Quiz Button

Nurses’ Code of Ethics

 

Purpose: This course is intended to give the nurse an overview of the Nurse’s Code of Ethics, and assist the nurse in developing his or her ethical decision making skills.

 

Course Objectives:

1. Define key ethical principles.

2. Explore what ethics are and how they apply to nurses.

3. Learn about the ways in which the nurse practices with compassion and the recognition of human dignity and worth that is present in every individual.

4. Identify the primary commitment of the nurse and what the nurse should seek to protect.

5. Identify the nurse’s relationship with responsibility and accountability.

6. List the nurse’s obligations to maintain competence, the continuation professional growth.

7. Understand how the nurse facilitates improvement in the healthcare environment and assists in the advancement of the profession.

8. Indicate how the nurse collaborates with other health professionals to meet the health needs of the community, the nation, and the world.

9. Discuss how the profession of nursing is responsible through associations and their members for articulating nursing values, for maintaining the integrity of the profession and its practice, and for shaping social policy.

10. Understand ethics in practice.

 

 

 

Key Ethical Principles

Autonomy – Ability of an individual to make a uncoerced, informed                               decisionBeneficence – Doing good, performing acts of kindness Confidentially – Spoken, written or acted on in privacy Human Dignity – Respect for the intrinsic worth of humans Informed Consent – Right and responsibility to freely and voluntarily consent or refuse treatment or a procedure Nonmaleficence– Doing no harm Privacy – Being secluded from the presence of others _________________________

Course Content

What Are Ethics?

Ethics deal with the actions of being right and wrong and what is good and what is bad. Ethics help assure that things are fair and people are treated with dignity. Ethical principles improve professional relationships with clients, patients and co-workers. Ethics are vitally important in all professional fields including medicine, nursing, business and philosophy.

While there can be differing views about what is right and what is wrong, professional codes of ethics are established by experts in each profession, and they determine how the professional should behave. They do not provide specific solutions. They serve as a guide for moral and ethical conduct.

Ethics are not always aligned with internal emotions or feelings. Emotions and feelings sometimes steer people into doing things that may or may not be ethically correct. Also, laws are not always ethical, and historically there are many examples of this. Consider laws enacted by Adolf Hitler or by pre-Civil War America. Would you consider slavery or involuntary medical experiments ethical?

Nurses and Ethics

Nursing embraces human rights and provides care without regard to conditions of race or culture. In nursing, the patient may be an individual, a family, or a community. Florence Nightingale developed a pledge in the 1800’s that is the basis for much of the current code of ethics. Below is the pledge developed by Florence Nightingale:

“I solemnly pledge myself before God and in the presence of this assembly, to pass my life in purity and to practice my profession faithfully. I will abstain from whatever is deleterious and mischievous, and will not take or knowingly administer any harmful drug. I will do all in my power to maintain and elevate the standard of my profession, and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling. With loyalty will I endeavor to aid the physician in his work and devote myself to the welfare of those committed to my care. (2)”

The American Nurses Association (ANA) Code of Ethics for Nurses serves the following purposes:

• As a statement of the ethical obligations and duties of every nurse
• To act as the profession’s non-negotiable ethical standard
• To express nursing’s understanding of it’s commitment to society

The words "ethical" and "moral" are used throughout the Code. "Ethical" is used to refer to reasons for decisions about how one ought to act professionally, using the above mentioned approaches. The word "moral" overlaps with "ethical" but it’s more aligned with personal belief and cultural values.

The Nurses' Code of Ethics is a dynamic document that changes as the American morals and values change. In fact, as of June 2014, the ANA is in the process of revising the Code of Ethics again.

There is also an international Code of Ethics for Nurses that closely parallels the premise of the ANA Code of Ethics. The International Council of Nurses (ICN) Code of Ethics is grouped into four distinct areas that define the responsibilities of the individual nurse and nursing as a whole. The four areas are to:

1. Promote health
2. Prevent illness
3. Restore health
4. Alleviate suffering

The American Nurses Association (ANA) Code of Ethics has nine provisions grouped into three general areas. The three general areas of the ANA Code of Ethics are involved with the:

 

1. Fundamental values and commitments of the nurse
2. Boundaries of duty and loyalty
3. Duties beyond individual patient encounters

The following content describes the nine provisions of the ANA Code of Ethics. This description is only a review of the main points. To access the complete Code, follow the link provided in the References section.

