The 2015 NMC Code of Conduct has four key themes that it promotes and emphasises and the four key themes are prioritising people, practicing effectively, preserving safety and promoting professionalism and trust.
Within the code each of these four themes explores subsequent sub issues and points and in order for nurses to be an embodiment of the code and to adhere to it fully a clear understanding of the duty of candor in addition to effectively applying the duty of candor to nursing practice is essential.
For nurses and other healthcare professionals alike the duty of candor is not a concept or ideal that individuals have and option to adhere to but as identified in its name it is a duty and thus an obligation that must for this reason be clearly understood and appreciated by all nurses without exception.
Nursing is a professional discipline and one that is worthy of high respect both internally within the profession and the health service and externally from the wider public. In order for nursing to continue to be a professional discipline and one that generates respect it is essential that all nurses are an embodiment of the duty of candour which means that all nurses must be open and honest about their practice with their patients, their colleagues, their employers and other individuals or bodies as appropriate.
It is important to emphasize that the duty of candour is a concept that aims to enhance and improve nursing and healthcare practice and for this reason alone it should be viewed not with suspicion, negativity or fear but with positivity, maturity and seriousness.
Nurses should be open and enthusiastic to constantly learning and if individual nurses and the wider departments and organizations than nurses work within take seriously the duty of candor and put it effectively into practice then learning can taken place and help nursing practice to improve. When near misses occur and when mistakes are made it is imperative such situations are appropriately investigated and that learning can take place, investigators of incidents and all those involved must be open, honest and reflective post a negative incident from occurring.
From all negative incidents the likelihood of future incidents needs to be minimized and those involved in negative incidents need to reflect on how they can learn and develop and improve practice, not just for themselves as individuals but for the benefit of professional colleagues and ultimately the patients that nurses and their colleagues care for.
Openness, honesty and transparency are the central themes of the duty of candor, the process is not one that seeks to blame or embarrass individuals when things go wrong but to learn from mistakes. If nurses are to be professionals then mistakes must be acknowledged and learning must take place, if nurses are to be professionals then they must be honest at all times and finally if nurses are to be professionals they must be transparent in their practice.
Patient safety must be at the heart of good nursing practice and to this effect this means risks to patients, healthcare staff and others must always be minimized and that learning cultures need to become common place.
The NMC and the GMC have produced a joint booklet on the duty of candor and what this means for doctors and nurses as well as other healthcare professionals. The document can be accessed via the NMC website, the GMC website or by typing the following link into your browser.
The duty of candor is not something to be ignored, it is a concept that exists for a reason - to improve healthcare practice and enhance patient safety.
Donato Tallo is a registered nurse working in the acute hospital sector