Authors

  1. Modic, Mary Beth DNP, RN, CDE

Article Content

Aristotle, one of the greatest thinkers the world has ever known, was the first to classify knowledge into distinct disciplines including ethics, biology, and mathematics. He was a preeminent proponent of a liberal arts education, believing that education of the whole person contributed to the good of society. He averred that "educating the mind without educating the heart is no education at all."

 

Aristotle dedicated most of his life to promoting the concept of human flourishing. He purported, in his ethical writings, that each person has an innate responsibility to strive, develop, and become his or her best self. This concept is known as eudaimonia or human flourishing (Treddenick, 2004). Flourishing is the purist of all human endeavors and is the purpose of a well-lived life (Seligman, 2014). Human flourishing should be considered a verb, not a noun, as it is about the actions a person takes to cultivate personal well-being (Bunkers, 2010). It is about living the richest life one can have by being virtuous.

 

As nursing professional development (NPD) practitioners and preceptors, one of the most important components of our work is to help our newest colleagues flourish. It is incumbent on us to continue to learn, to be curious, and to be active participants in the advancement of our profession. We can do this by reflecting on the virtues that serve as the templates for all of our decisions. Virtues are critical to our flourishing-they define what we cherish and what gives our lives purpose. Embracing our highest ideals and integrating them into our actions is essential to human flourishing (Craig & Snook, 2014). Aristotle advocated that virtue is a moral mean between the deficiency of that trait and the excess of that trait, also known as the "Golden Mean" (Treddenick, 2004). Having a virtue is different from having a skill, because what matters is not just the outcome but the intention in which the action is taken. Listed below are a few of the virtues we may use in precepting, coaching, and nurturing (Table 1).

  
Table 1 - Click to enlarge in new windowTABLE 1 Virtues That Contribute to Human Flourishing

Empathy is at the core of being human. It is also one of the most important elements for leadership success. Empathy is the ability to imaginatively step into the shoes of another and attempt to gain a perspective that will guide further interactions (Krznaric, 2014). Expressing empathy with new nurses fosters relationship building and conveys an appreciation of the struggles of assimilating to a new environment. Although nurses are known for their empathy, it is not always used as frequently as it could be with new staff. It has been suggested that our younger colleagues are less empathic. Borba (2016) reported that teens are now 40% lower in empathy levels than three decades ago (p. xv). Modeling empathic statements with patients and families can aid orientees by expanding their empathic vocabulary.

 

Industrious is a virtue that conveys diligence, dedication, and being earnest. Helping new nurses develop a "rhythm" in their work is important. New nurses want to work alongside preceptors who enjoy their work and have mastered the intricacies of care and relationships. Preceptors can share the joy and gratification being a nurse brings.

 

Courage is a quality that enables nurses to advocate and display strength in the face of suffering and grief. It is also a trait that requires preceptors to speak up when there is a breakdown in care or deviation in safe practice. Aristotle called courage the first virtue because it makes all of the other virtues possible.

 

Respect is an attribute used by NPD practitioners and preceptors to convey that new nurses have worth and contribute in a positive manner to the success of the unit. Whether the new nurse is a recent graduate from nursing school or a person with 8 years of experience, the manner in which respect is conveyed or withheld can determine the quality of the orientation experience and whether the new nurses wish to remain on the unit after orientation is complete.

 

Kindness is a visible demonstration of commitment to the welfare of others. It means becoming involved and taking responsibilities for actions to benefit another. As NPD practitioners and preceptors, we must convey that there is no shame in seeking the hand of companionship as an orintee progresses through all of the intricacies of the learning journey we call "orientation."

 

Curious-being curious is an important trait that should be fostered. People who are curious are always asking questions and looking for connections and patterns. It is one of humanity's greatest virtues (Leslie, 2014). Promoting curiosity in orientation can set the stage for the new nurse's intellectual appetite. Preceptors can share questions and observations that they had while being in orientation. They can provide clinical research or evidence-based practice articles that reveal interesting findings about their patient population or practice setting.

