VIRTUES

o Definition
Virtue Refers to excellence in character. Virtues are thought of as purposive dispositions and character traits that are developed throughout life. These are praiseworthy traits of human character. Schools, social institutions, and families help to shape a persons moral character. Virtue Ethics Deals with questions such as, What sort of person must I be? and What makes an individual a good or virtuous person? rather, than What is right or good to do? When people practice virtue ethics they do not use universal rules or principles to guide their actions. Rather than focusing on what is right or wrong, virtue ethics is based on the excellence of ones character and the consideration of what a person wants to become.

o Historic Influences and Tradition

The origin of virtue ethics is associated with the ancient Greeks, most notably Plato and Aristotle. In Eastern philosophy specifically in Buddhism, virtue ethics is valued. Likewise, in nursing, virtue ethics is valued as manifested in the works of Florence Nightingale.

o Virtues in Bioethics
Virtues are the character of the health care provider, which are morally praiseworthy traits. These characters are immeasurable, when these virtues are cultivated into a nurses personality; it is believed that that he/she can grow into a compassionate, humble, courageous health care professional with integrity. Professional Virtues Purity and holiness have religious overtones but these are embodied in The Hippocratic Oath. In nursing, to maintain purity and manifest a holy disposition is also important. The following Codes of Ethics for Nurses have implied statements: . The nurse at all times maintains standards of personal conduct which reflects well on the profession and enhance public confidence (International Code of Ethics for Nurses) .The nurse owes the same duties to self as to others including the responsibility to preserve integrity and safety (American Nurses Associations Code of Ethics, approved June 30, 2001) [Nurses must] perform their professional duties inconformity with existing laws, rules, regulations, measures,and generally acceptable principles of moral conduct andproper decorum. (Code of Ethics for Filipino Registered Nurses) The above statements imply that virtues in nursing are important in order to act based on

social values and needs, as they are applied to realities of health and nursing care in a changing society. Secular Virtues According to Plato, the four classical Greek virtues which are found to be praiseworthy are: justice, temperance, courage, and wisdom. These virtues enable the nurse to be firm in facing adversity, intactness of character, to be kind and optimistic, and to experience great joy in serving. Religious Virtues Roman Catholics tend to affirm both Greeks and Christian virtues, thus having a full list of seven virtues (namely prudence, justice, temperance, fortitude, faith, hope and love); while Protestants, being more prone to see tension between the Greeks and Christians, often limit their list to the three Pauline virtues such as faith, hope, and love (agape or charity). In addition to the Biblical Christian virtues, other major religions also put forward virtue lists such as contentedness, gratitude, generosity, and magnanimity from among the Muslims. The ancient Hindu Caraka Samhita lists care, attention, humility, and constant reflection. The famous Confucian virtues are humaneness, compassion, and filial piety. Filial piety is important in ancient Chinese medical ethics. It has been seen as implying that Chinese physicians are ideally like family member treating patients as brothers rather than the more distant professional relation that is the norm in Western culture.

o Virtue- Based Nursing Model

The Moral Ground Model has its foundation in Aristotles approach to virtue ethics with a proposed path to moral ground adapted from the Eightfold Path of Buddhism. Both the ethics of Aristotle and Buddhism are teleological philosophies, meaning that they both focus human morality on moving toward a final purpose or goal. The model implies that as nurses go about in their day-to-day activities, they are aware that this routine may give them dissatisfaction from their profession. But, nurses are also aware that they have to focus less on their dissatisfaction instead, they need to carry on with their work. The following activities and attitudes will develop the nurses intellectual and moral virtues which could facilitate growth in her character as a person and as a nurse in the profession: Insight (sophia) Sophia is translated as wisdom. This is the ability to think well about the nature of the world, and it involves careful deliberation of universal truths. The nurses sensitivity to the situations of people around her can make her learn from their experiences. Remaining open to learning

can educate nurses about intellectual virtues that provide insight into the nature of reality, which could shape them to become practically wise. Practical wisdom (phronesis) Phronesis is sometimes translated as prudence. It is the capability to consider the mode of action in order to deliver change, especially to enhance the quality of life. It involves using ones insight into reality in deliberatively reasoning and applying the intellectual virtue of practical wisdom in directing ones actions. It includes knowing how a person of virtue chooses to act. Nurses are expected to be prudent at all times. He/she could exercise prudence by careful analysis of the actions and the decisions that he/she makes especially in rendering care to clients. Inability to be prudent could lead to situations involving negligence or malpractice. Choice (prohairesis) Morality is achieved through choice (prohairesis), facilitated by insight, practical wisdom, and evenness of emotional states. Moral virtues and the excellence of the nurses disposition, or character, are cultivated through habitual practice such as effective communication and compassionate caring. Goal or telos It embodies personal and professional excellence in nursing which is characterized as active happiness and well-being that is consistent with an enlightening awareness of the causes of moral suffering as well as the awareness of the sacredness of the day to day moral nature of nurses work.

o Virtues of the Health Care Provider

Fidelity Refers to the obligation of a person to be faithful to agreements, responsibilities, and commitments that he has made to himself and to others. It is the main principle that supports the concept of accountability of nurses and other professionals.