Provision 1. The nurse, in all professional relationships, practices with compassion and the recognition of human dignity and worth that is present in every individual.

• Respect for human dignity. In the provision of care, the nurse respects the beliefs and customs of the individual, family, or community. The nurse takes into account the values and needs of all persons in the professional relationship.
• Relationships to patients. The need for health care is universal regardless of the unique differences of each patient. The nurse establishes therapeutic relationships with patients and administers nursing care that respects the unique differences of the patient. This includes considerations of lifestyle, value system, and religious beliefs. Respect for the values and beliefs, of the patient, does not imply that the nurse condones those beliefs or practices on a personal level.
• The nature of health problems. The nurse respects the rights, dignity, and worth of all those who require nursing services for support, comfort, health restoration, or health promotion and prevention. The nurse does not allow the disease, disability, or functional status of the patient to determine the individual’s worth. The nurse plans and individualizes care to allow the person to live with as much physical, spiritual, social, and emotional well-being as possible.
• The right to self-determination. Respect for human dignity requires that the nurse acknowledge and understand that the patient has certain rights and one of the foremost rights is the right to self-determination. Self-determination is also called autonomy and forms the basis for informed consent within the healthcare system. Nurses have an obligation to be aware of patient rights and to advocate for the patient in the provision of their rights. The nurse also has a duty to assess the understanding of the patient regarding information presented and to further clarify or explain information given so the patient has a clear understanding of that information. The nurse also recognizes that individuals are members of a community and that there may be situations in which the benefits of the community at large outweigh the patient’s right to autonomy, such as when issues of the public health are at stake. Limitation of individual rights is always a deviation from the standard of care and is justified only when a less restrictive means of preserving the greater good is not available.
• Relationships with colleagues and others. The principle of respect extends to all those with whom the nurse interacts. The nurse maintains relationships that are caring and compassionate with a commitment to fair treatment of others and to conflict resolution. The nurse serves and functions in many roles and within each of these roles the nurse treats colleagues, employees, students, and assistants with dignity and respect. This means that the nurse does not engage in actions that are based on prejudice or harassment or threatening of others. The nurse also engages in the collaboration with others to ensure the provision of quality healthcare services.

Provision 2. The primary commitment of the nurse is to the patient, whether the patient is defined as an individual, group, or community.

• The interests of the patient are primary. The paramountinterest of the nurse is in provision of unique care that is based upon the needs of the patient. The nurse attempts to include the patient in the planning of care provision, allowing for the ability of the patient to participate. The nurse assures that the patient finds the plan of care acceptable and oversees the implementation of that plan. The plan of care considers the place of the patient within family networks and where conflict exists between the wishes of the patient and other family members, attempts are made to resolve the conflict. When the conflict remains unresolved, the nurse holds to the commitment that the wishes of the patient remain supreme.
• Conflict of interest for nurses. In health care, the nurse may frequently encounter situations where conflicts of interest exist. The nurse never exploits the patient for any type of personal gain whether it be financial or psychological. The nurse considers his/her personal values, the values of the patient, and others involved in the care process when guiding the patient to make decisions. The nurse foremost assures that those decisions are based on the safety, comfort, and best interests of the patient and the care plan. Conflicts may arise when incentive plans to decrease spending oppose the needs of the patient. When the nurse perceives a potential conflict of interest, he/she should reveal the potential conflict to all pertinent parties and in some instances, remove himself/herself from the situation.
• Collaboration. Collaboration is not just cooperation. It is the concentrated effort of multiple members of the healthcare team in order to achieve a desired outcome. The role of nursing within the team must be clearly defined, represented, and preserved. There should be open dialogue and shared decision making among all members of the healthcare team and the patient. Nurses should advocate for the participation of all relevant members of the healthcare team, and ascertain that all vital questions are asked and that necessary information for informed decision-making is provided. Collaboration exists through many different levels in nursing and may be direct or indirect. Indirect collaboration occurs through the support of team members directly involved in care process by way of the setting of standards, the teaching of skills, the management of care environments, or the enlargement of knowledge among the team members.
• Professional boundaries. The intimate nature of nursing often presents challenges as nurses share problems and difficulties with patients that can be quite stressful. The nurse strives to maintain appropriate professional boundaries at all times to avoid compromise of the therapeutic relationship. Nurse-patient and nurse-colleague relationships differ from unstructured personal friendships. The working of colleagues in close concert with one another and dependence between the nurse and colleagues and the nurse and the patient present circumstances in which professional boundaries can become blurred or distorted. When the nurse finds that professional boundaries are becoming endangered she/he should seek assistance from peers/supervisors or seek to remove themselves from the situation.

Provision 3. The nurse seeks to protect the health, safety, and rights of the patient.

• Privacy. The nurse acts as an advocate for the patient’s right to privacy. The need for medical care does not justify unwanted intrusions into a patient’s privacy. The nurse safeguard’s not only the patient’s physical privacy, but also ensures that sensitive auditory information is not overheard during discussions with the patient or colleagues about the patient’s case. The nurse also takes measures to maintain the confidentiality of the patient’s medical record.
• Confidentiality. The trust between the patient and the patient’s safety could be compromised by unnecessary revelation of medical information. The nurse should ensure that information is revealed in an ethical manner and on a need to know basis within the bounds of the law and with the patient’s permission using the minimum amount of information necessary. With regard to public health, or the safety of others the nurse may have to reveal information for the greater good within the bounds of the law. However, the nurse always follows standards of care or policies regarding such information. Where conflict seems to exist, or the nurse is unsure of a definite course of action, the counsel of a supervisor should be sought.
• Protection of patients in research. Each patient has the right to make an informed decision regarding their participation is research. Nurses have a responsibility to ensure that patients are presented with information about any research being performed to the extent that an informed decision can be made. In addition, the patient has the right to refuse to participate in, or choose to withdraw from, any research project at any time. The nurse should also be aware that conflicts may arise from research conducted upon vulnerable groups of individuals such as the mentally ill, children, prisoners, students, the poor and the elderly. Nurses have a duty to question, report, and refuse to participate in research that they deem morally objectionable.
• Standards and review mechanisms. Nursing has a duty to ensure that only individuals who are competent and exhibit the skills and knowledge necessary to practice remain in the nursing profession. Nursing educators have a duty to affirm that basic competency is achieved and that a commitment to professional practice standards is promoted before the individual nurse begins to practice. Nurse managers and administrators have a responsibility to evaluate the skills and competence of each nurse under their supervision prior to assigning the nurse tasks beyond entry- level academic preparation. The nurse has a responsibility to know and to maintain current standards of practice. Nurses are expected to report errors committed or observed during the course of their practice to appropriate supervisory personnel. The nurse should not under any circumstance, condone through silence or participate in any act which serves to place blame or to hide the commission of an error.
• Acting on questionable practice. The nurse has a responsibility foremost to the patient across the lifespan and inclusive of all settings in which health care services are needed. Being an advocate means that the nurse takes action against any incompetent, illegal, unethical, or impaired practice by any member of the health care team or healthcare system that jeopardizes the health, well being or rights of the patient. When the nurse becomes aware of questionable or inappropriate practice, the nurse should express concerns to the person who is responsible for the questionable conduct. When elements of the healthcare system threaten the safe delivery of care, the well being of the patient or encroach upon the rights of the patient, the issue should be brought to the attention of the manager or the administrator. If indicated or deemed necessary, the matter should be brought to the attention of the higher authority or to outside regulatory agencies as appropriate. Some situations may warrant the inclusion of more than one regulatory body. Reporting unethical practice or issues of competence may present substantial risk to the nurse, even when done appropriately, however those risks do not eliminate an obligation to address serious risks to patient safety.
• Addressing impaired practice. The duty of the nurse is to protect the patient, the public, and the profession from harm when a colleague’s practice appears to be impaired. The nurse exhibits compassion to colleagues who are recovering from illness or whose illness interferes with job performance. When a nurse suspects that a colleague’s practice is impaired, the nurse has a duty to protect the patient and to assure that the impaired individual receives the necessary help needed for recovery. The nurse should begin by consulting supervisory personnel, it may also be necessary to confront the nurse in a supportive manner and assist the impaired nurse in accessing appropriate resources. If the impaired person represents a threat to their self or others then the nurse should report the problem to those in authority to address the situation. This must occur regardless of whether the impaired person has sought help or not.

