Many trust and respect between the two parties,

Many professions have their own code of ethics, including nursing.

This lesson will walk you through the nine provisions within the nursing code of ethics and how to interpret these in your own practices.

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Code of Ethics for Nurses

Wouldn’t it be great if we never had to make difficult decisions? If we never had to deal with controversy or advocate for what’s right in the face of hostility? Unfortunately, the nursing profession is not immune to these kinds of situations, and there will come a time in any nursing career where a path needs to be chosen. Following the Code of Ethics for Nurses will help you choose the right one.The American Nurses Association (2014) states: ‘the Code of Ethics for Nurses was developed as a guide for carrying out nursing responsibilities in a manner consistent with quality in nursing care and the ethical obligations of the profession.’ After years of revising, the initial Code for Nurses was developed in 1985.

The American Nurses Association House of Delegates accepted the final draft in June 2001, which included nine provisions and was termed the Code of Ethics for Nurses.When working in the service industry, a code of ethics is a fundamental document that, in essence, is an agreement between those being served and those who are serving. It also provides direction and assistance when the right decision isn’t always obvious. In a profession where the stakes are high, tough decisions will inevitably be made at some point, and this is where it gets tricky.

Our lives are interchanging, and our professional ethics are not the same as our personal ethics and, at times, may conflict.Our personal code of ethics, or our conscience, drives us to be our best in our private lives, while our professional ethics drive us to be our best in our careers. But which one wins out when we have to abandon one or the other? As nurses, the answer may not always be clear, so let’s take a closer look at the nine provisions set forth by the American Nurses Association.

The Nine Provisions

Provision 1: ‘The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes or the nature of health problems.’For example, nurses caring for the elderly or the disabled need to offer the same level of care as they would to a newborn baby or mother of three.

Provision 2: ‘The nurse’s primary commitment is to the patient, whether an individual, family, group or community.’In situations where an extended family is adamant about a loved one’s care and their ideas differ from the actual patient, as long as the patient is competent, their wishes are the nurse’s command.Provision 3: ‘The nurse promotes, advocates for and strives to protect the health, safety and rights of the patient.’There may come a time when a nurse may disagree with another care provider, including a physician. Whether right or wrong, it is the nurse’s duty to advocate for their patient even if it is difficult for them to challenge another colleague, especially an authority figure. However, this must be done tastefully and with respect to all those involved.

Provision 4: ‘The nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation of tasks consistent with the nurse’s obligation to provide optimum patient care.’Some tasks are required to be delegated to other team members, such as the nurse’s aide, so there needs to be a high level of trust and respect between the two parties, because the ultimate responsibility still remains that of the registered nurse.Provision 5: ‘The nurse owes the same duties to self as to others, including the responsibility to preserve integrity and safety, to maintain competence and to continue personal and professional growth.’Shifts, especially those lasting between 12 and 13 hours, are grueling and will eventually take their toll on the health and wellness of nurses. Taking care of their own mind and bodies is essential and will in turn improve the care they provide their patients.Provision 6: ‘The nurse participates in establishing, maintaining and improving health care environments and conditions of employment conducive to the provision of quality health care and consistent with the values of the profession through individual and collective action.’A chaotic environment, or one that is not supportive, cannot possibly result in high quality health care.

It is not only the nursing administration’s duty to promote a positive environment, it is every health care professional’s duty to support and respect one another and, in turn, work as an effective team in providing quality care.Provision 7: ‘The nurse participates in the advancement of the profession through contributions to practice, education, administration and knowledge development.’A nurse is an educator, and in order to do that they must maintain a level of awareness and expertise about evidence based and best practice. Whether continuing their education with certificates that enhance their knowledge in their specific areas of nursing or being awarded an advanced degree in nursing, they are bettering their practice for themselves and their patients.

Provision 8: ‘The nurse collaborates with other health professionals and the public in promoting community, national and international efforts to meet health needs.’Working as an active part of the team is an essential quality that all nurses must possess whether that team is colleagues or community members. Many nurses volunteer their services abroad as well, working to immunize and teach those less fortunate how to care for themselves and their loved ones.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.

‘Nurses are the authority in their field and need to be leaders in regards to upholding a level of professionalism and determining what best practice is. The American Nurses Association is an excellent example of this through its promotion of nursing as a profession now and in the future.

Lesson Summary

Using the approved Code of Ethics for Nurses, written by the American Nurses Association, will give any nurse a strong ethical platform in which to make hard decisions in their own practices. Different situations will apply to different provisions, each one representing a different set of challenges but all equally important. Maintaining a code of ethics will show those who are receiving care that the profession of nursing is held to a high standard that all nurses are required to follow every day.

Learning Outcomes

When this lesson is done, you should be able to:

  • Recognize the Code of Ethics for Nurses and the American Nurses Association
  • Identify the nine provisions of the code of ethics

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