‘Practice what you preach’: Nurses’ perspectives on the Code of Ethics and Service Pledge in five South African hospitals

Abstract

BackgroundA recent focus of the global discourse on the health workforce has been on its quality, including the existence of codes of ethics. In South Africa, the importance of ethics and value systems in nursing was emphasised in the 2011 National Nursing Summit.ObjectiveThe study explored hospital nurses’ perceptions of the International Code of Ethics for Nurses; their perceptions of the South African Nurses’ Pledge of Service; and their views on contemporary ethical practice.MethodsFollowing university ethics approval, the study was done at a convenience sample of five hospitals in two South African provinces. In each hospital, all day duty nurses in paediatric, maternity, adult medical, and adult surgical units were requested to complete a self-administered questionnaire. The questionnaire focused on their perceptions of the Code of Ethics and the Pledge, using a seven-point Likert scale. STATA® 13 and NVIVO 10 were used to analyse survey data and open-ended responses, respectively.ResultsThe mean age of survey participants (n=69) was 39 years (SD=9.2), and the majority were female (96%). The majority agreed with a statement that they will promote the human rights of individuals (98%) and that they have a duty to meet the health and social needs of the public (96%). More nuanced responses were obtained for some questions, with 60% agreeing with a statement that too much emphasis is placed on patients’ rights as opposed to nurses’ rights and 32% agreeing with a statement that they would take part in strike action to improve nurses’ salaries and working conditions. The dilemmas of nurses to uphold the Code of Ethics and the Pledge in face of workplace constraints or poor working conditions were revealed in nurses’ responses to open-ended questions.ConclusionContinuing education in ethics and addressing health system deficiencies will enhance nurses’ professional development and their ethical decision-making and practice.

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“…Based on the findings of our study and other studies [35][36][37][38] we therefore emphasize the need for a multi-level intervention targeted at improving working conditions and reducing health system deficiencies to promote HCP professional development and quality of patient care. To improve professionalization of HCPs, we recommend training on personalised, culturally and contextually appropriate care [39,40], which can be included in university curricula for medical and nursing students and in the regular in-service training for HCPs.…”

Transforming nursing policy, practice and management in South Africa

“…White et al explore hospital nurses’ perceptions of the international Code of Ethics for nurses, their perceptions of the South African Nurses’ Pledge of Service, and their views on ethical practice ( 19 ). The majority of study participants agreed with a statement that they will promote the human rights of individuals (98%), and that they have a duty to meet the health and social needs of the public (96%) ( 19 ).…”

“…White et al explore hospital nurses’ perceptions of the international Code of Ethics for nurses, their perceptions of the South African Nurses’ Pledge of Service, and their views on ethical practice ( 19 ). The majority of study participants agreed with a statement that they will promote the human rights of individuals (98%), and that they have a duty to meet the health and social needs of the public (96%) ( 19 ). More nuanced responses were obtained for some questions, with 60% agreeing with a statement that too much emphasis is placed on patients’ rights as opposed to nurses’ rights and 32% agreeing with a statement that they would take part in strike action to improve nurses’ salaries and working conditions.…”

The workers opinions have a value in the Code of Ethics: Analysis of the contributions of workers in virtual Forum Catalan Institute of Health

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