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Acknowledging small acts of kindness

As regular readers will know, a number of recent editorials in Nursing Ethics have focused on unethical health-care practice. It is necessary to strive to understand this and to work in our different areas of practice to eradicate it. It is also important to draw attention to, celebrate and reward ethical practice. Therefore, I would like to share a practice example that highlights, I believe, the very best of nursing practice. It was just after 9 am on a Monday morning when an email with the subject ‘Fab student’ was forwarded to me by a colleague. The email was from a staff nurse in the emergency department of a local hospital. She described a practice situation where one of our student nurses had, in her view, gone beyond the call of duty in delivering end-of-life care to a patient. I contacted both the student and the staff nurse and asked them to describe the situation in detail. Each wanted to give credit to the other for the actions that undoubtedly enhanced the final hours of an elderly patient. The staff nurse, Sarah, emailed me her version of events. She described her busy practice area and the admission of a patient she called ‘Lily’ (not her real name). Lily was a 78-year-old woman who was admitted from a residential home. ‘She had been an independent woman who only gave up work a couple of years before which she worked as a carer in a rest home herself’. Lily had no family and had arrived at the hospital, around lunchtime, after collapsing and having a period of unconsciousness. A variety of diagnoses were initially suggested. She was found to have significant abdominal pain and was referred to the surgical team who thought she may have a perforated bowel secondary to an obstruction. Sarah said: