This essay will discuss how nurses are expected to cope with rapid change in a complex health care system that values the ‘bottom line’ and efficiency while sustaining excellence in caring and healing practices, to which nurses struggle to maintain their commitment. Despite barriers to excellence in nursing practice, such as diminished resources, time constraints and perceived threats to quality of care, many nurses perform what may be called good work.Good work in nursing is defined as work that is technically and scientifically effective as well as morally and socially responsible. When nurses perform good work and remain committed to excellence, they experience fulfillment as they contribute to the well-being of their patients. Experienced nurses committed to excellence during challenging times serve as exemplars for others seeking to sustain a commitment to good work. Using the qualitative methodology of the Good Work.

Defining good work in nursing

Good work in nursing may be defined as providing quality care for and assisting persons in achieving a level of wholeness and health that would enable them to attain their desired goals or life plan.5 To the extent that professional caring is essential in helping persons to achieve their desired life goals, nurses committed to good work must be skilled in professional caring. Elements essential to professional care include: (1) affection, a positive regard for the one receiving care; (2) cognition, the knowledge of what is essential to achieve the well-being of the one receiving care; (3) volition, the commitment to use one’s knowledge in the best interest of the one receiving care; (4) imagination, the capacity to share the lived experience of the one receiving care; (5) motivation, the predisposition to place the interest of the patient before one’s own interest; and (6) expressiveness of action, use of verbal and non-verbal behaviors to convey care.5 These conditions are supported by virtues such as respect, compassion, intellectual honesty, accountability, empathy, altruism and caring, all supporting the primacy of caring in the nursing profession.

The concepts of values and virtue are integral to the concept of good work in nursing and therefore merit definition. Burns6 defines values as end states, goals or explicit purposes according to which decisions about behavior are made. According to Pellegrino, healing, helping, caring well and acting in the best interest of the patient are the end states or goals of nursing and medicine. Virtues predispose a person to act well in pursuit of end states, goals or explicit purposes. Virtues, such as fidelity to trust, compassion and caring predispose the nurse, physician or other health professional to act habitually in the best interest of the patient. Pellegrino acknowledges that the health professional may not achieve a state of perfection in the pursuit of excellence. However, the good nurse or physician will always strive to be better by going beyond mere expectations to achieve a higher end or goal. Virtue ethics provides a framework and principles of conduct to guide the nurse or physician acting in the best interest of the patient.

While considering mentorship as a way of progression in the profession, it is important for the nurse to think critically and objectively about what this role entails. Nurses who are considering becoming involved in student supervision and mentorship in any clinical setting should have knowledge of the importance of mentorship, its process and basic principles. Although mentorship programmes aim to help staff understand the concept of mentorship, thinking clearly and critically about the role before joining such programmes is important. Reading about the concept, talking to experienced nurses and those undertaking mentorship courses can help. This knowledge can encourage nurses to reflect on and understand their attitude to and aptitude for mentorship which, in turn, could improve their academic performance and enhance self-satisfaction.