Caring after Francis: moral failure in nursing reconsidered

Abstract

This discussion paper considers recent nursing failures. Drawing on a selection of key literature and ongoing research, it argues that nursing failures are a possibly inevitable consequence of work in healthcare systems with their combination of cognitive, bureaucratic, professional and work-related pressures. It also argues that nursing has a residual tendency to be viewed as primarily character-based moral work and that this can encourage understandings of causes of failures and their solutions in similar terms, i.e. as moral failures of caring requiring recruitment of those with the appropriate characters. Drawing on ongoing research with those training for the profession at an English university, it suggests that while the profession focuses on the recruitment of those with a ‘caring’ orientation it has not developed an adequate explanation to support new recruits in understanding the causes of inadequate practice. This leaves those entering the profession without a strong model with which to understand their own work or its failures-what I refer to as ‘critical resilience’.