Mar 01,2017
By David Kenneth Wright

Nursing memes at odds with our values

Educator David Kenneth Wright believes that the punchlines delivered in some social media portrayals of nursing pose a new evolutionary threat to the discipline

In 2011, nursing scholar Wendy Austin published “The Incommensurability of Nursing as a Practice and the Customer Service Model: An Evolutionary Threat to the Discipline.” The threat, she argued in this scholarly paper, is an insidious erosion of nursing’s ethical foundations. Values of compassion and empathy are giving way to simpler ideas of politeness and customer satisfaction. Questions about whether Disney should run your hospital are taken seriously, and nurses are expected to be efficient at the expense of making meaningful connections with those in their care.

As a nursing educator, I want my students to understand the ethical foundations of our discipline. I try to teach them to hone their senses so they see, hear and feel the vulnerability of patients and their families. These goals may sound simple, but forces that stand in the way of nurses’ ethical engagement with those in their care are many. They are insidious and too often go unchallenged.

One such force is the proliferation of certain nursing memes — purportedly clever and humorous images and text that are posted online and shared widely by nurses through social media. However, these memes can distort our senses, blunting our abilities to detect human vulnerability and, in so doing, poison the relational ethics of our practice.

I can already hear the detractors. “Lighten up!” “Don’t you have a sense of humour?”

I assure you, I do.

Humour often plays an important role in our practice. Sharing a laugh with patients during intimate bodily care can protect their sense of dignity. Making jokes, even morbid ones, with colleagues in the backstage of our units can give us the energy we need to forge ahead through landscapes that often feel overburdened with pain, suffering and death. We need humour to survive. But in trying to elicit a laugh, the most provocative memes incite us to deny or ignore patient and family vulnerability:

“You have been charged $50 for each time you pushed your call light unnecessarily.”

“Nurses are like [inserted image of a nurse with her arms raised to the sky ] — Thank you Lord, that annoying family member left.”

“Be nice to me…I may be your nurse someday. Just remember that catheters and needles come in sizes that I choose.”

“You can’t fix stupid. But you can sedate it.”

As Austin reminds us in her article, nursing’s fundamental ethical commitment to fidelity has remained constant throughout our discipline’s evolution. To identify as a nurse is to make certain promises, such as helping patients and families maintain dignity and integrity. In contrast, these examples of memes condone and normalize attitudes that make light of and dismiss the vulnerabilities of patients and families, for whom much is at stake in the clinical encounter. Nurses should resist, not perpetuate, ideas that patients who call out for help deserve retribution or that family members who seek attention are irritating. And we should categorically reject the idea that we would ever wield as punishment the power entrusted to us over another person’s body and consciousness.

Are nurses being serious when they participate in this form of humour? Of course not. But that is not the point.

Moral distress, the emotional destabilization we face when we feel prevented from doing what is right for our patients, is painful. But the upside to moral distress is that it reveals a moral engagement in our practice. If we are distressed, it is a sign that our patients, and their vulnerabilities, matter to us.

Moral disengagement is a greater threat to the relational ethics of our discipline than moral distress. I suggest that nursing memes like the ones I’ve highlighted reveal a devolution in attitude toward moral disengagement and that we need to correct it. Let’s think about how, before we decide to post, like or share these so-called funny images about nursing care.

David Kenneth Wright, PhD, RN, CHPCN(C), is an assistant professor in the school of nursing, University of Ottawa.

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