Provision 4. Responsibility and Accountability

• Acceptance of Responsibility and Accountability. Nurses are responsible for their own practice and the care that their patients receive. Nursing practice includes acts of delegation, research, teaching, and management. The nurse is responsible for following standards of care in all practice. The nurse must exercise judgment in accepting responsibilities, delegating, and seeking the counsel of others in the course of their duties. When advanced practice nurses write orders for treatments to be carried out by other nurses, then both the nurse writing the order and the nurse that is carrying out the order have responsibility for the judgments and actions taken as these are not acts of delegation.
• Accountability for nursing judgment and action. To be accountable means that you answer to yourself and to others for your actions. Nurses practice within a framework or morality that values self-determination, respect, and dignity. Nurses are accountable for their actions within this framework regardless of institutional policies or procedures.
• Responsibility for nursing judgment and action. Responsibility is the liability or accountability that comes from actions completed as part of a particular role. Nurses accept or reject specific role demands based upon their particular educational and experiential abilities. Nurses must not allow others to perform nursing care that is prohibited by nursing standards or state nursing practice acts. The individual nurse is also responsible for assessing their own competence and keeping their practice within the standards of the current standards of care for the specialty in which they are practicing and the state nursing practice acts. When a nurse assesses that the needs of the patient go beyond their individual competence he/she should seek appropriate resources through supervisors, colleagues, or other venues to ensure that the care given the patient meets standards and that the health and safety needs of the patient are met.
• Delegation of nursing activities. The nurse isresponsible for the quality of nursing care given to patients. The nurse is responsible for assessing the competency of other nurses and healthcare personnel before transferring or assigning care duties of patients to other colleagues. The nurse is also responsible for monitoring the activities of these personnel and evaluating the quality of care that is provided to the patient. Nurses must not assign task to individuals which he/she knows that they are not qualified to perform. Nurses that serve in a management or administrative functions must assure that policies and guidelines are in place to assist nurses in achieving competencies necessary to provide safe and effective care for patients. Nurses who function in the role of educator share a responsibility for providing safe and effective care for the patient. The educator must carefully assess the skills of the person assigned to provide nursing care and must give support to the learner in order to protect both the patient and the learner.

Provision 5. The nurse has a duty to self to maintain competence and to continue professional growth.

• Moral self-respect. Nurses have the same moral obligation to self as they do to others. The nurse must maintain self- respect, professional growth and competence, wholeness of character and personal integrity.
• Professional growth and maintenance of competence. Competence affects one’s self esteem, self worth, professional status and gives meaning to work. Nursing is held to the highest standards through peer review and self-evaluation. Continuing to maintain professional competence has implications for others, but also for the individual nurse as well. This continuing competence requires a commitment to lifelong learning and an awareness of ongoing issues and changing standards in the practice of professional nursing.
• Wholeness of character. Nurses have personal and professional identities which are not totally integrated nor are totally separate. The wholeness of character encompasses relationships with patients also. When asked by the patient to give a personal opinion on a subject, the nurse is generally free to do so provided that the opinion does not hamper or influence the validity of the patient’s informed decision making. The nurse should also make sure that the opinion does not place them in the position of crossing personal or professional boundaries and is morally correct. The nurse must be aware that their professional role may unduly influence the patient in decision-making. Therefore, assisting the patient to clarify his or her own values and beliefs is likely to prove to be the most helpful.
• Preservation of integrity. Economic constraints within the healthcare system may be especially problematic for the integrity of the nurse. Threats to integrity may include requests to deceive patients, withhold information, to falsify records, or the verbal abuse of patients or co-workers. Other request may involve requests for the nurse to act in ways that are a violation of the values of the profession or in direct violation of the code of ethics. Nurses have a duty to retain the integrity of their profession and to accept compromise only to the extent that the compromise upholds the values and integrity of the profession. Integrity preserving compromises do not risk the dignity or well-being of others. Nurses who are faced with requests that violate the integrity of the profession should voice their objections. When a particular action, activity, or treatment is morally objectionable to the nurse, or when it may put both the patient and the practice of nursing at risk the nurse may refuse to participate upon moral grounds. This objection may not protect the nurse against penalty. The nurse who chooses to object should make the decision known in appropriate ways and if possible with plenty of time for alternate means to be made for patient care. The nurse is obligated to preserve patient safety, not abandon the patient, and to withdraw participation only when alternative means for patient care have been made.

