Although dignity has been widely explored in the context of healthcare, it has rarely been the subject of empirical exploration when care is delivered by community district nursing teams. This paper demonstrates how a commonplace community nursing task (changing dressings) can constitute a clinical lens through which to explore the ways in which community nurses can influence patients' dignity. This ethnographic study involved two research methods: interviews with patients and nurses (n=22) and observations of clinical interactions (n=62). Dignity can manifest during routine interactions between community nurses and patients. Patient-participants identified malodour from their ill-bodies as a particular threat to dignity. Nurses can reinforce the dignity of their patients through relational aspects of care and the successful concealment of ‘leaky’ bodies.
Policy and guidance recognise the importance of dignity in healthcare (Department of Health and Social Care (DHSC), 2015; Dignity in Care, 2019). A quality indicator from the National Institute for Health and Care Excellence (NICE) states that nurses and health professionals should ‘treat patients with respect, kindness, dignity, compassion, understanding, courtesy and honesty’ (NICE, 2012; 2021). However, by noting that dignity is an indicator of quality, there is a danger that it may be viewed as an optional extra, rather than a standard element of care. In practice, caring for patients with dignity is mandated through professional codes of practice for nurses (International Council of Nurses (ICN), 2012; Nursing and Midwifery Council (NMC), 2018), yet dignity remains difficult to define (Social Care Institute for Excellence (SCIE), 2020) and, of course, operationalise.
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