The
nursing profession is one of the most respected and honourable professions that
require high ethical standards and professionalism. To ensure that nurses practice
ethically and professionally, there is a code of ethics and professional conduct
that guides their behaviour and actions.
The
Code of Ethics and Professional Conduct for Nurses is a set of guidelines that outlines
the ethical principles and values that nurses must uphold in their practice. It
provides a framework for decision-making and guides nurses in their interactions
with patients, families, colleagues, and the wider community.
The
Code of Ethics and Professional Conduct for Nurses is a vital tool in promoting
the nursing profession's values and principles, ensuring high-quality care for patients,
and maintaining the public's trust in the nursing profession.
ICN CODE OF ETHICS
The
International Council of Nurses (ICN) first adopted an international code of ethics
for nurses in 1953. Since then, it has been revised and reaffirmed on several occasions,
most recently in 2021.
The
ICN Code of Ethics for Nurses serves as a statement of the ethical values, responsibilities,
and professional accountabilities that guide nursing practice for both nurses and
nursing students. It provides a framework for ethical decision-making that meets
the professional standards set by regulatory bodies, although it is not a code of
conduct.
The
Code outlines ethical guidance for nurses regarding their roles, duties, responsibilities,
behaviours, professional judgment, and relationships with patients, fellow healthcare
professionals, and the wider community. It serves as a foundational document that
can be built upon, in combination with local laws, regulations, and professional
standards, to guide ethical nursing practice in all settings, roles, and domains.
PREAMBLE
From
the origins of organised nursing in the mid-1800s and recognising nursing care is
deeply rooted in the traditions and practices of equity and inclusion and in the
appreciation of diversity, nurses have consistently recognised four fundamental
nursing responsibilities: to promote health, to prevent illness, to restore health,
and to alleviate suffering and promote a dignified death. The need for nursing is
universal. Inherent in nursing is a respect for human rights, including cultural
rights, the right to life and choice, the right to dignity and to be treated with
respect. Nursing care is respectful of and unrestricted by considerations of age,
colour, culture, ethnicity, disability or illness, gender, sexual orientation, nationality,
politics, language, race, religious or spiritual beliefs, legal, economic, or social
status.
Nurses
are valued and respected for their contributions to improving the health of individuals,
families, communities, and populations locally, nationally, and globally. They coordinate
services with those of other health care professionals and related groups. Nurses
demonstrate values of the profession such as respect, justice, empathy, responsiveness,
caring, compassion, trustworthiness, and integrity.
THE ICN CODE
The
ICN Code of Ethics for Nurses has four principal elements that provide a framework
for ethical conduct: nurses and patients or other people requiring care or services,
nurses and practice, nurses and the profession, and nurses and global health.
1. NURSES AND PATIENTS
OR OTHER PEOPLE REQUIRING CARE OR SERVICES
1.1. Nurses’ primary
professional responsibility is to people requiring nursing care and services now
or in the future, whether individuals, families, communities, or populations (hereinafter
referred to as either ‘patients’ or ‘people requiring care’).
1.2. Nurses promote
an environment in which the human rights, values, customs, religious and spiritual
beliefs of the individual, families and communities are acknowledged and respected
by everyone. Nurses’ rights are included under human rights and should be upheld
and protected.
1.3. Nurses ensure
that the individual and family receive understandable, accurate, sufficient, and
timely information in a manner appropriate to the patient’s culture, linguistic,
cognitive, and physical needs, and psychological state on which to base consent
for care and related treatment.
1.4. Nurses hold
in confidence personal information and respect the privacy, confidentiality, and
interests of patients in the lawful collection, use, access, transmission,
storage, and disclosure of personal information.
1.5. Nurses respect
the privacy and confidentiality of colleagues and people requiring care and uphold
the integrity of the nursing profession in person and in all media, including social
media.
1.6. Nurses share
with society the responsibility for initiating and supporting action to meet the
health and social needs of all people.
1.7. Nurses advocate
for equity and social justice in resource allocation, access to health care and
other social and economic services.
1.8. Nurses demonstrate
professional values such as respect, justice, responsiveness, caring, compassion,
empathy, trustworthiness, and integrity. They support and respect the dignity and
universal rights of all people, including patients, colleagues, and families.
1.9. Nurses facilitate
a culture of safety in health care environments, recognising and addressing threats
to people and safe care in health practices, services, and settings.
1.10. Nurses provide evidence-informed, person-centred care,
recognising and using the values and principles of primary health care and health
promotion across the lifespan.
1.11. Nurses ensure that the use of technology and scientific
advances are compatible with the safety, dignity, and rights of people. In the case
of artificial intelligence or devices, such as care robots or drones, nurses ensure
that care remains person-centred and that such devices support and do not replace
human relationships.
2. NURSES AND PRACTICE
2.1. Nurses carry
personal responsibility and accountability for ethical nursing practice, and for
maintaining competence by engaging in continuous professional development and lifelong
learning.
2.2. Nurses maintain
fitness to practice so as not to compromise their ability to provide quality, safe
care.
2.3. Nurses practise
within the limits of their individual competence and regulated or authorised scope
of practice and use professional judgement when accepting and delegating responsibility.
