The Active Conscience: Yet Another Reason Why Nurses Rock

Society is filled with shady 'professionals' who have no problems engaging in lying, theft, deception, fraud, and cover-ups at the expense of the people whom they're supposed to help. Nurses should take pride in continuing to act upon their active consciences to do right by their patients. Without an active conscience, nothing much is stopping a person from doing really horrible things to humankind. Nurses Announcements Archive Article

The Active Conscience: Yet Another Reason Why Nurses Rock

"The only thing worse than an active conscience is one that's retroactive." - Harold Coffin.

An active conscience is defined as an inner awareness of right and wrong, good and bad, that a person uses to constantly steer his or her conduct toward taking the ethically righteous course of action in life.

Having an active conscience is extremely important, because without one, there's not much else to stop a person from perpetrating awful acts against others, perhaps except the external threat of legal punishment. Then again, people who do not possess active consciences would most likely do something bad if they felt they had a strong chance of not getting caught.

Based on purely anecdotal support, I would say that the overwhelming majority of nurses have active consciences that guide them to do the right things, even when the most difficult situations arise. As an example, nurses have topped the list on Gallup surveys for many years, having been voted the 'most trusted' professionals by members of the public who respond to the poll.

Nurses, who have led the rankings for 11 consecutive years, were ranked "high" or "very high" for honesty and ethics among 85% of respondents (Laidman, 2012). In other words, a large segment of the population trusts us to tell the truth, be ethical, and do right by them.

Not all individuals have active consciences, which leads them to lie, cheat, steal, mislead, falsely blame, and engage in many other unsavory exploits that devastate peoples' lives. For instance, the shady insurance salesman who convinces unsuspecting people to purchase useless discount plans by deceptively claiming they are health insurance policies lacks an active conscience. This is obvious because the blatant deceit does not bother him one bit.

Also, the live-in caregiver who sneakily makes unauthorized bank withdrawals from accounts belonging to her trusting elderly client lacks an active conscience because the theft does not create any inner struggles between right and wrong.

Unfortunately, several of the entities that employ nurses are filled with managerial employees who seem to not have active consciences. Many nurses wonder how some hospital administrators, chief nursing officers, and unit managers are able to look the other way while understaffing, a lack of supplies, and poor working conditions negatively affect patient care. Some nurses are puzzled by the current trend of placing customer service on the highest pedestal while patient care gets placed on the back burner. Other nurses stare in disbelief as the unit manager is rushing them to transfer the deceased patient out of room 401 to make room for a new admit coming from the emergency room. How can this be happening?

Is the love of monetary profit causing some peoples' consciences to become inactive?

In this difficult healthcare climate, nurses should be immensely proud of themselves for continuing to act upon their active consciences to do the right thing for their patients. Without an active conscience, the world would become a frightening place with people who are incapable of feeling shame, guilt and remorse.

Work-Cited / References

Laidman, J. (December 6, 2012). Nurses Remain Nation’s Most Trusted Professionals. Medscape Medical News. Retrieved January 2, 2012 from http://www.medscape.com/viewarticle/775758

TheCommuter, BSN, RN, CRRN is a longtime physical rehabilitation nurse who has varied experiences upon which to draw for her articles. She was an LPN/LVN for more than four years prior to becoming a Registered Nurse.

102 Articles   27,612 Posts

Share this post


Thank you for sharing this article!

Specializes in LTC and School Health.

Great Article. I have come across some nurses without an active conscience and it is down right scary. I like them as a person but I wouldn't let them touch me or my family member with a ten foot pole.

There are a lot of people in the medical field, including nurses, who will lie and/or throw someone else

under the bus to save or protect him or her self.

Loved this, so many great points!

I do think there can also be a subset of sorts, where an individual does have an active conscious (mostly, it's only sociopaths don't) but do NOT follow their own inner moral code. These people might appear to be guilt-free, but, i rather suspect, that there is some inner turmoil of some type going on inside them now and then, or maybe some emotional, or even physical symptoms as a result of behaving in a manner they knew was wrong,

or perhaps their own self-esteem---- their own ability to view their own self as "good"---- is now diminished. But, i'd readily agree, some humans suffer far more,

or far more obviously, for breaking from their own inner moral code.

My point there is, most humans do have an active conscious,

it's getting people to FOLLOW their own inner moral code that is also important. There are many levels of morality,

as well as many kinds of morality,

from behaving appropriately out of fear of punishment/ or for reward,

to doing it because of your own inner moral code requires that you do.

I am resisting urge to link a fascinating survey/quiz on how to discover what factors might influence the kind of moral-decision-making an individual follows....sometimes, what is legal, or generally accepted by a society,

or an organization,

and what is moral,

can vary.......guess that'd be an entirely different thread, though, ha ha!!

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
There are a lot of people in the medical field, including nurses, who will lie and/or throw someone else under the bus to save or protect him or her self.
Yes, this is unfortunately true. This is evidenced by fabrications on nurses notes, falsely blaming coworkers for one's own mistakes, engaging in cover-ups, telling lies about other people, and the list goes on. Every group has some bad apples.

