Dignity and me

Dignity is concerned with how people feel, think and behave in relation to the worth or value of themselves and others. To treat someone with dignity is to treat them as being of worth, in a way that is respectful of their diversity, as valued individuals. In care situations, dignity may be promoted or diminished by: the physical environment; organisational culture; by the attitudes and behaviour of nurses and others and by the way in which care activities are carried out. When dignity is present people feel in control, valued, confident, comfortable and able to make decisions for themselves.

When dignity is absent people feel devalued, lacking control and comfort. They may lack confidence and be unable to make decisions for themselves. They may feel humiliated, embarrassed and ashamed. Dignity applies equally to those who have capacity and to those who lack it. Everyone has equal worth as human beings and must be treated as if they are able to feel, think and behave in relation to their own worth or value. Nurses should, therefore, treat all people in all settings and of any health status with dignity, and dignified care should continue after death.

So what does it mean to you? Take a moment to think of all the words that you associate with dignity, and all those words that indicate a lack of it. Then explore the animation below to see the words in the selection and compare them with your ideas.

Did you identify words in common, or recognise ones you hadn’t thought of?  When you were thinking about your workplace, did you recall examples – dignified or not – related to:

These three themes – people, processes and place recur throughout this learning. All three work together to promote dignity. Which of these do you have influence over? Your influence on dignity at work will be shaped by your beliefs and values.

Self-awareness

What we believe and value will influence our professional practice, right down to the smallest interaction or task we engage in therefore we need to be aware of our beliefs and values, how they are shaped by our culture and upbringing – and be open enough to question and reflect on them. In relation to dignity, there are three key messages about self-awareness:

  1. We need to know and respect ourselves before we can respect the dignity of others.
  2. We need to be aware of the impact of ourselves on others – and vice versa.
  3. We need to be able to provide care that takes account of the beliefs and values of others that are very different from our own.

Listen to Siobhan's story which illustrates these points and as you do, reflect on how you might have felt and behaved if it had been you in Siobhan's situation. Use these questions to clarify your values and beliefs. You may wish to document your responses in a reflective statement for your e-Portfolio using the Reflective learning record template (PDF 42KB) - [How to access PDF files]. 

What do you see?

You may have seen or heard a poem by nurse Phyllis McCormack which begins:

What do you see nurse, what do you see?
What are you thinking when you look at me?
A crabbit old woman, not very wise,
Uncertain of habit with far away eyes,
Who dribbles her food and makes no reply
When you say in a loud voice, "I do wish you'd try."

The poem goes on to describe a person of worth, and a life well lived. The author had been a nurse in a psychiatric hospital and was dismayed by the lack of compassion from some of the staff and so wrote this poem anonymously for the hospital magazine in the hope that it would promote a change in attitude. Watch and listen to the opening scene played by Virginia McKenna OBE, and reflect on the degree of awareness the nurses show Elsie. What needs to change if Elsie's care is to improve and become centred on her needs? You may wish to include your responses in your reflective statement.

 

Personal presentation

The way we look including the clothes we wear are not neutral! As much as we would like to believe the old adage: “It’s not what you’re like on the outside, but what you’re like on the inside, that counts” – our clothes are a form of communication, they tell people something about us. Nursing uniforms and the personal appearance of nurses have been the subject of debate – and much criticism – ever since Florence Nightingale’s day. Personal presentation is often linked to the concept of dignity because of the way uniforms make nursing staff feel and behave, and how the appearance of nursing staff has an impact on patients, clients, carers and colleagues. The following activities allow you to explore some of the issues about what contributes to a dignified appearance, and what may be perceived as undignified. Take a few moments to consider the images in this next activity and reflect on:

Dignity is difficult to define because it can mean different things to different people. This includes personal presentation – your opinions on what gives you a dignified presence may be similar to, or very different from the nurses who expressed their thoughts in the previous activity. However, there are some principles that apply wherever you work. Uniform or work clothing should be:

Look at your employer's dress code or policy. Do you conform to it? Are there any suggestions you could offer to your employer to strengthen it? Your RCN Health and Safety representative can provide advice if you have concerns. Find out who they are by contacting your local RCN office or branch – details are on your RCN membership card, on the RCN website, in your handbook, or telephone RCN Direct: 0345 772 6100.

Self awareness tools

Here are two useful tools to provide a more structured approach to analysing your self-awareness. Chochinov’s ABCD framework (2007) invites you to reflect on an episode of care and your part in it, specifically your:

What went well? What do you think you need to modify if the situation arose again?
 
Matiti and Cotrel-Gibbons (2006) used the SWOT framework to invite nurses to identify:

You might like to try a SWOT analysis relating to dignity in your workplace.