The NMC Code in the light of Jesus – ‘Preserve Safety’

(Read The Code online – The Nursing and Midwifery Council (nmc.org.uk)

I have recently been prompted to re-engage with our Nursing and Midwifery Code of Professional Conduct, and in this blog, I consider this in light of the biblical principles by which I seek to live my life. Perhaps one of the things that prompted me was an awareness that we often see a failure to meet professional standards. This can be due to workload pressure, time constraints, and resource limitations. However, despite workload pressures, our duty of care remains the same; we are accountable for our practice, and we must continue to aim to meet standards of care consistently.

‘Do unto others’

When a parent entrusts their baby to a midwife’s care, the midwife assumes the responsibility of ensuring the child’s safety. Similarly, when an elderly person visits our clinic for their annual review and advice on managing their long-term condition or new dementia diagnosis, we are responsible for their safety and wellbeing. This is not just a professional duty but a personal commitment we made when we became nurses and midwives. I’ve been examining each of the four critical elements of our professional code of conduct, considering how we can embody these principles in our workplace, guided by the teachings of Jesus. I hope this revisiting of The NMC Code serves as a helpful and motivating reminder.

‘Preserve safety’ (Sections 14 to 19) as an element of our Code is broad, somewhat general, but nonetheless highly relevant. It is a cornerstone of our practice, guiding us to ensure the safety of our patients and honouring them as if they were members of our own family. One of the foundational teachings of Jesus in the Sermon on the Mount was ‘to do to others what you would have them do to you’ (Matthew 7:12). We can all too easily lose sight of this gold standard in our busy daily schedule, and sometimes it may feel easier to cut corners in the name of speed and efficiency. However, safety and person-centred care are essential within all clinical contexts. This can range from being meticulous about checking and double checking the medications we administer to using infection control measures and aseptic non-touch techniques in administering best practices in clinical practices such as wound care. Whatever the aspect of care we are involved in, patient safety and well-being should be at the forefront of our minds.

Practically speaking, this will mean keeping up with clinical competencies, no matter how arduous mandatory training sometimes feels. Remembering that part of our duty of care is to ensure we work within the limits of our competence often means being aware of the skills of others in the team and asking for their help, advice and support. Recognising one another’s gifts and abilities and working as a team can be strengthening and empowering. However, it also takes a dose of humility and honesty to ask a colleague for their help. Team relationships and rapport are built through episodes of shared care, and we realise we are stronger together.

Consider your work setting; how have you had to preserve patient safety this week, and how did you feel about this?

Duty of Candour

The ‘duty of candour’ as an element of the Code (Section 14) means that we carry out our clinical nursing practice with transparency and honesty, raising concerns immediately whenever we are involved in situations that put patients or public safety at risk. An example of this may be when an incorrect dose of medication has been given, or a medication that should have been given has been missed for some reason.

In Matthew 5, Jesus guides us to be clear in our communication, saying in verse 37, ‘All you need to say is simply “Yes” or “No”’. We should seek to be open and honest to keep things clear and avoid mixed messages. We can give a gentle response and yet still be definite and professional in our communication, though this is a communication skill about which we are always learning and in which we can always improve.

The professional duty of candour is about being open when things go wrong, reporting errors, and seeking to put measures in place to ensure these don’t happen again. Safe clinical practice can be achieved if we recognise and work within the limits of our competence, recognise when we have reached the limit of our own ability, and refer in a timely manner to ensure help is accessed from another suitably qualified, experienced professional.

Are there any times when you have needed to speak openly and honestly about a specific issue to ensure a better outcome for a patient?

Advocacy

Nursing often brings us into direct contact with people who are in extremis of vulnerability, from a premature newborn to a person at the end-of-life stage of advanced dementia. These patients are looking to and trusting us to preserve their safety and wellbeing. One of Jesus’ greatest commissions was put forward in Matthew 25:40, ‘Whatever you did for one of the least of these brothers and sisters of mine; you did for me’. We are in the privileged position of advocacy for these persons, and we are professionally obligated to take all reasonable steps to protect the vulnerable (Section 17). This will involve appropriately sharing information if we believe someone may be at risk of harm so that their wellbeing and safety can be optimised. Another example from the life of Jesus was that he was an advocate for the vulnerable, consistently speaking up for the poor and encouraging us to be defenders of the weak.

How have you advocated for the vulnerable in your work in recent months?

You might like to pray together about our responsibility as patient advocates and ask God to enable you to be the best that you can be as you represent his love to the people you care for.

 Further reading

The Independent Review

 The 2020 – 2025 NMC Strategy

Duty of Care