Provision 6. The nurse facilitates improvement of the healthcare environment.

• Influence of the environment on moral virtues and values. Virtues are moral habits that influence people to do what is right and are the hallmark of a morally good person. Excellence is the habit that predisposes a person to perform a task well. Virtues and excellence can be nurtured or hindered by the environment. Nurses have an obligation to assist in the creation, and maintenance of environments that nurture excellence and virtues.
• Influence of the environment on ethical obligation. All nurses have a responsibility for creating, maintaining, and fostering environments that are supportive toward nurses meeting their ethical obligations. Working environments include the norms of peers as well as policies and procedures of the organization. Elements that can either be barriers or foster ethical practice include incentive programs, disciplinary policies, health and safety programs, and organizational structure. Environments which allow for grievance procedures and the fair and equitable treatment of nurses foster the performance of nursing care according to standards.
• Responsibility for the healthcare environment. The nurse is responsible for fostering a moral environment that supports and respects peers and identifies issues that need to be addressed. Nurse administrators have the responsibility for making sure that their nurses have input into the safety and working conditions within their facility. Nurses should not condone nor agree to unsafe nursing practices even if they do not participate in unsafe practices; to do so is paramount to condoning the practices. Nurses should not remain employed in facilities which violate patient rights or participate in unsafe practices. Nurses should address concerns about the healthcare environment through appropriate channels.

Provision 7. The nurse assists in advancement of the profession through contributions to practice, education, administration, and knowledge development.

• Advancing the profession through active involvement in nursing and in health care policy. Nurses should contribute to the advancement or leadership of professional organizations, by serving in mentoring roles, leadership positions, or on professional committees within their organization. The self-employed nurse can serve to advance the profession by acting as a model of professional integrity. Advancement of the profession can also be accomplished through civic activities. Nurse educators promote the advancement of nursing through the fostering of professionalism and civic values. Nurse managers and administrators are responsible for providing an environment that promotes ethical integrity and professionalism; while nurse researchers and responsible for contributing to the body of knowledge that supports and advances nursing practice.
• Advancing the profession by developing, implementing, and maintaining professional standards in clinical, administrative, and educational practice. It is the responsibility of nurses to identify their own scope of practice as permitted by professional practice standards and guidelines, by state and federal laws, by relevant societal values, and by the Code of Ethics. The nurse administrator or manager must establish, maintain, and promote conditions of employment that enable nurses within that organization or community setting to practice in accord with accepted standards of nursing practice and provide a nursing and healthcare work environment that meets the standards and guidelines of nursing practice. The nurse educator is responsible for promoting and maintaining optimum standards of both nursing education and of nursing practice in any settings where planned learning activities occur. Nurse educators must also ensure that only those students who possess the knowledge, skills, and competencies that are essential to nursing graduate from their nursing programs.
• Advancing the profession through knowledge development, dissemination, and application to practice. The nursing profession should engage in scholarly inquiry to identify, evaluate, refine, and expand the body of knowledge that forms the foundation of its discipline and practice. In addition, nursing knowledge is derived from the sciences and from the humanities. Ongoing scholarly activities are essential to fulfilling a profession's obligations to society. All nurses working alone or in collaboration with others can participate in the advancement of the profession through the development, evaluation, dissemination, and application of knowledge in practice. However, an organizational climate and infrastructure conducive to scholarly inquiry must be valued and implemented for this to occur.