2.4. Nurses value
their own dignity, well-being, and health. To achieve this requires positive practice
environments, characterised by professional recognition, education, reflection,
support structures, adequate resourcing, sound management practices and occupational
health and safety.
2.5. Nurses maintain
standards of personal conduct at all times. They reflect well on the profession
and enhance its image and public confidence. In their professional role, nurses
recognise and maintain personal relationship boundaries.
2.6. Nurses share
their knowledge and expertise and provide feedback, mentoring and supporting the
professional development of student nurses, novice nurses, colleagues, and other
health care providers.
2.7. Nurses are patient
advocates, and they maintain a practice culture that promotes ethical behaviour
and open dialogue.
2.8. Nurses may conscientiously
object to participating in particular procedures or nursing or health-related research
but must facilitate respectful and timely action to ensure that people receive care
appropriate to their individual needs.
2.9. Nurses maintain
a person’s right to give and withdraw consent to access their personal, health and
genetic information. They protect the use, privacy and confidentiality of genetic
information and human genome technologies.
2.10.Nurses take appropriate actions to safeguard individuals,
families, communities, and populations when their health is endangered by a co-worker,
any other person, policy, practice or misuse of technology.
2.11. Nurses are active participants in the promotion of patient
safety. They promote ethical conduct when errors or near misses occur, speak up
when patient safety is threatened, advocate for transparency, and work with others
to reduce the potential of errors.
2.12. Nurses are accountable for data integrity to support and
facilitate ethical standards of care.
3. NURSES AND THE
PROFESSION
3.1. Nurses assume
the major leadership role in determining and implementing evidence-informed, acceptable
standards of clinical nursing practice, management, research, and education.
3.2. Nurses and nursing
scholars are active in expanding research-based, current professional knowledge
that supports evidence-informed practice.
3.3. Nurses are active
in developing and sustaining a core of professional values
3.4. Nurses, through
their professional organisations, participate in creating a positive and constructive
practice environment where practice encompasses clinical care, education, research,
management, and leadership. This includes environments which facilitate a nurse’s
ability to practice to their optimal scope of practice and to deliver safe,
effective, and timely health care, in working conditions which are safe as well
as socially and economically equitable for nurses.
3.5. Nurses contribute
to positive and ethical organisational environments and challenge unethical practices
and settings. Nurses collaborate with nursing colleagues, other (health) disciplines
and relevant communities to engage in the ethical creation, conduct and dissemination
of peer reviewed and ethically responsible research and practice development as
they relate to patient care, nursing, and health.
3.6. Nurses engage
in the creation, dissemination and application of research that improves outcomes
for individuals, families, and communities.
3.7. Nurses prepare
for and respond to emergencies, disasters, conflicts, epidemics, pandemics, social
crises, and conditions of scarce resources. The safety of those who receive care
and services is a responsibility shared by individual nurses and the leaders of
health systems and organisations. This involves assessing risks and developing,
implementing, and resourcing plans to mitigate these.
4. NURSES AND GLOBAL
HEALTH
4.1. Nurses value
health care as a human right, affirming the right to universal access to health
care for all.
4.2. Nurses uphold
the dignity, freedom and worth of all human beings and oppose all forms of exploitation,
such as human trafficking and child labour.
4.3. Nurses lead
or contribute to sound health policy development.
4.4. Nurses contribute
to population health and work towards the achievement of the United Nations Sustainable
Development Goals (SDGs). (UN n.d.)
4.5. Nurses recognise
the significance of the social determinants of health. They contribute to, and advocate
for, policies and programmes that address them.
4.6. Nurses collaborate
and practise to preserve, sustain and protect the natural environment and are aware
of the health consequences of environmental degradation, e.g., climate change. They
advocate for initiatives that reduce environmentally harmful practices to promote
health and well-being.
4.7. Nurses collaborate
with other health and social care professions and the public to uphold principles
of justice by promoting responsibility in human rights, equity, and fairness and
by promoting the public good and a healthy planet.
4.8. Nurses collaborate
across countries to develop and maintain global health and to ensure policies and
principles for this.
CODE OF ETHICS FOR NURSES IN INDIA
1. The nurse respects
the uniqueness of individual in provision of care – Nurse
1.1. Provides care
of individuals without consideration of caste, creed, religion, culture, ethnicity,
gender, socio-economic and political status, personal attributes, or any other grounds
1.2. Individualizes
the care considering the beliefs, values, and cultural sensitivities
1.3. Appreciates
the place of individual in the family and community and facilitates participation
of significant others in the care.
1.4. Develops and
promotes trustful relationship with individual(s)
1.5. Recognizes uniqueness
of response of individuals to interventions and adapts accordingly
2. The nurse respects
the rights of individuals as partner in care and help in making informed choices
- Nurse
2.1. Appreciates
individual’s right to make decisions about their care and therefore gives adequate
and accurate information for enabling them to make informed choices
2.2. Respects the
decisions made by individual(s) regarding their care
2.3. Protects public
from misinformation and misinterpretations
2.4. Advocates special
provision to protect vulnerable individuals/groups.
