nursing code of ethics

A Guide to the Nursing Code of Ethics

If you’re talking about workplace stress, the nursing profession would rank pretty high up the list. While providing direct care to people in a vulnerable state, nurses can come across all kinds of dilemmas. It is hard to keep your personal feelings out of the way when working with people in such close quarters. So, these moments can really drain you and throw you off balance. This is where the nurses’ Code of Ethics becomes significant. 

With ideals of quality patient care at its core, it also serves as a safeguard for nurses. It outlines professional practices that prioritize the patient and provide a yardstick for setting professional boundaries for nurses. This Code acts like a compass, helping nurses stay focused and aware of their duties even in complex healthcare scenarios where everything can’t be categorized as black and white. 

The four main ethical principles in nursing

Nursing goes beyond just caring for the sick. A patient can’t be indifferently treated as just a sick body. Factors like human rights and social justice also come into play. That’s why nurses need to be ethically aware to treat patients with compassion. Ethics ensure that the patient is not dehumanized and treated with dignity while being dependent on healthcare workers for their recovery. The four foundational pillars of the Nursing Code of Ethics are: 

1. Nonmaleficence

 This principle forms the backbone of ethics in nursing. It translates to ‘do no harm’. Nurses can’t act in any way that can endanger a patient’s well-being. They must ensure that the path to recovery is designed with the patient’s interest in mind. This ensures the best possible patient care outcomes in a given scenario with compromising integrity.

2. Autonomy

Prioritizing patient rights acknowledges the patient’s authority over their own body. The principle of autonomy ensures that nurses serve as efficient patient advocates. They must educate the patients about their conditions and treatment plans so that they can make informed decisions. 

On the other hand, they must also ensure that the patient’s wishes are respected by other healthcare professionals too. This becomes especially important when conflict in opinion arises. If a patient refuses curative treatment, healthcare professionals must respect it. They can’t coerce the patient into making decisions against their beliefs.   

 3. Beneficence

 Nurses have a moral obligation to act in the patient’s best interests. This is one of the factors that propels nursing high up in the list of most trusted professions. Basic acts and procedures like checking up on the patient regularly, assisting them with daily tasks, maintaining hygienic practices  and ensuring their overall safety come under beneficence.  

 4. Justice

The principle of justice exists to negate discrimination. It dictates that everyone should have equal rights to medical resources according to their need. While assigning clinical care or prioritizing patientcare, patients must not be discriminated against on basis of status, ethnicity, age, religion or sexual orientation. 

Also read: Nurses and Social Media: Best Practices for Maintaining Professional Boundaries

The nine provisions of the Code

The four ethical principles have been further explained as nursing responsibilities through nine provisions in the nurses’ Code of Ethics. These are: 

Provision 1: 

“The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person.” 

This provision summarizes how nurses must be impartial to their patients regardless of their gender, status, religion, beliefs or even their health. This sentiment is based on the right to human dignity and states that every patient has the right to self determination that must be recognized and enforced by nurses. This provision also covers how nurses must be respectful to their colleagues and ensure an environment of civility.  

Provision 2:

“The nurse’s primary commitment is to the patient, whether an individual, family, group, community, or population.” 

This provision outlines that nurses must prioritize the needs and well-being of their patients. In case of conflict of interest, the nurse must work on acknowledging their personal biases and put the interests of the patients first. 

Provision 3:

“The nurse promotes, advocates for, and protects the rights, health, and safety of the patient.” 

It is up to the nurses to promote a culture of safety around their practice. Nurses must protect the confidentiality of their patients. If occasion calls for confidential information to be revealed, it must be done so under policies and mandates so that it is not misused. 

Provision 4: 

“The nurse has authority, accountability and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to provide optimal patient care.” 

Nurses are accountable for patient care decisions taken for treatment and are responsible for ensuring that these decisions don’t endanger the patient’s self-determination or well-being in any manner. They must also ensure that these decisions are taken within the scope of nursing practice. 

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.” 

As healthcare professionals, nurses have the responsibility of promoting a healthy quality of life for themselves and for others. Besides this, they must also maintain their competency in practice while growing professionally and personally. 

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 an ethical obligation to ensure that their environment of practice is safe for administering quality patient care. 

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 are responsible for contributing towards scientific growth through practice and enquiry. From research to policy development, nurses must take part in expanding the knowledge base of the medical community. 

Provision 8: 

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

Nurses must be committed to the cause of reducing disparities in access to healthcare. They must participate in collaborative efforts promoting human rights and work towards making healthcare more accessible.  

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.”      

All nurses must, through practice and advocacy, seek to integrate social justice in nursing. By asserting the values of nursing through practice, nursing responsibilities enhance professional integrity while working towards standardizing quality patient care.  

The key to quality medical care 

The nurses Code of Ethics not only outlines the duties of a nurse but also sets professional standards of practice. Like a double-edged prong, it ensures the wellbeing of nurses and patients alike. The framework outlined by the Code emphasizes the significance of ethical practice in nursing, thus, enhancing the professional identity and integrity of nurses. By acknowledging the importance of ethics in nursing, the Code ensures that the nursing profession remains accountable and responsible for the development of the medical community. 



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