Provision 8. The nurse collaborates with other health professionals and the public in promoting community, national, and international efforts to meet health needs.

• Health needs and concerns. The nursing profession is committed to promoting the health, welfare, and safety of all people. The nurse has a responsibility to be aware not only of specific health needs of individual patients but also of broader health concerns such as world hunger, environmental pollution, lack of access to healthcare, violation of human rights, and inequitable distribution of nursing and health care resources. The availability and accessibility of high quality health services to all people require both interdisciplinary planning and collaborative partnerships among health professionals and others at the community, national, and international levels.
• Responsibilities to the public. Nurses, individually and collectively, have a responsibility to be knowledgeable about the health status of the community and existing threats to health and safety. Through support of and participation in community organizations and groups, the nurse assists in efforts to educate the public, facilitates informed choice, identifies conditions and circumstances that contribute to illness, injury and disease, fosters healthy lifestyles, and participates in institutional and legislative efforts to promote health and meet national health objectives. In addition, the nurse supports initiatives to address barriers to health, such as poverty, homelessness, unsafe living conditions, abuse and violence, and lack of access to health services. The ethical nurse recognizes that health care is provided to culturally diverse populations in this country and in all parts of the world. In providing care, the nurse should avoid imposition of the nurse's own cultural values upon others. The nurse should affirm human dignity and show respect for the values and practices associated with different cultures and use approaches to care that reflect awareness and sensitivity.

Provision 9. The profession of nursing, as represented by associations and their members, is responsible for articulating nursing values, for maintaining the integrity of the profession and its practice, and for shaping social policy.

• Assertion of values. It is the responsibility of a professional association to communicate and affirm the values of the profession to its members. It is essential that the professional organization encourages discourse that supports critical self-reflection and evaluation within the profession. The organization also communicates to the public the values that nursing considers central to social change that will enhance health.
• The profession carries out its collective responsibility through professional associations. The nursing profession continues to develop ways to clarify nursing's accountability to society. The contract between the profession and society is made explicit through such mechanisms as

○      The Code of Ethics for Nurses

○      The standards of nursing practice

○      The ongoing development of nursing knowledge derived from nursing theory, scholarship, and research

○      Educational requirements for practice

○      Certification

○      Evaluating the effectiveness of professional nursing actions

• Intraprofessional integrity. A professional association is responsible for expressing the values and ethics of the profession and also for encouraging the professional organization and its members to function in accord with those values and ethics. Thus, one of its fundamental responsibilities is to promote awareness of and adherence to the Code of Ethics and to critique the activities and ends of the professional association itself. Values and ethics influence the power structures of the association in guiding, correcting, and directing its activities. Legitimate concerns for the self-interest of the association and the profession are balanced by a commitment to the social goods that are sought. Through critical self-reflection and self-evaluation, associations must foster change within themselves, seeking to move the professional community toward its stated ideals.
• Social reform. Nurses can work individually as citizens or collectively through political action to bring about social change. It is the responsibility of a professional nursing association to speak for nurses collectively in shaping and reshaping health care within our nation, specifically in areas of health care policy and legislation that affect accessibility, quality, and the cost of health care. Here, the professional association maintains vigilance and takes action to influence legislators, reimbursement agencies, nursing organizations, and other health professions. In these activities, health is understood as being broader than delivery and reimbursement systems, but extending to health-related socio-cultural issues such as violation of human rights, homelessness, hunger, violence, and the stigma of illness.

Ethics in Practice

Patients always have the right to choose which treatment they want and refuse treatments they do not want. The nurse’s role is to help educate the patient about their disease process and treatment options. When teaching under these settings, it is critical to be as objective as possible and not let personal biases influence the teaching. End of life issues are sometimes difficult, and not all nurses agree with every decision. The nurse must respect the choices made by the patient or the appointed decision maker for the patient (also called a proxy, agent or Health Care Power of Attorney).

