Introduction
Values-based nursing (VBN) is a fundamental concept in the field of adult nursing, focusing on the integration of personal and professional values into clinical practice to deliver patient-centred care. This essay explores the significance of values-based nursing within the context of adult nursing, considering its role in enhancing patient outcomes, fostering therapeutic relationships, and addressing ethical challenges. The discussion will examine the theoretical foundations of VBN, its practical applications in clinical settings, and the challenges nurses may encounter when aligning personal values with professional responsibilities. By critically analysing relevant literature and evidence, this essay aims to underscore the importance of VBN for nursing practice and its implications for delivering high-quality care in diverse healthcare environments.
Understanding Values-Based Nursing
Values-based nursing refers to a framework that prioritises the incorporation of values—both of the nurse and the patient—into the decision-making process and delivery of care. According to McCormack and McCance (2017), VBN is rooted in person-centred care, which emphasises respect for individual dignity, autonomy, and personal beliefs. This approach requires nurses to reflect on their own values, such as compassion, empathy, and integrity, and to understand how these align with professional codes of conduct, such as the Nursing and Midwifery Council (NMC) Code (NMC, 2018). The NMC Code explicitly mandates that nurses prioritise people, practise effectively, preserve safety, and promote professionalism and trust, all of which are underpinned by core values.
In adult nursing, values-based practice is particularly significant due to the complex needs of patients, who often present with chronic conditions, mental health challenges, or end-of-life care requirements. For instance, a nurse caring for an elderly patient with dementia must balance clinical interventions with respect for the patient’s autonomy and personal history, even when communication is limited. Therefore, VBN provides a lens through which nurses can navigate such complexities, ensuring that care remains holistic and individualised rather than purely procedural.
The Importance of Values-Based Nursing in Clinical Practice
One of the primary reasons VBN is critical to nursing practice is its role in fostering therapeutic relationships. Research by Peplau (1991), a seminal figure in nursing theory, highlights the importance of interpersonal relationships in healthcare, suggesting that trust and mutual respect between nurse and patient are foundational to effective care. In adult nursing, where patients may feel vulnerable due to illness or loss of independence, a values-based approach ensures that nurses demonstrate empathy and compassion, thereby enhancing patient trust. For example, actively listening to a patient’s concerns about a treatment plan and addressing their fears can significantly improve adherence and emotional well-being (Stickley and Freshwater, 2006).
Moreover, VBN supports ethical decision-making, which is often a challenge in adult nursing due to conflicting priorities or resource constraints. The Royal College of Nursing (RCN) underscores that nurses frequently face ethical dilemmas, such as balancing patient autonomy with the need for medical intervention (RCN, 2020). A values-based approach encourages nurses to consider the patient’s perspective alongside clinical guidelines, ensuring decisions are not solely driven by protocol but also by respect for individual choice. For instance, in cases involving do-not-resuscitate (DNR) orders, a nurse guided by VBN would engage in sensitive discussions with the patient and family to honour their wishes while adhering to legal and ethical standards.
Challenges in Implementing Values-Based Nursing
Despite its importance, integrating values-based nursing into practice is not without difficulties. One key challenge is the potential conflict between personal and professional values. As Baillie and Black (2015) note, nurses may encounter situations where their personal beliefs—such as religious or cultural views—clash with patient needs or institutional policies. For example, a nurse who holds personal objections to certain medical procedures, such as abortion, may struggle to provide non-judgmental care. The NMC Code (2018) requires nurses to set aside personal biases to prioritise patient well-being, but achieving this balance can be emotionally taxing and requires ongoing reflection and support, such as through clinical supervision.
Another barrier is the systemic pressure within healthcare settings, including time constraints and staff shortages, which can hinder the application of VBN. Research by the NHS England (2020) indicates that workload pressures often prevent nurses from spending adequate time with patients to fully understand their values and preferences. In such contexts, care may become task-oriented rather than person-centred, undermining the principles of VBN. Addressing this issue requires organisational support, such as adequate staffing levels and training in values-based care, to empower nurses to prioritise meaningful patient engagement over procedural efficiency.
Strategies to Support Values-Based Nursing
To overcome these challenges and embed VBN into everyday practice, several strategies can be employed. Firstly, education and training are vital. Undergraduate nursing programmes should incorporate modules on values-based care, encouraging students to reflect on their own values and biases while developing skills in empathetic communication (McCormack and McCance, 2017). Additionally, continuing professional development (CPD) opportunities, such as workshops on ethical decision-making, can support qualified nurses in maintaining a values-based approach throughout their careers.
Secondly, healthcare organisations must foster a culture that prioritises VBN. This includes creating environments where nurses feel supported to raise concerns about ethical dilemmas or workload issues without fear of reprisal. The NHS Constitution (Department of Health and Social Care, 2021) advocates for a compassionate culture within healthcare, which aligns with VBN principles. Indeed, implementing regular team debriefs or peer support groups can provide nurses with a space to discuss challenges and share best practices in values-based care, thereby enhancing resilience and professional growth.
Conclusion
In conclusion, values-based nursing is a cornerstone of effective adult nursing practice, promoting person-centred care, ethical decision-making, and therapeutic relationships. By aligning personal and professional values with patient needs, nurses can deliver care that respects individual dignity and autonomy, even in complex or challenging situations. However, barriers such as personal bias and systemic pressures can impede the application of VBN, necessitating ongoing education, organisational support, and cultural change within healthcare settings. The implications of prioritising VBN are profound, as it not only improves patient outcomes but also enhances nurses’ professional satisfaction by reinforcing the humanistic essence of nursing. Ultimately, embedding values-based nursing into practice is essential for meeting the diverse and evolving needs of adult patients in contemporary healthcare, ensuring that care remains compassionate, respectful, and truly holistic.
References
- Baillie, L. and Black, S. (2015) Professional Values in Nursing. CRC Press.
- Department of Health and Social Care (2021) The NHS Constitution for England. GOV.UK.
- McCormack, B. and McCance, T. (2017) Person-Centred Practice in Nursing and Health Care: Theory and Practice. 2nd ed. Wiley-Blackwell.
- NHS England (2020) NHS Workforce Health and Wellbeing Framework. NHS England.
- Nursing and Midwifery Council (NMC) (2018) The Code: Professional Standards of Practice and Behaviour for Nurses, Midwives and Nursing Associates. NMC.
- Peplau, H.E. (1991) Interpersonal Relations in Nursing: A Conceptual Frame of Reference for Psychodynamic Nursing. Springer Publishing Company.
- Royal College of Nursing (RCN) (2020) Ethics and Nursing Practice. RCN.
- Stickley, T. and Freshwater, D. (2006) The art of listening in the therapeutic relationship. Mental Health Practice, 9(5), pp. 12-18.
