Introduction
The role of a nurse in adult nursing is multifaceted, demanding a blend of clinical expertise, compassion, and adherence to professional standards. In the United Kingdom, the Nursing and Midwifery Council (NMC) provides a framework for nursing practice through its Code, which outlines four key themes: prioritise people, practice effectively, preserve safety, and promote professionalism and trust. These themes underpin the fundamental elements of a nurse’s role, ensuring care is patient-centered, evidence-based, and ethically sound. This essay aims to explore these four NMC themes in depth, demonstrating their significance in shaping nursing practice within the context of adult nursing. By examining each theme, supported by relevant academic literature and examples from practice, the essay will highlight how nurses balance technical skills with interpersonal and ethical responsibilities. Ultimately, it will argue that these themes collectively form the bedrock of effective nursing care, guiding practitioners in addressing the complex needs of adult patients.
Prioritise People: The Heart of Nursing Care
The first NMC theme, ‘prioritise people,’ places the patient at the core of nursing practice, emphasising the importance of dignity, respect, and individualised care. This principle requires nurses to listen to patients, involve them in decision-making, and respond to their physical, emotional, and cultural needs (NMC, 2018). In adult nursing, this is particularly pertinent when caring for diverse populations with varying health conditions, such as chronic illnesses or mental health challenges. For instance, when managing care for an elderly patient with dementia, a nurse must adapt communication styles and involve family members to ensure the patient’s preferences are respected, even when direct communication is limited.
Evidence suggests that patient-centered care not only improves health outcomes but also enhances patient satisfaction. A study by McCormack and McCance (2017) highlights that when nurses prioritise patients’ values and preferences, trust and therapeutic relationships are strengthened, leading to better adherence to treatment plans. However, challenges may arise, such as time constraints in busy hospital wards, which can hinder the ability to provide truly individualised care. Despite this, the NMC mandates that nurses must consistently strive to place patients’ needs first, a principle that remains a cornerstone of ethical practice in adult nursing. Indeed, this theme underscores the importance of empathy—a quality that arguably defines the essence of nursing.
Practice Effectively: Competence in Clinical Care
The second theme, ‘practice effectively,’ focuses on the need for nurses to deliver care based on the best available evidence, maintain up-to-date knowledge, and work within their scope of competence (NMC, 2018). For adult nurses, this involves a range of clinical skills, from administering medications to wound care, as well as effective communication with multidisciplinary teams. Staying current with evidence-based practices is critical; for example, adopting updated guidelines on pressure ulcer prevention can significantly reduce patient harm in long-term care settings.
Research by Traynor et al. (2010) indicates that continuous professional development (CPD) is essential for maintaining effective practice, particularly as healthcare technologies and protocols evolve. Nurses must engage in lifelong learning, whether through formal training or reflective practice, to ensure their skills remain relevant. However, barriers such as limited access to training or high workloads can impede this process, highlighting a limitation in translating this theme into practice. Nevertheless, effective practice is non-negotiable, as it directly impacts patient outcomes. In adult nursing, where patients often present with complex comorbidities, competence and collaboration are vital to delivering safe, high-quality care.
Preserve Safety: Protecting Patients and Staff
The NMC’s third theme, ‘preserve safety,’ underscores the responsibility of nurses to protect patients, themselves, and others from harm by identifying risks and acting promptly to mitigate them (NMC, 2018). In adult nursing, this includes adhering to infection control protocols, ensuring accurate medication administration, and escalating concerns about patient deterioration. For example, using early warning scoring systems to monitor vital signs can help nurses detect and respond to acute changes in a patient’s condition, potentially saving lives.
Safety also extends to raising concerns about inadequate staffing or resources, a significant issue in the NHS. A report by the Royal College of Nursing (RCN) (2020) found that understaffing often compromises patient safety, increasing the likelihood of errors. While nurses are trained to prioritise safety, systemic challenges can limit their ability to fully uphold this principle. Furthermore, preserving safety involves safeguarding—recognising signs of abuse or neglect in vulnerable adults and taking appropriate action. Generally, this theme reflects the nurse’s role as a protector, ensuring that care environments remain secure for all involved.
Promote Professionalism and Trust: Upholding Ethical Standards
The final NMC theme, ‘promote professionalism and trust,’ requires nurses to act with integrity, maintain confidentiality, and foster public confidence in the profession (NMC, 2018). In adult nursing, professionalism manifests through accountability—taking responsibility for actions and decisions—and adhering to ethical guidelines, such as obtaining informed consent before procedures. Trust is equally critical; patients must feel confident that their personal information is protected and that nurses will act in their best interests.
A study by Hoeve et al. (2014) suggests that professionalism in nursing is shaped by societal perceptions and the nurse’s ability to demonstrate compassion alongside clinical expertise. However, breaches in professionalism, such as poor communication or unprofessional conduct, can erode trust, with lasting implications for patient engagement. Nurses must therefore navigate complex ethical dilemmas—for instance, balancing honesty with sensitivity when discussing a poor prognosis. Typically, promoting professionalism involves self-reflection and adherence to the NMC Code, ensuring that nurses serve as role models within healthcare settings.
Conclusion
In summary, the four NMC themes—prioritise people, practice effectively, preserve safety, and promote professionalism and trust—collectively define the fundamental elements of a nurse’s role in adult nursing. Each theme contributes uniquely to the delivery of high-quality care, from placing patients at the heart of practice to upholding safety and ethical standards. While challenges such as resource constraints and systemic pressures can impede the full realisation of these principles, the NMC framework provides a robust guide for nurses to navigate complex healthcare environments. The implications of these themes are far-reaching, shaping not only individual patient outcomes but also the broader perception of nursing as a trusted profession. As a student of adult nursing, engaging with these themes fosters a deeper understanding of the responsibilities and skills required to excel in this field. Ultimately, by embedding these principles into practice, nurses can address the diverse needs of adult patients, ensuring care that is compassionate, competent, and safe.
References
- Hoeve, Y.T., Jansen, G. and Roodbol, P. (2014) The nursing profession: public image, self-concept and professional identity. A discussion paper. Journal of Advanced Nursing, 70(2), pp. 295-309.
- McCormack, B. and McCance, T. (2017) Person-Centred Practice in Nursing and Health Care: Theory and Practice. 2nd ed. Wiley-Blackwell.
- Nursing and Midwifery Council (NMC) (2018) The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates. NMC.
- Royal College of Nursing (RCN) (2020) Staffing Levels Report 2020. RCN.
- Traynor, M., Stone, K., Cook, H., Gould, D. and Maben, J. (2010) Disciplinary processes and the management of poor performance among UK nurses: bad apple or systemic failure? A scoping study. Nursing Inquiry, 17(4), pp. 305-312.
