Understanding the Nursing Code of Ethics

Nurses must maintain strict ethical standards, which can be challenging in an environment that requires rapid decision-making resulting in life-altering consequences. To compound the issue, nurses are caring for an older, chronically ill patient population where the interventions do not always have clear-cut benefits, calling into question how nurses can best support the provision of ethical care.

In the absence of distinct guidelines, these ethical challenges place tremendous stress on the existing nursing workforce and can dissuade individuals from entering the profession altogether — a particularly unfavorable outcome given the current nursing shortage. Therefore, nurses must understand the range of moral dilemmas they can encounter and the processes to follow to ensure the uninterrupted delivery of ethically sound care.

What Are the 9 Ethics Provisions Nurses Must Follow?

To assist nurses in navigating complex ethical decisions, the American Nurses Association (ANA) has a published Code of Ethics for Nurses. Containing nine distinct provisions, the code is “nonnegotiable,” says the ANA. It “establishes the ethical standard for the profession and provides a guide for nurses to use in ethical analysis and decision-making.”

The nine provisions are as follows:

1. The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person.
2. The nurse’s primary commitment is to the patient, whether an individual, family, group, community or population.
3. The nurse promotes, advocates for, and protects the rights, health and safety of the patient.
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.
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.
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 healthcare.
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.
8. The nurse collaborates with other health professionals and the public to protect human rights, promote health diplomacy and reduce health disparities.
9. The profession of nursing, collectively through its professional organization, must articulate nursing values, maintain the integrity of the profession, and integrate principles of social justice into nursing and health policy.

What Makes a Nursing Action Ethical?

There are ethical implications for all nursing actions, so nurses must know how to measure or predict those implications when making care decisions. According to The Online Journal of Issues in Nursing (OJIN), “for a nursing action to be considered ethical, it should be aimed at promoting the goals of nursing in conjunction with the patient’s wishes.”

In general, the goals of nursing are to protect, promote and restore health and well-being, prevent illness and injury and alleviate suffering across populations. These goals translate into four primary ethical principles that should direct all nursing actions, according to OJIN:

1. The right to self-determination
2. Promotion of good
3. Avoidance/minimization of harm
4. Fairness/equal distribution of benefits and burdens

How Can Nurses Learn More About Ethical Decision-Making?

The Youngstown State University (YSU) RN to BSN program dives deeper into the ethical considerations nurses face in a modern healthcare environment. The accelerated online degree program aims to help students “exhibit critical thinking in decision-making and problem-solving while adhering to the Code of Ethics for Nurses.” Coursework expands on acceptable ethical conduct and identifies ways to maintain care standards in an increasingly complex landscape.

Ultimately, nurses will continue to encounter complicated ethical situations. However, by adhering to the nine provisions outlined in the ANA’s code and maximizing opportunities to further their critical thinking capabilities, such as those offered in a BSN program, nurses can develop a deeper understanding of ethical nursing guidelines and the impact on care.

Learn more about YSU’s online RN to BSN program.