Social Justice and the ‘good’ nurse

Inequalities in health between social classes and other groups have been known about for some time but despite attempts to address them, they remain highly visible as a failure of social justice. The Health and Social Care Act 2012 passed into law statutory duties on the NHS to have regard to the need to reduce health inequalities, and the NHS Constitution states that: ‘[the NHS] has a wider social duty to promote equality through the services it provides and to pay particular attention to groups or sections of society where improvements in health and life expectancy are not keeping pace with the rest of the population.’ However this aim is not mentioned in the NHS Outcomes framework, and in the current fiscal climate and associated budgetary pressures, the prospect of progress at the policy level appears slim.

This leaves individual practitioners in a difficult situation. In some countries, notably in north America, the advancement of patients’ health via social justice is a stated aim of the nursing profession, and as part of a regulatory Code of Ethics, this appears to be a clear duty for every nurse. No such clause exists in the UK Code, so that action promoting social justice cannot be regarded as a professional duty which must be undertaken by all nurses. This paper argues that although advocating for social justice is therefore not required of all just-good-enough nurses, those practicising just within their Code, it is however a necessary feature of the ‘good’ nurse. The issue is addressed from both education and practice: via conceptual discussion of the ‘good’ nurse from a nurse academic, and illustration of good practice in promoting social justice from a practicing nurse.