Category Archives: Nursing ethics

The Nursing Code of Ethics – What Should you Expect?

Grant Eckert asked:

Perhaps history’s most famous nurse, Florence Nightingale, gave her name to the earliest version of today’s Code of Ethics back in 1893, when a “Nightingale Pledge” was established. In 1926, The American Journal of Nursing published a provisional code, although it wasn’t formally accepted by the American Nursing Association until over 30 years later, in 1960.

Since then, the Code of Ethics has been revised and amended several times, although the underlying principles have remained the same. Nurses are still expected to perform their duties with integrity, and do the best job they can. As most people know, their job is difficult to begin with. A nurse is not only a caregiver; he or she is expected to have a wide range of other assets too, such as tact, patience and the ability to communicate.

If you are a nurse, you may not be tested on the Code and you won’t be expected to commit it to memory, but you will need to be familiar with its basic concepts. You may be required to attend seminars on the principles of the Code and perhaps review actual cases, particularly ones in which a difficult or ethical decision was reached.

Due to the fact that the Code also changes, and is amended to from time to time, nurses need to keep up with any updates as well. Arguably, the duties of a nurse have become even more challenging over recent years, due to such things as cost-conscious hospitals, a shortage of nurses in some areas and more complex medical treatments.

Most of us know what ethics are, as we make ethical decisions in our everyday lives. Ethics is actually a branch of philosophy – the word ethics comes from the Greek word ethos which means habitual usage, custom, conduct and character. Put another way, ethics are the guidelines which guide an individual or group in their everyday behavior.

Nurses perhaps know this more than anyone. Each day, nurses are faced with making life and death decisions, sometimes with no more than a few seconds to decide. Although nurses have the necessary authority and skills required to make independent decisions about a particular patient or situation, they are still responsible to the profession in general.

The first three provisions of the Code are perhaps the most important. They cover such basics as the nurse’s commitment to the patient, respect for human dignity and ensuring the privacy of every patient. Nurses can put these principles into practice every day by doing things such as explaining procedures fully, ensuring privacy and ensuring they have a patient’s full consent.

The Code of Ethics is also closely linked with patients’ rights and a section addresses this often touchy subject. A comprehensive bill of rights is a surprisingly recent concept. A Patients Bill of Rights was not enacted until 1973 by the American Hospital Association and was revised in 1992. By law, a patient must be informed of their rights upon being admitted to a hospital.

The Code of Ethics often conflicts with patients’ rights, for example, a patient may refuse treatment or discharge themselves against the better judgment of the nurse. In this case, a nurse must respect the wishes of the patient even though it may go against some of the principles of the Code of Ethics. The Code states that a nurse may never act to deliberately end a person’s life, although they should attempt to alleviate a patient’s suffering even if this causes death

Frequently, a person may have a set of religious or cultural beliefs which leads them to make decisions about their health that many of us would consider unhealthy or dangerous. The Code also addresses the question of funding for medical research and states that a nurse can choose not to participate in such research if they consider it to be unethical.

To some degree, the Code of Ethics also means that nurses must take responsibility not only for their own actions, but for the actions of other nurses too; the Code states that a nurse must take action if he or she observes others acting in an, “incompetent, unethical, illegal or impaired” manner. A nurse is also expected and encouraged to report such behavior, which is not always an easy thing to do.

Many hospitals actually have ethics committees or even an ethicist on the staff. He or she may be called upon in cases where a life or death decision has to be made, a decision that most of us would care to make. Not surprisingly, often the question of ethics arises in those situations in which it is being considered to cease life support and allow a terminally ill patient to die.

Ethics in the Field of Nursing

Shawn Thomas asked:

Nursing is a profession that demands trust. A patient places their health and well being not only in the hands of their physicians, but in the hands of their nurses as well. So, to ensure that new nurses understand, and experienced nurses remember, this aspect of their profession, a nurse’s code of ethic was developed. Ethics in the field of nursing are meant to hold nurses accountable to the highest standards for patients care. It is important to note that there are many versions of this code. However, since most the notable difference is the terminology and level of detail in which each topic is described, we will touch on the most common concepts or provisions.

The first and most important provision of ethics in the field of nursing is to practice with the compassion and understanding that all individuals should treated with dignity and respect regardless of their health problems, social status, race, religion, disability, financial status, or creed. This particular ethical provision is broken down to further outline the importance of a nurse’s relationship with patience, the respect for human dignity, the relationships with colleagues and peers, and the right of self-determination, or a patient’s right to decide their fate provided they are given accurate information regarding their condition and options.

The second provision in the code of ethics for nurses is that a nurse’s primary commitment is to the patient. This section discusses how nurses should wade through conflicts where a nurse’s patient and others, typically family members, other loved ones, or employers, have differing opinions on care and treatment needed. In these situations a nurse must maintain the integrity of the nursing profession, by safeguarding the patient’s best interest. This provision also specifies the need for collaboration between nurses, other medical professionals, and any other person relevant to a patient’s care. Finally there is section that outlines the need for professional boundaries. The code of ethics describes the need for nurses to maintain professionalism in relationships with patients and colleagues in order to ensure their patients receive the best care possible.

Next, there is the need for a nurse to promote not only a patient’s health and wellbeing, but also the rights of a patient. This provision covers the need for privacy and confidentiality. This section specifies that only the information vital to a patient’s health should be disclosed and only to those who are directly involved in that patient’s care. However there are exceptions to this provision. Information should also be disclosed if it may protect other individuals or become a public health concern. There are also exceptions to the rule for things such as peer reviews, third party payments, lawsuits, and rehabilitations; but patient information must be disclosed in a way that upholds any and all privacy policies, protocols, laws, and/or regulations. Taking appropriate action when any member of a health team is acting inappropriately or practicing under any undo influence is also covered under this provision.

The fourth provision discusses the need for nurses to take responsibility and to be held accountable for their actions. The actions of a nurse will affect a patient’s standard of care. Therefore, nurses must ensure that they show sound judgment in treating patients and delegating tasks to other nurses. In delegating, nurses must ensure that they delegate to a healthcare professional who is capable and qualified to complete the task.

Since nursing can be a thankless profession, the next provision mandates that nurses treat themselves with the care in which they treat their patients. This provision calls for the nurse to continue to grow and learn their craft; take time for him or herself; and, preserve their integrity and moral self-respect.

There are also provisions that outline a nurse’s responsibility to the public and the need for nurses to positively influence their working environment. Nurses have a responsibility to use their knowledge for the betterment of those around them. They should not get caught up in the negativity of others, even if it is coming from coworkers or superiors in their workplace.

The final provisions call for nurses to strive to take the profession forward through research, identifying health needs and concerns, and by staying abreast of and implementing best practices for patient care, healthcare, and new technology.

Ethics in the field of nursing is as important as the profession itself. So to ensure uniformity the American Nurses Association created a Nursing Code of Ethics. However, it is important to note that although this is the most popular code, there are others, specifically for various other countries. This standard for nurses has been updated over the years and will continue to change with the healthcare industry. Yet, the heart of the ethical code for nurses is and will always be the health and welfare of their patients.