Letter to the Editor by Cockerel on "Vigilance: The Essence of Nursing"

Patient Safety: Who Guards the Patient?

March 27, 2006
in response to Vigilance: The Essence of Nursing by Geralyn Meyer, PhD, RN; Mary Ann Lavin, ScD, RN, FAAN (June 23, 2005)
with reply by authors

Dear Editor:

I am writing in response to the article, "Vigilance: The Essence of Nursing." I support the philosophy that caring is fundamental to nursing. I have been a nurse for 26 years and have worked in various areas of nursing. I agree with the authors' statements that vigilance is not seen, felt, or heard by others. Vigilance is gained through knowledge and caring. This is knowledge we have and is expressed explicitly or implicitly. It takes a trained professional to act upon this knowledge. Nurses use their body of knowledge and experience to provide humane care.

The American Nurses Association Code of Ethics (2001) supports the idea of being vigilant in that it identifies a nurse as a leader and vigilant advocate for the delivery of dignified and humane care. There have been many times in my career that I have collected "within normal limits" data on a patient but continued to monitor that patient because of simply having a feeling that something was just not right with the patient.

Being vigilant becomes second nature to a nurse. If nurses were not to be vigilant, we would likely see an increase in adverse patient outcomes. Vigilance is something nurses do without being consciously aware of it. I thank the authors for bringing this out and showing how being vigilant is not just doing your job. Being vigilant is caring.

Alice J. Cockerel RN, MSM
Advanced Patient Care Facilitator
Baptist Hospital of Miami
Miami, FL


American Nurses Association. (2001). Code of ethics for nurses with interpretive statements. Washington DC: Author.