Nurses are ethically required to look at their workplace and attempt to maintain and improve an environment that provides good quality of care. While all nurses have an obligation for this duty, some nurses may have a larger role than others. Nurses who work in administration have a primary role in assuring that the healthcare environment provides good quality health care, and staff nurses should be encouraged to point out workplace issues that are not optimal for quality patient care. When an organization repeatedly ignores the nurses' code of ethics, the nurse should talk to administration to try to remedy the situation, then find employment elsewhere if the ethical problems continue. In severe cases, the problems should be reported to higher authorities, such as state or local boards of health or even law enforcement.

Nurses have an ethical responsibility to collaborate with other healthcare professionals in the workplace and in the community to improve the quality of health care. Examples include volunteering in the schools or churches to teach about health issues or working with national organizations such as the American Heart Association.

Nurses have an ethical responsibility for contributing to nursing's reputation in the community. Examples include behaving professionally in social situations, volunteering in the community, working with politicians to help shape policy and testifying to support health and safety laws.

Steps nurses can take to improve their ethical behavior

• Respect the universal human dignity of all people
• Be aware of situations that promote unethical behavior, e.g., a work environment where nurses are more likely to compromise their ethics to reduce their stress
• Assume responsibility and accountability for all of your actions
• Refer to the Code of Ethics when you're unclear and need guidance
• Participate in continuing education to strengthen your competence
• Participate in activities that promote a good work environment
• Develop strong relationships with colleagues who give you ethical mentoring and support
• Identify the care plan goals based on the patient's input that reflects his/her values and needs
• Advocate for the patient's immediate and long-term rights, health, safety and well-being
• Maintain patient confidentiality in both verbal and written communications
• Refrain from participating in conflicts of interest, including those with financial benefit for the nurse
• Do not be disrespectful, insulting or demeaning to patients, families, co-workers or employers
• Report the findings of research completely, honestly and fairly
• Break patient or co-worker confidentiality when required by law to prevent the person harming him/herself or others

 

What should a nurse do if s/he encounters an unethical practice?

Nurses who compromise their integrity risk the integrity of the profession as well. Examples of unethical practices include any situation that:

• Is illegal
• Tricks a client
• Steals medications
• Falsifies documentation
• Involves substance abuse at work
• Is a violation of patient rights or safety
• Is evidence of a co-worker providing incompetent care

 

Nurses need to care for themselves so they can be competent and caring workers. Nurses are responsible for detecting their own problems from within, and determining the best actions to maintain their integrity, professional growth, safety and competence. It is each nurse’s responsibility to know his/her weakness and improve them and to keep up with advances in their specialty.

If a nurse is not behaving ethically, then in most cases their co-workers should address the problems with them. If this does not remedy the situation, then the problems should be reported to the supervisor. Depending on the situation, it may be reasonable to go directly to the supervisor to discuss how to handle the situation, or ask the supervisor to intervene. There is not one set of procedures to follow in every situation.

Quiz Button

References

American Nurses Association (2010). The Code of Ethics for Nurses with Interpretive Statements. American Nurses Association, Inc. http://www.nursingworld.org/mainmenucategories/ethicsstandards/codeofethicsfornurses/code-of-ethics.pdf

Burkhardt, M. A., & Nathaniel, A. K. (2014). Ethics & issues in contemporary nursing.

Butts, J. B., & Rich, K. L. (2013). Nursing ethics: Across the curriculum and into practice. Burlington, MA: Jones & Bartlett Learning.

McAllister, M., & Lowe, J. B. (2011). The resilient nurse: Empowering your practice. New York: Springer Pub.

Nightingale F. Nightingale Pledge. Code of ethics. Retrieved from: http://nursingworld.org/FunctionalMenuCategories/AboutANA/WhereWeComeFrom/FlorenceNightingalePledge.aspx

Sigma Theta Tau International. (2012). Nursing ethics in everyday practice. Indianapolis, IN: Sigma Theta Tau International.

Yeo, M. T. (2010). Concepts and cases in nursing ethics. Peterborough, Ont: Broadview Press.

 

Back to Courses