Spiritual and Cultural Values in Nursing Ethics

Introduction: Ethics and Moral Values in Nursing

What spiritual and cultural values come into play for a nurse on the job — whether caring for a seriously ill patient or conducting a routine physical checkup? Ethics and moral values play a central role in the healthcare field, and especially for nurses, who often provide patient-centered, one-on-one care in hospital or clinical settings. A nurse must set the bar high when it comes to integrity, ethics, morals, and respect for all people, including those from other cultural backgrounds. This is a standard worth upholding not just professionally but in personal life as well; after all, a nurse cannot be a cold, heartless, indifferent person in private and then become an ethical, caring, moral professional at work. This paper uses scholarly research to accurately portray the ethical and moral values a nurse must possess to be effective — and to a large extent, those values reflect deeply personal beliefs and practices.

Human Love as the Foundation of Nursing

In the Scandinavian Journal of Caring Sciences, Kangasniemi and Haho reference a nursing textbook written in 1911 by Swedish nurse Estrid Rodhe, which remains valuable today because of its emphasis on the altruism and unselfishness nursing should represent. Rodhe's book highlights nursing knowledge, the ethical requirements of the profession, and, as the authors note, "Understanding the past helps us comprehend current issues in nursing" (Kangasniemi, et al., 2012). Rodhe's achievement is remarkable for going beyond job-related and healthcare-related concerns to address the very heart of nursing — the ethical values that must be practiced in order to provide the greatest possible care for patients.

This book was unique for several reasons. Most notably, very few nursing textbooks at the time focused on ethical values. The book's title was About Nursing Ethics, and it was the "very first textbook in Finland that focuses on nursing ethics" (Kangasniemi, 803). It was also the first nursing textbook actually written by a nurse; the next textbook to address nursing ethics from a nurse's perspective would not appear for another seventy years. In the intervening period, whatever nursing texts appeared on the subject were written by "physicians, theologians or educators" (Kangasniemi, 803).

The authors remind readers that a theoretical premise for any profession is never "independent of the current period and context" and is "under constant change" (Kangasniemi, 804). This is certainly true of nursing and of the society that nurses serve. The field has changed considerably, shaped by technological innovation and the continuing high cost of healthcare. And yet, no matter how the profession evolves, the need for an ethical approach to care remains constant.

There is a deep obligation and moral commitment to living up to the highest standards in healthcare. When one considers the conditions under which nurses in Rodhe's era were obliged to work, gratitude for modern-day practice seems entirely appropriate. Yes, there are challenges — sometimes the workload is outrageous in terms of overtime and the ongoing shortage of qualified nurses — but working in the 21st century, compensated fairly based on talent, experience, and knowledge, is something to be genuinely appreciated.

Credit should always be given to Florence Nightingale for her pioneering emphasis on nursing values in the late nineteenth century, but a great deal of credit belongs to Rodhe as well. In the years Rodhe worked, nurses were "subordinated to physicians"; their pay was very low, their working hours brutally long, and there was a "scarcity…of educated nurses and care materials" (Kangasniemi, 804). The record shows that nurses in the late nineteenth and early twentieth centuries were deeply committed to their patients and willing to bear many burdens in service of that commitment — a legacy that demands respect.

Estrid Rodhe and the Origins of Nursing Ethics

Reflecting on that legacy encourages a deeper assessment of personal values, including spiritual ones. Those whose caring hands are trained to help others in need are often sustained by belief in something greater than themselves. One need not be affiliated with a specific religion or denomination to hold a spiritual outlook — to believe that every person is here for a purpose, and that for a nurse, that purpose includes stewardship toward others. Rodhe's entire professional life was an expression of love: the love that goes into caring for an ill or injured person. That need is no less urgent today.

Further research in A History of Nursing: The Evolution of Nursing Systems from the Earliest Times to the Foundation of the First English and American Training Schools for Nurses (Nutting, et al., 1912) reveals that Rodhe was also the editor of the Swedish Nurses' Journal, launched in 1909. This demonstrates a level of professional leadership that went well beyond writing a single book. The journal appears to have been the first of its kind in the nursing profession, and Nutting describes it as having a "fine, high tone and point-of-view in nursing matters" (251).

Nutting further characterizes Rodhe as a "strong, true, lofty character of most winning personality" (251) and describes her as "deeply absorbed in all the work of organisation going on among nurses over the world" (251). Rodhe — a figure whose legacy any ethically committed nurse might aspire to emulate — was "full of the joy of sharing in it to the full, when, in August, 1911, she was suddenly taken away by death"; she would "long be truly mourned by nurses at home and abroad," Nutting wrote (251). Her book was published the very year she died, which makes its appearance both coincidental and deeply poignant.