The Moral And Ethical Principles Of Respect Essay

The Moral And Ethical Principles Of Respect Essay

The Moral And Ethical Principles Of Respect Essay

The aim of a previous study was to describe nursing in Slovenia generally, and to iden-tify the most appropriate nursing model for that country. One specific finding was the issue of partner-like relationships; this article deals with that issue only. An interpretive paradigm and qualitative research design were used with a modified grounded theory approach. Interviews were carried out with selected nursing leaders (n 24) and other professionals (n 6) in order to draw on their knowledge and experience to describe the reality of nursing phenomena. The results of this research suggest that participants wish to use a theory that emphasizes clients and treats them as equal partners in nurs-ing, promotes health, and rests on interpersonal relationships. The participants described the missing or obscure parts in nursing and their own beliefs and values about human beings and nursing. Descriptions of and the need for partner-like relationships, and the specific elements of such relationships, were of main concern. The participants argued that nurses need high quality and continuing education to ensure competent nursing practice. The indication is that Slovenia should move to graduate and undergraduate nurse education to foster expert reflective practice in order to abolish routinized care carried out in a hierarchical system. The Moral And Ethical Principles Of Respect Essay


The participants in this study believed that, for nursing to be improved in Slovenia, nurses need a body of knowledge, human and moral values and commitment to their work that will above all be expressed in human interpersonal relationships.

An increasing dissatisfaction among nurses became evident, with indicators point-ing to the need for nurses to follow a culturally and nationally appropriate nursing model. A research study undertaken to test this notion revealed unexpectedly that it was the interpersonal domain that was of main concern. The researcher set out to test the hypothesis that a generally acceptable and useful nursing model would give Slovenian nurses a better understanding of their role, and more autonomy and authority, and enable them to provide more holistic patient care. This was indirectly

Address for correspondence: Majda Pajnkihar, Institute for Nursing Care, University of Maribor, Faculty of Health Sciences, Žitna ul. 15, 2000 Maribor, Slovenia. Tel: 398 62 300 47 31; E-mail: The Moral And Ethical Principles Of Respect Essay

Nursing Ethics 2009 16 (1) © 2009 SAGE Publications 10.1177/0969733008097989

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confirmed by revealing an emphasis on partner-like relationships with patients as the core of this understanding. This article concentrates specifically on the various aspects of partner-like relationships. The Moral And Ethical Principles Of Respect Essay

Political and historical background

It is necessary to give a brief historical overview in order to allow understanding of the present needs for nursing in Slovenia. After the Second World War Slovenia became a republic of the former Yugoslavia, with a Communist party in power and a social political framework of health care services.

In 1992, one year after independence, a number of health care reforms were intro-duced, emphasizing patient participation in planning and managing health care. Special consideration was given to client protection and client rights. Together with a compulsory health care insurance system, people were given the right to select per-sonal physicians in both private and public primary health care. Other prominent matters in the reform were the improvement of relationships between health care professionals, particularly between physicians and nurses.1,2. The Moral And Ethical Principles Of Respect Essay

However, the Slovene health care institutions are still influenced by the former social political system, which was characterized by collective responsibility in insti-tutions, obscuring the uniqueness of people, individual responsibility and human interpersonal relationships. With these changes, nurses are aware that they need to move to an appropriate nursing model in order to respond to clients’ needs and expectations under the reforms. One of the main problems encountered is a short-age of nurses.

Nursing background

Currently, there are five nursing colleges in Slovenia and more are planned.

In 2007 the University of Maribor College of Nursing Studies was promoted to Faculty of Health Sciences. All nursing colleges began to reshape their nursing cur-ricula according to the Bologna Protocol. Despite many positive changes in the curricula, there is still a strong emphasis on medical knowledge and input. For example, the cur-riculum consists of 40 hours of theoretical paediatric nursing taught by nurses and 40 hours of paediatrics taught by physicians. The Moral And Ethical Principles Of Respect Essay

Academic nursing education and the development of nursing theories seem to be closely connected. In order to establish a clear base to enhance creativity, develop-ment and progress in the discipline, it is essential to re-examine and further develop the unique body of nursing knowledge. Understanding the basic elements of a theory and its role, as well as assessing and taking a critical view of it, can help to develop the knowledge that nurses need for their everyday work. A culturally appro-priate model based on partner-like relationships with patients is therefore essential.

Although many nursing theories were studied for this research, the four that are relevant to the topic of this article are briefly mentioned below. Henderson’s3–5 con-ceptual model was examined because this is the one known best in Slovene educa-tion, research and practice. Peplau’s6,7 work was important because she describes personal relationships as the most essential element in nursing. Orem’s8,9 theoretical writing has been relevant in nursing education for over a decade because of the. The Moral And Ethical Principles Of Respect Essay

Nursing Ethics 2009 16 (1)

Nurses’ (un)partner-like relationships with clients 45

concept of self-care. Finally, in her caring model, Watson10–16 discusses the philosoph-ical and spiritual basis of caring and sees caring as the moral and ethical ideal for nursing and for the preservation of human dignity.

All these theories have their roots in American nursing, which presents problems for Slovene students’ understanding of them when they are introduced in the nursing curriculum. There is a shortage of literature on this subject in the Slovene language and the nurses cannot see applications of these theories in practice.

Literature review

In order to understand the claim that the nurse–patient relationship is central to understanding the concept of nursing, various components had to be considered, studied and understood. For the main study, different nursing models were analysed, but they are not detailed here; instead, the emphasis is on specific aspects of interpersonal relationships. The Moral And Ethical Principles Of Respect Essay


Communication is an essential element in the nurse–patient relationship and good nursing care. It is also an important tool for supporting patients emotionally and encouraging them to be involved in their own care.17 Communication also enhances the mental well-being of nurses18 and increases job satisfaction.19 Peplau6,7 also emphasized the importance of verbal and non-verbal communication. Pajnkihar and Lahe20 point out that interpersonal communication and mutual partnership are at the core of nursing because they sustain respect and human dignity, individuality and autonomy from the moment of first meeting. The Moral And Ethical Principles Of Respect Essay


Reed et al.21 claim that the relationship between patients and caregivers needs to be constantly renegotiated to boost dignity. When dignity is promoted, clients are empowered and their independence22 becomes the ‘core’ of the caring process in client-centred nursing.19,22–27 Autonomy and independence are both related to dignity.28


The moral and ethical principles of respect and dignity are foundational to interper-sonal relationships. The American Nurses Association Code of ethics for nurses29 and the Slovene Code of ethics for nurses and health technicians of Slovenia30 state that clients have a right to be respected for their human dignity. This requires recognition of the right to self-determination. Yet Tadd et al.31 found that nurses were frequently unaware of their codes or did not use them in practice; and Lešnik32 stated that nurses in their research sample were unable to describe codes in practice.The Moral And Ethical Principles Of Respect Essay

Respect is frequently referred to in professional codes, health documents, and everyday conversations.33 Respect acknowledges the ‘dignity, inherent worth, and uniqueness of humans, and their potential for self determination’ (p. 213).34 Regarding ways of expressing it, Browne34 claims that respect is an essential compon-ent of caring that arises from a deep interest in humanity.

Nursing Ethics 2009 16 (1). The Moral And Ethical Principles Of Respect Essay