May 25, 2022
You cannot overstate the importance of regulations and ethical principles in your nursing practice. When it’s all said and done every nurse does more than just a job, they are responsible for sustaining human life and encouraging the best care practices.
Principles of Ethics for Nurses
The American Nurses Association Code of Ethics governs nurses in the United States. This Code is your guide for carrying out nursing responsibilities in a way that's consistent with the quality of nursing care your patients expect. Following the Code makes sure you're meeting the ethical obligations of the nursing profession. There are four broad principles at play in the code of conduct for nurses.
1. Autonomy
Nurses recognize each patient has the right to self-determination and decision-making. You are an advocate for your patients. That means it's up to you to make sure your patients receive medical information about their cases. You're expected to educate them as necessary. It's your responsibility to spell out the available options so your patients can make the best choices for themselves.
2. Beneficence
Nurses act for the good and welfare of others through compassion, kindness, and charity.
3. Justice
Nurses provide care with equal fairness regardless of a patient's financial status, religion, gender, or sexual orientation.
4. Nonmaleficence
In short, this means nurses do no harm. As a nurse, your patients expect you to help them achieve a positive outcome while causing the least amount of harm possible.
The American Nurses Association (ANA) addressed legal and ethical issues in nursing by developing a formal code of ethics for nurses in the 1950s. It has undergone multiple revisions since then. It now contains nine specific points to help guide nurses in the ethical practice of their profession.
Code of Ethics for Nursing
The Code of Ethics incorporates the four principles at the core of the nursing profession.
- Nurses fulfill their duties with compassion and respect for their patient's inherent worth, dignity, and unique individuality.
- A nurse's primary commitment is to the patient, whether an individual, a family, group, community, or population.
- It is the nurse's responsibility to promote, advocate for, and protect the patient's health, safety, and rights.
- Nurses are accountable for their nursing practice. They hold authority and responsibility for making decisions and taking action consistent with their obligation to provide the best patient care they can.
- Nurses should demonstrate a personal commitment to promoting health and safety. They should serve as an example of integrity and wholeness of character. Nurses maintain competence in their skills and continue growing professionally and personally.
- Individually and as a member of the nursing profession, the nurse accepts the responsibility to establish, maintain, and improve a work setting based on ethical principles. The nurse advocates for and actively promotes a working environment conducive to safe, quality healthcare.
- Regardless of role or setting, the nurse advances the nursing profession through scholarly research and inquiry, developing and adhering to professional standards, and the generation of nursing and healthcare policies.
- As valued healthcare team members, nurses collaborate with other health professionals and with the public to promote health diplomacy, protect human rights, and reduce health disparities.
- Through professional organizations and as individual professionals, nurses must uphold, demonstrate, and articulate nursing values, support and maintain professional integrity, and integrate principles of justice into nursing care and healthcare policies.
These provisions summarize the code of ethics that should guide you in ethical decision-making in your practice.
Regulations and the Professional Nurse
Governments began regulating nursing as a way to protect the nursing title and the public the nurses serve. The primary purpose of nursing regulations today is still to protect the public. This is achieved through rules that define the nursing practice, by approval of nursing education programs, and by monitoring the competency of practicing nurses through licensing, disciplinary rules, and state regulations.
Nurse Practice Acts
The state where you work grants you the right to practice nursing as a profession. Each state has a Board of Nursing that determines the guidelines of that state's Nurse Practice Act (NPA) and its rules. It is your responsibility to know and understand the NPA under which you practice. You have to keep up with changes to the NPA in your state and any changes in the scope of practice that directly impacts you.
Because the U.S. constitution does not include regulations for nursing practice, the oversight responsibility rests with the individual states. Each state has the power to make laws that govern and maintain public order, safety, health, and welfare.
NPA: A Nurse's Guide to Action
Each state's legislature has passed its version of the Nurse Practice Act (NPA.) Each state established a Board of Nursing with the authority to develop regulations and rules. These regulations must align with the state's NPA and cannot overstep it. Once enacted through the legislative process, the rules and regulations set by the Board of Nursing have the full force and effect of law behind them.
Though the specifics of each state's NPA varies, all address the following:
- Definitions
- Composition, authority, and scope of power held by a Board of Nursing
- Standards for educational programs within the state
- Nursing standards and scope of practice for each level of nursing licensure (NP, CRNA, RN, LPN, LVN, etc.)
- Types of licenses and titles
- Protection of titles
- Licensure requirements
- Grounds for disciplinary action, other violations, and possible avenues for remedy
What You Need to Know
NPAs are constantly being updated and revised. As a nurse, it's your responsibility to stay current on the trends and changes in the state where you practice.