Honesty Being fair and just in character and behaviour, not cheating or stealing, free of deceit. This is synonymous with sincerity, integrity, truthful, uprightness, and just. Honesty to self and in the performance of duty is expected from the nurse.

Humility This is defined as being modest in dealings, unpretentious, with simplicity, and submissive. Nurses are known for this virtue as they perform their role as a member of the health care team.

Respect This is showing a deferential esteem felt or shown toward a person. Nurses do not only show this virtue to the patients but to the other members of the health team, community, and society, or in any setting that she is involved.

Compassion This is a virtue that is important for the nurse because this enables her to serve others selflessly.

Prudence This is described as acting with cautiousness, with foresight, and with discretion. A nurse is expected to be prudent in all that she does, especially in the performance of her duty.

Courage This is the ability to disregard fear in acting out ones convictions and belief. There are also times in a nurses career when he/she becomes physically and emotionally exhausted and yet, somehow, finds the strength to go on. Nurses have to muster up strength and persevere to be able to perform their duties and responsibilities.

o Habits of the Health Care Provider

The Good Habits Be Proactive The proactive habit can be applied in multiple ways to foster healthcare interoperability. This is acting in a flexible manner in order to perform better and achieve more. This could be done in the communication of patient data through the use of information technology. Being proactive in healthcare results to: 1. Adaptability being flexible to adapt to the various data requirements 2. Independence removing total reliance to others to achieve your objectives 3. Satisfaction delivering responsive clients service With a proactive mindset and approach, there is interdependence among health care providers in health care delivery.

 Begin with the End in Mind Knowing what you want to achieve for your practice is important in deciding what integration approach should be taken. With better service as the vision, the health care delivery goals are better achieved. As a health care provider, the nurses involvement could increase the efficiency of service. These could be through collaboration with the other members of the health care team, and the integration of technology in the different departments and levels of care. Put First Things First The patient is first. Delivering high quality patient care in a timely and accurate manner is fundamental. What helps facilitate putting patients first? There are many answers to this question. Having the right physicians, nurses, and other personnel is an essential part of the formula. Having the right facilities and equipment is a vital part of the formula. Having the right systems, applications, and ways to connect them is an integral part of the formula. While the quality of care is largely determined by human hands, an expert mind and a caring spirit is also Seek First to Understand, Then to Be Understood Many times, we jump to what we need, rather than listening to what our patients are requesting. A simple question to ask is, to gain greater understanding should be What are you going to do with the information that I gave you? Understanding what our patients need, rather than assuming, is imperative. Synergize What does synergize actually mean? Another term for synergy is alliance. In the healthcare environment, instead of treating each party as a department, it may be better to treat them as alliances. For alliances to work, everyone involved needs to work together. That is the point of synergy, and it is necessary to make connected, healthcare initiatives to work and be effective. Sharpen the Saw If there is only one thing that we can do in our life or in our organizations, it should be to look continuously for ways to improve. Whether it is in our client relationships, the way we solve our problems, or the way that we approach solutions, keeping our eyes open to new ways on how do things is a must. This process of renewal will keep progress moving forward. To achieve healthcare interoperability in our communities, continuous improvement is a must, because (if for no other reason) there are so many changes to which we need to adapt. There

is a simple choiceadapt and improve or maintain the status quo and keep the paper flowing. The improvements can be realized through many different resources. From workshops and trade shows to case studies, white papers, and blogs, there are many different avenues to continue to grow and adapt. Also, there is simple interactiontalking with people from similar or different organizations to gain their perspectives can open the thought process. Setting aside the time to learn and improve is the first step. Vices of the Health Care Provider Vices are defects of ones character or behaviour. Most, but not all virtues are considered a mean between two kinds of vices, involving either an excess or a deficiency. For example, Aristotle named courage as a virtue, the excess of courage is rashness, and the deficiency of courage is cowardice. Another example is truthfulness; the excess is imposture, and the deficiency as selfdeprecation. Fraud This is a criminal deception using false representations to gain an unjust advantage. This could be synonymous with cheating, deceit, swindling, counterfeit, forgery, falsification, double-dealing. Nurses could fall into such situations when he becomes an accomplice to such circumstances or practices such actions. Pride A high or overbearing opinion of ones worth or importance. Nurses could at times exhibit such attitude over their achievements, or feeling of elation or satisfaction of achievements, qualities, or possessions, over individuals or other professionals. Example: Senior health care providers should act as mentors to the younger ones, but sometimes they are not as accommodating as expected. Greed This is described as the excessive desire especially for food or wealth. Nurses could be put to trap in situations such as greed for power, position and material wealth.