Understanding professional misconduct: Snowflakes,stoics or organisational culture?

Some time ago, we attended a conference on professional regulation where a speaker presented a sympathetic portrayal of registrants accused of misconduct. These registrants were, the speaker argued, subject to pressures and stresses in their everyday practice and the fitness to practise process itself also impacted negatively on registrants’ mental health. One conference delegate was heard to mutter under his breath: ‘Snowflakes!’

The role of professional regulation is, primarily, to safeguard the public. Regulators receive and must respond to concerns raised by members of the public, by employers, by colleagues and by registrants themselves. The complaints are many and various, ranging from accusations of rudeness and lack of respect towards care-recipients and families to examples of dishonesty, abuse and general misconduct.

So what are the causes and contributory factors relating to misconduct? And how seriously should we take an all too often presented claim that a registrant’s misconduct is due to organisational, systemic or societal pressures?

Research we have been involved in recently has highlighted the impact of pressurised work environments, of scarce resources, of inadequate employer and professional support and of public expectations. ¹ There was surprisingly less emphasis on individual culpability than might be expected in a number of cases where individuals appeared to seize opportunities to take advantage of clients or work colleagues.

In this Editorial, we wish to take the opportunity to consider the under the breath ‘snowflake’ suggestion, and caution against an overly sympathetic approach to registrants accused of misconduct. Individual factors are presented as mitigating or aggravating ‘reasons’ in situations of ‘misconduct’ and must be weighed appropriately in relation to organisational or societal factors. We would argue therefore that both individual and organisational/societal factors need to be considered.

The label ‘snowflake’ has been used as a derogatory term to characterise a generation of young people of the 2010s (Millennials). ² An unfair accusation, in our view. The label indicates that these young people lack resilience and are overly sensitive, taking offence and being too emotionally vulnerable. The term has also been used disparagingly in political circles, both left and right, to refer to people as thin-skinned and as ‘whingers’. ³

We consider the potential of the ‘snowflake’ label in relation to registrants accused of misconduct. Might it be the case that being overly sympathetic to their circumstances makes a virtue out of vices of malleability, faint-heartedness and unprofessionalism?

The phenomenon of ‘snowflake professionals’ might be in keeping with a view that external professional and environmental factors, as causes for complaints, are unhelpful and often a distraction from other more reasonable explanations. Registrants are in positions of power and responsibility and must be relied upon to do the right thing in challenging circumstances. They are paid a salary, commit to being regulated, agree to be accountable and autonomous and to adhere to professional standards. Readers please note that we are not here referring to, or discussing, the predicament of less privileged care-givers.

Surely, it might be argued, that if registrants do not adhere to those standards, there is no-one to blame but themselves? Surely if they don’t have the resilience required to weather the inevitable challenges of working with people in difficult circumstances, they should not have entered the profession? Surely recruiters, educators and senior practitioners have emphasised that health and social care practice is both challenging and rewarding?

Putting too much reliance on external reasons for fitness to practise complaints is detrimental to the professions.

Explanations focusing on external factors can also deny registrants’ individual responsibility for their behaviour and attitudes. Such explanations may, in fact, support a line of argument that renders them ‘snowflake professionals’, as individuals who are not resilient or robust enough to take a stand and to refuse to engage in misconduct. This may resonate with perspectives on moral distress whereby nurses are cast as victims and helpless. ⁴

The antidote to ‘snowflake professionals’ and lack of resilience is, we suggest, a focus on aspects of Stoic ethics. The philosophy that emphasises ‘no excuses’, strength of conviction and the virtues of wisdom, self-control, courage and justice ⁵ has much to offer professional ethics. Ancient insights from Marcus Aurelius, ⁶ for example, direct individuals to honour the best in themselves and to reflect on behaviour. This goes some way to engaging with the reality of professional practice.

We accept that this is a provocative and, perhaps, a rather severe perspective on individual responsibility in Fitness to Practise complaint situations. We aim primarily to counter views of registrants as victims, as impotent non-agents and as helpless and rudderless in the turbulent waters of health and social care practice. Rather, we wish to emphasise the moral agency of these important professionals and to promote reflection on the best means to equip them for practice rather than disempower them with discourses of victimhood and snowflakery.

A focus on the individual is necessary but not sufficient, however, and we do need also to consider contextual factors that impact individual behaviour. In addition to individual factors, we need to consider organisational culture and the relationship with individual practitioners. Insights from social psychology ⁷ highlight the corrupting influence of organisational culture. Research published in this journal over the years has focused on the significance of organisational culture or climate in decreasing moral distress. ⁸

There is, then, a necessary relationship between individual behaviour and organisational culture. However, we argue that we should not downplay the role of individual responsibility in unethical actions and omissions. The current focus of some innovative approaches to professional education that prioritise professionalism and moral resilience ⁹ is part of the solution to professional snowflakery. Educators and experienced practitioners have a responsibility to make students and novice practitioners aware of the challenging and privileged nature of their practice and of strategies to respond in both a constructive and effective way. Researchers need also to continue the quest to better understand individual factors that contribute to, and guard against, misconduct. In the meantime, any ‘snowflake’ registrants need to ensure they do not melt when confronting the inevitable challenges of professional practice.

We would welcome your responses to this Editorial. If you would like to comment, please email the Editor at nursing-ethics@surrey.ac.uk with a subject heading of ‘Snowflake Editorial’.