Day 7 -Melbourne - convicts, moral distress and challenging positions

The walk to the Melbourne Convention Centre for the ICN Congress brings me over the Yarra river via the Sandridge bridge (See http://en.wikipedia.org/wiki/Sandridge_Bridge). The bridge has transparent plates detailing the number of immigrants to the region from different countries and the background to their arrival. There are, for example, a large number of Irish people in Victoria and some arrived in the late 18th and early 19th century as convicts and labourers.

There is a little irony in the fact that at least some of those Irish travellers here to attend the ICN Congress are now engaging in debate regarding ethics.

The discussion in the parallel sessions explored varieties of ethics support for practitioners and differences and similarities in values' frameworks. The final main plenary of the day focused on ethics in end of life care with presentations from Australia (Megan Jane Johnstone on moral distress), Iran (Ahmed Nejetian on Islamic approaches to death)  and New Zealand (Elizabeth Niven on codes and dilemmas in dementia care).  Megan argued that we should abandon the concept of moral distress. Ahmed enabled us to better appreciate the Islamic approach to death drawing on his professional and personal experience. Elizabeth talked us through practice dilemmas regarding dementia care, for example a person who now requests meat after being a lifelong vegetarian, drawing on values from professional codes and traditional values. I invited Megan to submit her paper to Nursing Ethics as there is scope for much more critical debate regarding moral distress.

As those of you who have attended conferences know, much of the really interesting discussion takes place outside the formal sessions. I had dinner with colleagues from Italy, Ireland, Brazil, New Zealand and the UK. In addition to a good deal of debate about the conference sessions we also discussed the role of ICN and the withdrawal of the RCN from this. There was a consensus that this stance is not in the best interests of UK nurses.....a challenging position that seems difficult to defend.

Given the gains that come with membership of an international professional organisation, can UK nurses really mind that less than £2 of their annual fee to the RCN goes to ICN?

Today I am off to survey the great ocean road. More later.