished positive patient care values, those with a stronger adherence to moral convictions about the public good, and those with a clearly developed understanding of integrity parameters will depart, and possibly leave the profession. In this article, we provide an overview of the structural and contextual realities of nursing work within organisations and discuss how these factors can compromise whole unit integrity and seriously challenge mental health nurses' commitment to enacting integrity. In the final section of this article, broad suggestions for strengthening individual and group integrity are provided.

A threat to our integrity – Meanings of providing nursing care for older patients with cognitive impairment in acute care settings

“…Examples are stress of conscience, moral integrity, moral distress, professional commitment and burnout . Studies show that they are related to health professionals' experiences of not providing good care and not receiving help and support to avoid cynicism and to maintain sensitivity in the meeting with vulnerable patients . In other words, there seems to be at least a theoretical relationship between these concepts and patients suffering from care .…”

“…It has also been shown that if organisational obstacles hinder the pursuit of professional goals, negative emotions arise among nurses . This can force nurses to deaden their conscience to continue working in health care, potentially at the expense of their own identity as a good nurse, as irreconcilable demands and expectations may bring on ‘stress of conscience', which in turn can lead to burnout .…”

“…Results from several studies support the need to a radical rethink of healthcare practices in order to protect the personal–professional integrity of healthcare professionals thereby ensuring humane care and patient integrity . Considering integrity of practice at a group level is paramount as patient care invariably involves teamwork . It appears that a general organisational effort is necessary to support nursing staff and others in acute care .…”

Nurses’ experiences of unprofessional behaviors in the emergency department: A qualitative study

“…There is a need to recognize that nurses need to feel valued and supported, and as such, managers need to work on improving communication with nurses (Reid Ponte, Kruger, DeMarco, Hanley, & Conlin, 2004). As effective leadership and organizational culture are predictors of organizational outcomes (Smith, 2015), nurse leaders have a pivotal role to play in creating a healthy work environment that fosters a sense of coherence among staff (Bowen, Privitera, & Bowie, 2011;Reid Ponte et al, 2004), promotes professional behaviors and practices (Cleary & Horsfall, 2013), and reduces bullying and violence. As the ED is a stressful working environment for staff that leads them to exhibit unprofessional behaviors, human resource managers suggest devoting time in instilling positive resources of efficacy, optimism, and resilience to support positive staff work performance (Avey, Luthans, & Jansen, 2009;Griffin, Neal, & Parker, 2007).…”

Stress of Conscience Questionnaire (SCQ): exploring dimensionality and psychometric properties at a tertiary hospital in Australia

“…The impetus for Glasberg and colleagues [3] to develop the SCQ came from their review of literature, which identified a gap in tools for assessing the phenomenon associated with everyday stressful workplace situations in which health professionals perceived that their actions or inactions contradicted their conscience. In addition, ethical studies in health care linked failure to heed the voice of conscience with negative workplace outcomes such as health professionals distancing themselves from persons in need of care clients, experiencing burnout, ill-health and staff attrition [7][8][9][10][11]. Based on these findings, Glasberg et al [3] developed the SCQ and hypothesised that stress of conscience could be used as an early predictor of such negative workplace outcomes.…”