• Michelle Cleary and Jan Horsfall.
• Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. michelle cleary@nuhs.edu.sg
• Issues Ment Health Nurs. 2013 Sep 1; 34 (9): 673-7.

AbstractIntegrity is interpreted as a holistic phenomenon that incorporates personal characteristics, cognition, interpersonal awareness, and practical enactment-ultimately relating to matters society deems worthwhile. This approach enables integrity to be understood as both a personal morality and a social (group) morality. Mental health nurses embedded in a hierarchical bureaucratic organisation may act according to their personal morality and display moral strength in many situations; however, if the social morality of the group is at variance with their convictions, as individuals their capacity to be courageous and enact integrity will be tested. A likely consequence will be that those with the most cherished positive patient care values, those with a stronger adherence to moral convictions about the public good, and those with a clearly developed understanding of integrity parameters will depart, and possibly leave the profession. In this article, we provide an overview of the structural and contextual realities of nursing work within organisations and discuss how these factors can compromise whole unit integrity and seriously challenge mental health nurses' commitment to enacting integrity. In the final section of this article, broad suggestions for strengthening individual and group integrity are provided.

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