I still think the majority of nurses act upon their active consciences, and that the minority of nurses either lack active consciences or do not act upon the inner voice guiding them to do the right thing.

Specializes in TELE, CVU, ICU.

Your comments made me thick of Kohlberg's model of moral development:

Pre-conventional level (mostly children):

Follows intuitive thought

Conforms to rules out of fear of punishment or to get rewards

Fear of consequences if authority is disobeyed

Conventional level (most people):

Significant others are recognized

Good girl/ good boy orientation: Conforms to expectations to gain approval

Law & order orientation: Societal laws and rules are followed regardless of consequences

Post conventional level (advanced):

Obeys rules that are necessary for social order, understands they can be changed

Moral judgments internalized into ones own values, morals, standards of justice

Loved this, so many great points!

I do think there can also be a subset of sorts, where an individual does have an active conscious (mostly, it's only sociopaths don't) but do NOT follow their own inner moral code. These people might appear to be guilt-free, but, i rather suspect, that there is some inner turmoil of some type going on inside them now and then, or maybe some emotional, or even physical symptoms as a result of behaving in a manner they knew was wrong,

or perhaps their own self-esteem---- their own ability to view their own self as "good"---- is now diminished. But, i'd readily agree, some humans suffer far more,

or far more obviously, for breaking from their own inner moral code.

My point there is, most humans do have an active conscious,

it's getting people to FOLLOW their own inner moral code that is also important. There are many levels of morality,

as well as many kinds of morality,

from behaving appropriately out of fear of punishment/ or for reward,

to doing it because of your own inner moral code requires that you do.

I am resisting urge to link a fascinating survey/quiz on how to discover what factors might influence the kind of moral-decision-making an individual follows....sometimes, what is legal, or generally accepted by a society,

or an organization,

and what is moral,

can vary.......guess that'd be an entirely different thread, though, ha ha!!

Your comments made me thick of Kohlberg's model of moral development:

Pre-conventional level (mostly children):

Follows intuitive thought

Conforms to rules out of fear of punishment or to get rewards

Fear of consequences if authority is disobeyed

Conventional level (most people):

Significant others are recognized

Good girl/ good boy orientation: Conforms to expectations to gain approval

Law & order orientation: Societal laws and rules are followed regardless of consequences

Post conventional level (advanced):

Obeys rules that are necessary for social order, understands they can be changed

Moral judgments internalized into ones own values, morals, standards of justice

LOVE THIS, your post reminds me of the many thoughts that cross my mind,

when i get asked, cuz i am an atheist,

"well, if you don't believe in heaven or hell, what keeps you from just killing people then?"

*sigh*

it would seem, whenever i get asked that (shockingly often!)

that they have no concept of following one's own inner moral code...

Unfortunately I encountered 2 nursing instructors with sociopathic behaviors. One was my theory instructor and one was my clinical instructor also a CNO. Im a very shy passive person also consider myself an empath. These women were out to make my life hell. They won the battle but they wont win the war. Clinical Instructor failed me.. I caught her in a couple lies she wrote in my evaluation. I had more than three witnesses. She left mid semester when she had another group to teach. She either left to cover her butt or got fired. Dean gave me the go ahead to dispute the grade. I withdrew and didnt bother. I believe in forgiveness and she did give me good pointers when I asked her why she failed me every eval. Nothing could meet her expectations. As a student I thought teaching me and letting me prove I learned was going pass me but she told me id fail anyway. She even said I could show up the last week but no matter what I would fail. She took my right to earn a living away. Anyways these are just a few I met. I dated one for two years and he manipulated me into giving him all my savings and still till this day thinks he can leech. It finally clicked that there are people out there like that, 1 out of 25. Finally deleted all contacts with him and never replied to his BS. These people have absolutely no feeling at all. Its better to run while you can.

Specializes in hospice.

You dated an instructor, in clear violation of practically every university regulation in the civilized world? But yet it's all everyone else's fault. There's a little wrinkle you hadn't posted before.

I like this part of the article the best:

Many nurses wonder how some hospital administrators, chief nursing officers, and unit managers are able to look the other way while understaffing, a lack of supplies, and poor working conditions negatively affect patient care. Some nurses are puzzled by the current trend of placing customer service on the highest pedestal while patient care gets placed on the back burner.

There are times when I have to choose between what is best for the patient, safe for me, etc. and pleasing management or obnoxious families. I have become more assertive to safety and figure if they have a problem with me refusing an unsafe assignment or putting family demands at the bottom of my priorities, they can fire me or put a bad mark next to my name. But if a patient is harmed because I compromised safety to please higher-ups, I could not live with that.

Yes, ones active conscience is alive and well in nursing, thankfully.

What I find the most interesting is that any number of managers, directors and the like spend countless hours attempting to convince a nurse to NOT use one's active conscience. That is where the weird cult concept comes into play.

Even any number of nurses who are threatend with their jobs if they do not jump on the bandwagon.

This article is really, really good. And perhaps explains why most in upper managerial positions are not nurses.