3. The nurse respects
individual’s right to privacy, maintains confidentiality, and shares information
judiciously- Nurse
3.1. Respects the
individual’s right to privacy of their personal information
3.2. Maintains confidentiality
of privileged information except in life threatening situations and uses discretion
in sharing information.
3.3. Takes informed
consent and maintains anonymity when information is required for quality assurance/
academic/legal reasons
3.4. Limits the access
to all personal records written and computerized to authorized persons only.
4. Nurse maintains
competence in order to render Quality Nursing Care
4.1. Nursing care
must be provided only by registered nurse
4.2. Nurse strives
to maintain quality nursing care and upholds the standards of care
4.3. Nurse values
continuing education, initiates and utilizes all opportunities for
self-development.
4.4. Nurses values
research as a means of development of nursing profession and participates in nursing
research adhering to ethical principles.
5. The nurse if
obliged to practice within the framework of ethical, professional, and legal boundaries-
Nurse
5.1. Adheres to code
of ethics and code of professional conduct for nurses in India developed by Indian
Nursing Council
5.2. Familiarizes
with relevant laws and practices in accordance with the law of the state
6. Nurse is obliged
to work harmoniously with members of the health team - Nurse
6.1. Appreciates
the team efforts in rendering care
6.2. Cooperates,
coordinates, and collaborates with members of the health team to meet the needs
of people
7. Nurse commits
to reciprocate the trust invested in nursing profession by society Nurse
7.1. Demonstrates
personal etiquettes in all dealings 7.2Demonstrates professional attributes in all
dealings
CODE OF PROFESSIONAL CONDUCT FOR NURSES IN INDIA
1. Professional
Responsibility and accountability - Nurse
1.1. Appreciates
sense of self-worth and nurtures it
1.2. Maintains standards
of personal conduct reflecting credit upon the profession
1.3. Carries out
responsibilities within the framework of the professional boundaries
1.4. Is accountable
for maintaining practice standards set by Indian Nursing Council
1.5. Is accountable
for own decisions and actions
1.6. Is compassionate
1.7. Is responsible
for continuous improvement of current practices
1.8. Provides adequate
information to individuals that allows them informed choices
1.9. Practices healthful
behaviour
2. Nursing Practice
- Nurse
2.1. Provides care
in accordance with set standards of practice
2.2. Treats all individuals
and families with human dignity in providing physical, psychological, emotional,
social, and spiritual aspects of care
2.3. Respects individuals
and families in the context of traditional and cultural practices, promoting healthy
practices and discouraging harmful practices
2.4. Presents realistic
picture truthfully in all situations for facilitating autonomous decision-making
by individuals and families
2.5. Promotes participation
of individuals and significant others in the care
2.6. Ensures safe
practice
2.7. Consults, coordinates,
collaborates, and follows up appropriately when individuals’ care needs exceed the
nurse’s competence
3. Communication
and Interpersonal Relationships -Nurse
3.1. Establishes
and maintains effective interpersonal relationships with individuals, families,
and communities
3.2. Upholds the
dignity of team members and maintains effective interpersonal relationship with
them
3.3. Appreciates
and nurture’s professional role of team members
3.4. Cooperates with
other health professional to meet the needs of the individuals, families, and communities
4. Valuing Human
Being - Nurse
4.1. Takes appropriate
action to protect individuals from harmful unethical practice
4.2. Considers relevant
facts while taking conscience decisions in the best interest of individuals
4.3. Encourages and
supports individuals in their right to speak for themselves on issues affecting
their health and welfare
4.4. Respects and
supports choices made by individuals
5. Management -
Nurse
5.1. Ensures appropriate
allocation and utilization of available resources
5.2. Participates
in supervision and education of students and other formal care providers
5.3. Uses judgment
in relation to individual competence while accepting and delegating responsibility
5.4. Facilitates
conductive work culture in order to achieve institutional objectives
5.5. Communicates
effectively following appropriate channels of communication
5.6. Participates
in performance appraisal
5.7. Participates
in evaluation of nursing services
5.8. Participates
in policy decisions, following the principle of equity and accessibility of services
5.9. Works with individuals
to identify their needs and sensitizes policy makers and funding agencies for resource
allocation
6. Professional
Advancement -Nurse
6.1. Ensures the
protection of the human rights while pursuing the advancement of knowledge
6.2. Contributes
to the development of nursing practice
6.3. Participates
in determining and implementing quality care 6.4Takes responsibility for updating
own knowledge and competencies
6.4. Contributes
to core of professional knowledge by conducting and participating in research
CONCLUSION
The
Code of Ethics and Professional Conduct for Nurses is a vital document that
outlines the ethical principles, values, and expected professional conduct for
nurses worldwide. The code emphasizes the importance of patient-centred care,
professional competence, collaboration, and social responsibility. By following
the code, nurses can ensure that they are delivering ethical and competent care
to their patients while upholding the highest standards of professionalism and
accountability. The Code of Ethics and Professional Conduct for Nurses is a
crucial tool for promoting ethical nursing practice and maintaining the trust
and confidence of patients and the wider community in the nursing profession.