Eight in ten nurses in Britain say they are facing serious challenges to their ability to treat patients with care and compassion.

In research published by the University of Birmingham, the nurses cite staff reductions, time pressures, and “pen-pushing”, saying that these lead to moral disengagement and compromise of professional practice.

Researchers surveyed almost 700 nurses and trainees. They found that about 45% of respondents tend to follow strict rules, rather than their own moral compass, when faced with dilemmas over treatment and care.

Professor Kristján Kristjánsson, a co-author of the report from the Jubilee Centre for Character and Virtues, summarizes:

Many nurses felt their moral obligations to the patients had to be compromised due to the time constraints and staff shortage.

Many nurses said often there have been times when they come away from patients feeling they did not do as much for those patients as their hearts dictated and that the patients did not receive the care they deserved due to low numbers in staffing.

Despite the barriers, the study found nurses continuing to identify moral motivation as their reason for joining the profession. Those surveyed still said that they can work autonomously with the support colleagues, and that it is possible to maintain a level of emotional engagement with patients and their profession.

The report recommends that moral role modelling, with a greater emphasis on ethical theory, be placed at the heart of nursing education. This will curb the tendency to “‘go by the book’, circumventing individual reflection and responsibility and doing uncritically whatever the rules or standards of practice say”.

It urges help to trainees to relate values and virtues to their duties, and a “robust approach” to character evaluation when assessing the suitability of candidates for nursing.