Responsibility of nursing – from professional moral responsibility to technical accountability?

Abstract

This paper is motivated by the need to develop a better understanding of nurses’ professional responsibility. Traditionally, the responsibility of the nursing profession has been characterised by its altruistic service in the interest of the ill person. Altruism has been essential in order to fulfil the profession’s normative mandate. The development of the welfare state and the health services in recent decades has created new conditions for all professional work. In this paper we illuminate and discuss how this development seems to influence the responsibility of the nursing profession. The contribution of the paper is to identify and examine how new governing- and control systems within the welfare sector (New Public Management) jeopardize conceptions and practices of professional responsibility. The paper focuses particularly on the tensions between moral responsibilities and responsibility as a more technical accountability, concluding that it is legitimate to make demands of governance and control. The article concludes that there exists no harmonious ‘solution’ or ‘prescription’. Demands of efficiency have to be negotiated as part of the holistic responsibility of nursing without sacrificing professional values of professional ethics and the normative societal mandate.