What Is the Code of Ethics for Nurses? Overview and Tips
Nurses make decisions every day that can be life-changing for patients. But how can you know what’s right in a given situation? The Code of Ethics for Nurses is a set of guiding principles that can help you navigate complex decisions and ethical dilemmas. Whether you’re a new nurse or an experienced clinician, understanding nursing ethics is essential.
Nursing remains the most trusted profession, in part, because of a strong history in moral practice that dates back to the mid-19th century. Ethics are not an afterthought in nursing — the profession arose from a call to serve and an imperative to help others. Nursing ethical principles have evolved as medicine and the profession have grown more complex.
So, what is the Code of Ethics for Nurses? We’ll explore the provisions in the ANA Code, provide examples of the provisions in action, and share some tips for implementing the code in your workplace.
What Is the ANA Code of Ethics for Nursing?
The American Nurses Association (ANA) developed the Code as a foundational guide for the nursing profession, outlining ethical responsibilities and values that nurses must uphold. Designed to ensure high-quality care and professional growth, the Code serves as both a moral compass and a set of practice standards.
First adopted in the 1950s, the Code has been revised multiple times to reflect the evolving healthcare landscape. Today, it remains a vital framework in nursing education, professional development, and workplace policies. Many nursing schools incorporate the Code into graduation ceremonies, and healthcare organizations use it to shape decision-making.
The Code includes four guiding principles and 10 provisions, which were developed by incorporating feedback from over 3,000 nurses. Learn more in the sections below.
Key Principles in the ANA Code of Ethics for Nurses
ANA’s Code of Ethics for Nurses is based on four principles, including:
- Autonomy: Nurses empower patients to make informed decisions about their care while also exercising professional judgment within their scope of practice.
- Beneficence: Nurses prioritize the well-being of their patients, putting aside personal biases to support decisions that serve the patient.
- Justice: Nurses provide fair, equal, and dignified care to all patients, regardless of personal background, beliefs, or circumstances.
- Nonmaleficence: Nurses are committed to minimizing harm and ensuring patient safety.
Code of Ethics for Nurses With Interpretive Statements
While there used to be nine provisions in the Code, the most recent update now includes 10 nursing Code of Ethics provisions to reflect modern nursing practice. Below, we’ll list each provision as stated by the ANA and provide concrete examples to help illustrate the ANA Code of Ethics.
Provision 1: Compassion and Respect
“The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person.”
Example: A nurse is caring for a transgender patient who is nervous about being respected in a healthcare setting. The nurse asks the patient for their preferred name and pronouns and educates other care professionals about the patient’s needs.
Provision 2: Commitment to Patients
“A nurse’s primary commitment is to the recipient(s) of nursing care, whether an individual, family, group, community, or population.”
Example: A home health nurse is caring for an elderly patient who has fallen at home. The patient’s family wants them to move to a long-term care facility, but the patient strongly wishes to remain independent. The nurse knows that the patient is at risk of further falls and educates them about home safety. Ultimately it’s the patient’s decision to remain at home despite risks.
Provision 3: Trust and Advocacy
“The nurse establishes a trusting relationship and advocates for the rights, health, and safety of recipient(s) of nursing care.”
Example: A nurse notices that a nonverbal patient with developmental disabilities is showing signs of distress during their bath. Concerned that the patient’s pain may be overlooked, the nurse refers to the Code of Ethics for Nurses and advocates for the patient by contacting the care team to adjust the pain management plan.
Provision 4: Authority and Accountability
“Nurses have authority over nursing practice and are responsible and accountable for their practice consistent with their obligations to promote health, prevent illness, and provide optimal care.”
Example: A nurse notices that a post-surgical patient’s vital signs are trending in a concerning direction. Rather than waiting for the next scheduled assessment, the nurse immediately notifies the healthcare provider and suggests additional monitoring.
Provision 5: Self-Care
“The nurse has moral duties to self as a person of inherent dignity and worth including an expectation of a safe place to work that fosters flourishing, authenticity of self at work, and self-respect through integrity and professional competence.”
Example: A nurse is assigned to a patient who becomes verbally aggressive and physically threatening during care. After attempting de-escalation techniques with no success, the nurse reports the incident to the charge nurse and requests a reassignment. The charge nurse upholds the Code of Ethics for Nurses by reassigning the patient and requesting that the security team make additional rounds to support the team’s safety.
Provision 6: Responsibility for Ethical Environment
“Nurses, through individual and collective effort, establish, maintain, and improve the ethical environment of the work setting that affects nursing care and the well-being of nurses.”
Example: A nurse notices that two new hires on the unit are struggling with a heavy workload. Taking the initiative to support them, the nurse suggests introducing in-service education to help add structure to their training and encourages them to support one another.
Provision 7: Professional Advancement
“Nurses advance the profession through multiple approaches to knowledge development, professional standards, and the generation of policies for nursing, health, and social concerns.”
Example: A nurse working as the unit educator sets time aside every week to review new journal articles in their specialty and plan educational sessions around new care standards. They work to support the unit nurses in implementing new policies and improving care.
Provision 8: Collaboration
“Nurses build collaborative relationships and networks with nurses, other healthcare and non-healthcare disciplines, and the public to achieve greater ends.”
Example: A nurse uses social media to advocate for the profession, connect with other nurses, and promote positive change. Using online communities, the nurse can advance the common good for nursing professionals and the public.
Provision 9: Commitment to Justice
“Nurses and their professional organizations work to enact and resource practices, policies, and legislation to promote social justice, eliminate health inequities, and facilitate human flourishing.”
Example: A nursing leader joins the board of a healthcare nonprofit to promote access to care for marginalized communities. The nurse uses their background in policy development to shape equitable healthcare initiatives in their local area.
Provision 10: Global Impact
“Nursing, through organizations and associations, participates in the global nursing and health community to promote human and environmental health, well-being, and flourishing.”
Example: Leaders of a nursing organization participate in a global nursing conference, where they collaborate with international colleagues to share best practices for climate change disaster response.
5 Tips for Practicing the Nursing Code of Ethics
- Know the Code and what it means. Familiarize yourself with the ANA Code of Ethics for Nurses and understand how its provisions apply to real-world situations.
- Prioritize patient advocacy. Speak up when you witness unsafe practices. Make sure that patients are informed, and support them in making decisions that support their unique goals.
- Be your own nurse, first. If you don’t take care of yourself, it’s impossible to provide the best care for others. Ethical nursing practice includes prioritizing your own well-being — physically, mentally, and emotionally.
- Be a lifelong learner. Curiosity and open-mindedness will get you far in nursing, where evidence-based practice and care systems are constantly evolving.
- Lead by example. If you’re looking for a change agent on your unit, it could be you. While mentoring new nurses, communicating with family, or taking part in a morning huddle, remember that you’re modeling behavior for others.
Put the Code of Ethics for Nurses Into Practice
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