The Code of Ethics for Nurses and How It Translates to Nursing Practice

The original nursing code of ethics was adopted by the American Nurses Association (ANA) in 1950. With the many changes in healthcare over the years that have impacted the practice of nursing, it became necessary to revise and update the code.

Accordingly, after a thoughtful review process, ANA released the new Code of Ethics for Nurses With Interpretive Statements in January 2015.

This new Code retains the fundamental values and professional ideals of the original code, and expands by giving examples of how it could be used in specific clinical situations of today.

It expresses the nursing profession's commitment to society, both individually and collectively, to uphold its ethical values, obligations, duties and professional ideals.

Below are the nine provisions given in the Nursing Code of Ethics, each with a brief explanation of what it covers.

Provision 1: The nurse practices with compassion and respect for the inherent dignity, worth and unique attributes of every person.

• Each person is respected as a worthy human being, regardless of gender, ethnic background, religion, socioeconomic status or sexual orientation. The nurse establishes relationships of trust with patients and provides nursing care in a nondiscriminatory way.

• The nurse must give accurate, complete and understandable information to patients or surrogate decision-makers to facilitate informed decision-making.

• The nurse maintains professional, respectful and caring relationships with colleagues.

Provision 2: The nurse's primary commitment is to the patient, whether an individual, family, group, community or population.

• Nurses make decisions with this primary commitment in mind when establishing a plan of care, helping the patient or patient's family with patient care decisions, facing conflict of interest decisions or in relationships with other health professionals.

• Nurses are careful in maintaining appropriate personal relationship boundaries, with patients or with colleagues.

Provision 3. The nurse promotes, advocates for, and protects the rights, health and safety of the patient.

• Nurses must be vigilant in protecting the rights of privacy and confidentiality for individuals, families and communities. This includes confidentiality of information communicated in the nurse-patient relationship and all patient information. Nurses must uphold patients' right to privacy and confidentiality, especially in this age of rapidly evolving communication technology and the social media.

• In a situation where patients are asked to participate in research, nurses must make sure that they and their surrogates receive sufficient information to make informed decisions, and that they understand their right to refuse or withdraw from the research without fear of adverse consequences.

• Nurses have a duty to report any unethical practice by researchers.

• Nurses are responsible for knowing the code of ethics, relevant laws and regulations, and the employing organization's policies and procedures. They must report unethical, illegal or incompetent practices that place patients in jeopardy.

Provision 4. The nurse has authority, accountability and responsibility for nursing practice; makes decisions and takes action consistent with the obligation to promote health and to provide optimal care.

• Nurses are accountable for the quality of their practice and responsible for assessing their own competencies. When appropriate, they should seek consultation and collaboration from qualified nurses and other health professionals.

• If in a management or administrative position, they are responsible for providing a safe environment that protects both patient and nurse.

Provision 5. The nurse owes the same duties to self as to others, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence, and continue personal and professional growth.

• Nurses have a duty to themselves and others to preserve integrity and practice with compassion and competent care, and to promote personal health, safety and well-being. They must routinely evaluate their competence and keep up with advances in healthcare and nursing. They should continuously seek professional and personal growth.

Provision 6. The nurse, through individual and collective effort, establishes, maintains and improves the ethical environment of the work setting and conditions of employment that are conducive to safe, quality health care.

• Nurses have the responsibility to help develop and uphold a morally good environment which supports respectful and ethical practice and quality care to patients. They have a duty to resign from institutions that sustain patterns of violation of patients' rights and that require nurses to compromise standards of practice or personal integrity.

Provision 7. The nurse, in all roles and settings, advances the profession through research and scholarly inquiry, professional standards development, and the generation of both nursing and health policy.

• Nurses must participate in expanding the knowledge base of nursing practice through direct or indirect participation in research and other ways of advancing the profession. They can contribute by developing, maintaining and implementing professional practice standards and participate in nursing and health policy development.

• Nurses can lead or participate in institutional policy setting and join in community or national efforts to support nurses' professionalism and ethical integrity.

Provision 8. The nurse collaborates with other health professionals and the public to protect human rights, promote health diplomacy, and reduce health disparities.

• For nurses, health is a universal human right which includes access to health care, education concerning the prevention and treatment of health problems, and the provision of a safe and healthy environment for all. Nurses participate in efforts to advance health and human rights and to create a moral milieu that is sensitive to diverse cultural values and practices.

• In extraordinary circumstances such as an environmental catastrophe, nurses always stress human right protection, especially for the poor, homeless, elderly, mentally ill, prisoners, refugees, women, children and socially stigmatized groups.

Provision 9. The profession of nursing, collectively through its professional organizations, must articulate nursing values, maintain the integrity of the profession, and integrate principles of social justice into nursing and health policy.

• Through participation in professional organizations, nurses uphold the values of respect, fairness and caring and promote health in all sectors of the population.

• The professional organizations should be actively involved in the political process to protect public health and the profession of nursing.

As nurses, we are tasked with becoming familiar with, and adhering to, the Code of Ethics for Nurses. Only as a united profession can we ensure for the health and wellness of our patients, our communities, our nation and ourselves.