 

Mercy is a means of displaying forgiveness and is a critical preceptor characteristic. It is essential in promoting a "just" culture and supporting a nurse who may be the "second victim" in a fatal error. Research has shown that fatal errors are known to haunt caregivers the rest of their lives. Support, forgiveness, and understanding must be offered to the individual the moment the potential for emotional distress is discovered (Grissinger, 2014). The preceptor is instrumental in helping an orientee cope with an error or misstep, and the expression of mercy may prevent the devastating feelings of abandonment and isolation.

 

Honesty is a virtue that requires authenticity. Honesty builds safe connections and fosters security so true dialogue can take occur. It is the virtue that propels us to share feedforward and feedback about an orientee's performance in a genuine and tender manner so that it can be accepted and received in the intended manner (Modic, 2016). Nurses come by honesty naturally, as our profession has been ranked as the most honest and ethical profession for 14 consecutive years (American Nurses Association, 2016).

 

Gratitude is the virtue of rejoicing in what is. It is the virtue that begets other virtues. It is impossible to be callous or cruel, insensitive or indifferent when you feel grateful. Alexis de Tocqueville once described gratitude as "a habit of the heart." Expressing gratitude to orientees will help them flourish, because they are being recognized for their contributions. Acknowledging an orientee's progress with a grateful demeanor can foster a feeling of success.

 

Justice is a virtue that encompasses the concepts of fairness, equity, and impartiality. It may not be a virtue that preceptors often associate with orientation, yet it is an important one because the promotion of justice would minimize the potential for hazing, bullying, and "eating our young." Alexandra Robbins, in her book The Nurses, devotes a chapter to nurses bullying nurses. In her book, she recounts the following opinion of a Neonatal Intensive Care Unit nurse, "we've coddled these new young nurses. There is way too much hand holding[horizontal ellipsis]if a new nurse screws up or doesn't have her stuff together, she needs to know[horizontal ellipsis]nurses should eat their young to get rid of the weak" (Robbins, 2015, p. 143). Fortunately, this sentiment is not shared by most preceptors or NPD practitioners. Ensuring that patient assignments are fair and commiserate with a new nurse's skill level is an example of demonstrating justice.

 

Appreciative inquiry can provide a framework to reflect on your purpose as a preceptor. Consider the following questions:

 

1. Think about your experiences as a preceptor and recall when you have been the most influential. What resonates for you about that experience? What virtues did you use from the list above to optimize the learning experience? What was it about your work environment that afforded you the opportunity to do so?

 

2. What would you share with other preceptors about this "magical moment" in precepting?

 

3. Imagine the nurses who will join your unit in the next several years. What strategies could you use in the future to help them experience wonderful moments of learning and affirmation?

 

 

Precepting with purpose requires practice, self-reflection, and challenging the status quo. Virtue-based precepting reinforces that purpose. The ultimate purpose of precepting is to help nurses become their very best selves, resulting in eudaimonia-human flourishing!

 

References

 

American Nurses Association. (2016). Retrieved from http://www.nursingworld.org/2015-NursesRankedMostHonestEthicalProfession[Context Link]

 

Borba M. (2016). UnSelfie: Why empathetic kids succeed in our all-about-me world. New York, NY: Touchstone Press. [Context Link]

 

Bunkers S. S. (2010). A focus on human flourishing. Nursing Science Quarterly, 23(4), 290-295. [Context Link]

 

Craig N., Snook S. (2014). From purpose to impact. Harvard Business Review, 92(5), 105-111. [Context Link]

 

Grissinger M. (2014). Too many abandon the "second victims" of medical error. Pharmacy and Therapeutics, 39(9), 591-592. [Context Link]

 

Krznaric R. (2014). Empathy. New York, NY: Penguin Group. [Context Link]

 

Leslie I. (2014). Curious. New York, NY: Basic Books. [Context Link]

 

Modic M. B. (2016). Feedforward-Nurturing the practice of others. Journal for Nurses in Professional Development, 32(1), 47-48. [Context Link]

 

Robbins A. (2015). The nurses-A year of secrets, drama, and miracles with the heroes of the hospital. New York, NY: Workman Publishing. [Context Link]

 

Seligman M. E. (2014). Flourish. New York, NY: Free Press. [Context Link]

 

Treddenick H. (Ed.). (2004). Aristotle: The Nicomachean ethics. London, UK: Penguin. [Context Link]