Spelling Out R-E-S-P-E-C-T
Beth Ulrich, EdD, RN, CHE

Respect – we talk about it a lot. Often we talk about a lack of respect. But what is respect? How do you know if someone respects you? How do other people know that you respect them?

The first provision of the ANA Code of Ethics says that “The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth, and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems.” There is additional discussion of respect with patients, colleagues, and even on the responsibility for self-respect.

But what is respect? Theoretical and philosophical discussions often trace the concept of respect to Immanuel Kant in the late 1700s and discuss a myriad of variables involved in defining and displaying respect. These detailed discussions are thought-provoking but only give us hints as to what respect means to nurses specifically.

While working on two recent national surveys of registered nurses, I have become increasingly interested in the issue of respect and nurses. In the first survey, conducted in 2002, RNs who were planning to leave their current jobs indicated that more respect from management would cause them to reconsider leaving. With that in mind, we delved further into the respect issue in our 2004 survey and the results have stimulated even more discussion. In the 2004 survey, more respect from front line management and from administration continued to be influential in whether RNs stayed in or left their current jobs. In addition, 71% of the RNs responding said that increased respect for nurses would help solve the current nursing shortage. Sadly, only 21% believed that the shortage would lead to more respect. We also added a question in 2004 with seven items that had been suggested by various authors as indicative of respect (i.e., involving nurses in decision-making and listening to nurses’ concerns) and asked the participants to tell us if these items indicated respect to them; but no item was selected by more than 43% of the respondents. Clearly, we had more to study.

Previous and subsequent literature reviews have been surprising in the paucity of research on respect and nurses/nursing. Respect is discussed in general, but rarely is the term clearly defined nor are the behaviors that would indicate respect. Defining respect seems a bit like déjà vu. Quality was once discussed in the same way – you know it when you see it. Fortunately, we have gotten much better in recent years in defining quality indicators and now we can talk about quality in much more finite terms.

We face the same challenge with the issue of respect. It is difficult to tell people to show us respect when we have not adequately defined the behaviors we want to see. In my travels across the U.S., I often ask nurses to tell me what respect means to them and to describe how they know a person respects them or how they indicate their own respect for others. More often than not, nurses have trouble answering the questions. At best, they describe disrespect.

So I now pose the questions to each of you. What does respect mean to you? What specific behaviors let you know that you are respected by another individual? What specific behaviors do you exhibit when you respect another person?

I very much want to hear your answers and I invite you to email them to me (BethUlrich@aol.com). With your help, we can better define respect and the behaviors that indicate it. Only then can we make or expect positive changes.

Beth Ulrich, EdD, RN, CHE
Editor
E-mail: BethUlrich@aol.com