Introduction
This essay explores the ethical and professional frameworks that underpin the role of nursing associates in the UK healthcare system. As a relatively new role introduced to bridge the gap between healthcare support workers and registered nurses, nursing associates are expected to adhere to strict guidelines to ensure patient safety, maintain professional standards, and uphold public trust. This discussion will focus on the key frameworks provided by the Nursing and Midwifery Council (NMC), alongside broader ethical principles such as autonomy, beneficence, and accountability. The essay will examine how these frameworks shape clinical practice, the challenges nursing associates face in adhering to them, and their significance in ensuring high-quality care. By delving into these areas, this piece aims to provide a sound understanding of the expectations placed on nursing associates within the health science field.
The Role of the Nursing and Midwifery Council (NMC) Code
The primary professional framework governing nursing associates is the NMC Code, which sets out the standards of conduct, performance, and ethics for nursing and midwifery professionals in the UK. Introduced in 2015 and updated in 2018, the Code applies to nursing associates following their inclusion on the NMC register from 2019 (Nursing and Midwifery Council, 2018). The Code is structured around four key themes: prioritising people, practising effectively, preserving safety, and promoting professionalism and trust. These principles ensure that nursing associates deliver person-centred care while maintaining accountability for their actions.
For instance, under the theme of prioritising people, nursing associates must respect patients’ dignity and ensure their needs are met with compassion. This can be challenging in high-pressure environments where time constraints may compromise individualised care. However, the NMC Code mandates that patient well-being remains at the forefront, highlighting the importance of empathy and effective communication. As Glasby and Dickinson (2014) argue, person-centred care not only improves patient outcomes but also enhances trust in healthcare professionals. Thus, adherence to the NMC Code ensures that nursing associates contribute positively to patient experiences, even under resource constraints.
Ethical Principles in Nursing Associate Practice
Beyond the NMC Code, nursing associates must navigate a range of ethical principles that inform decision-making in clinical settings. Key among these are autonomy, beneficence, non-maleficence, and justice, often referred to as the four pillars of medical ethics (Beauchamp and Childress, 2013). Autonomy requires nursing associates to respect patients’ rights to make informed decisions about their care, which involves providing clear, accurate information and supporting shared decision-making. Beneficence and non-maleficence, on the other hand, obligate nursing associates to act in patients’ best interests while avoiding harm. This dual responsibility can sometimes create tension, for example, when a patient refuses treatment that could be life-saving.
Furthermore, the principle of justice demands fair and equitable treatment of all patients, regardless of background or personal circumstances. In practice, this can be complex, particularly in the context of limited NHS resources where prioritisation decisions must be made. As Seedhouse (2009) notes, ethical dilemmas often arise when resources are scarce, and nursing associates must rely on clinical judgement and ethical frameworks to navigate such challenges. Therefore, a sound understanding of these principles is essential for nursing associates to balance competing demands while upholding their professional duty.
Accountability and Professional Boundaries
Accountability forms a critical component of the professional framework for nursing associates. According to the NMC Code, they are accountable for their actions and must be able to justify decisions made in the course of their duties (Nursing and Midwifery Council, 2018). This includes maintaining accurate records, reporting concerns promptly, and reflecting on practice to identify areas for improvement. Accountability ensures that nursing associates remain answerable to patients, employers, and the NMC itself, fostering a culture of transparency and trust.
Equally important are professional boundaries, which protect both patients and practitioners by maintaining a clear separation between personal and professional relationships. The NMC guidance explicitly warns against overstepping boundaries, such as developing inappropriate emotional attachments or exploiting a position of power. Breaches of boundaries can undermine patient trust and lead to disciplinary action. A study by Holder and Schenthal (2007) highlights that maintaining boundaries is particularly challenging for healthcare workers in smaller communities, where personal and professional lives may overlap. For nursing associates, who often work closely with patients over extended periods, ongoing training and reflection are vital to ensure compliance with this aspect of professional practice.
Challenges in Adhering to Ethical and Professional Frameworks
While the frameworks provided by the NMC and ethical principles offer clear guidance, nursing associates often encounter significant challenges in adhering to them. One prominent issue is workplace stress, which can compromise the ability to deliver care in line with professional standards. High patient-to-staff ratios, long shifts, and emotional burnout are well-documented factors that impact healthcare workers’ performance (West and Dawson, 2012). In such contexts, nursing associates may struggle to prioritise patient needs or maintain the level of compassion expected by the NMC Code.
Additionally, ethical dilemmas can arise when personal values conflict with professional obligations. For example, a nursing associate may have moral objections to certain medical procedures, yet they are required to support patients’ choices under the principle of autonomy. Resolving such conflicts requires a nuanced understanding of ethical frameworks and, often, consultation with supervisors or ethics committees. Indeed, as Dimond (2015) suggests, ongoing professional development and access to mentorship are crucial for nursing associates to address these challenges effectively. Without such support, there is a risk that ethical and professional standards may be inadvertently compromised.
Conclusion
In conclusion, the ethical and professional frameworks guiding nursing associates are integral to ensuring safe, effective, and compassionate care within the UK healthcare system. The NMC Code provides a robust foundation, emphasising the importance of prioritising people, practising safely, and maintaining professionalism. Alongside this, ethical principles such as autonomy, beneficence, and justice shape decision-making and promote equitable care. However, challenges such as workplace stress and ethical dilemmas highlight the complexities of adhering to these standards in practice. The implications of these frameworks are significant, as they not only safeguard patient well-being but also uphold public confidence in the nursing associate role. Ultimately, by embedding these principles into their daily practice and engaging in continuous reflection, nursing associates can navigate the demands of their role while contributing to high-quality healthcare delivery. This balance of ethical integrity and professional accountability remains at the heart of their contribution to the NHS and beyond.
References
- Beauchamp, T.L. and Childress, J.F. (2013) Principles of Biomedical Ethics. 7th ed. Oxford: Oxford University Press.
- Dimond, B. (2015) Legal Aspects of Nursing. 7th ed. Harlow: Pearson Education.
- Glasby, J. and Dickinson, H. (2014) Partnership Working in Health and Social Care: What is Integrated Care and How Can We Deliver It? 2nd ed. Bristol: Policy Press.
- Holder, K.V. and Schenthal, S.J. (2007) Watch your step: Nursing and professional boundaries. Nursing Management, 38(2), pp. 24-29.
- Nursing and Midwifery Council (2018) The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates. Nursing and Midwifery Council.
- Seedhouse, D. (2009) Ethics: The Heart of Health Care. 3rd ed. Chichester: Wiley-Blackwell.
- West, M.A. and Dawson, J.F. (2012) Employee engagement and NHS performance. London: The King’s Fund.
