Nursing Code of Ethics and Integrity

Integrity is a vital quality in healthcare; it involves being truthful, fair and holding high moral standards in nursing practice. Healthcare is dynamic, and as a nurse, one will interact with various medical personnel, patients, and family members. Having a high value of integrity enables the nurse to do right by everyone concerned. The patient-nurse relationship is therapeutic and is grounded on ethics (Bratz & Sandoval-Ramirez, 2018). Nursing practice is based on a blended humanistic and exquisite skill. Moral integrity enables one to execute his care delivery duties in an accountable and ethical manner.

According to the American Nurses Association, nursing ethics refer to a compact statement of the ethical obligation and duties to all who join the nursing profession. They were founded by Florence Nightingale in 1893 and termed the “Nightingale Pledge (Stievano & Tschudin, 2019).” The nursing code of ethics provides the guidelines on how nurses should execute their responsibilities using methods that are in line with the required standard of care and the ethical obligation of the nursing profession.

The American Nurses Association has formed a code of ethics that outlines an American Nurse’s core goals, obligations, and values. According to ANA, this code serves the following three purposes: it is a concise statement of every individual’s ethical commitment and duties who enters the nursing profession. It is the profession’s non-negotiable moral standard and it is an expression of nursing’s understanding of its commitment to society. The code of ethics is built on four main principles: autonomy, beneficence, justice, and nonmaleficence (Stievano & Tschudin, 2019). Principles should always be observed by all caregivers to provide quality, timely, and the most humane care to all clients.

The principle of autonomy requires that each patient’s right to self-determination and individual decision-making be observed when providing care. Nurses should serve as patient advocates and provide all required information and medical education to enable them to make the right decision. Details such as the risks involved in a particular medical procedure, its benefits, complications, and the available alternatives should be provided (Stievano & Tschudin, 2019). When implementing care plans, the nurses should comply with the patient’s wishes. It is ethical to respect other factors that influence the patients’ decisions, such as age, culture, sexual orientation, gender, and the social system.

The principle of beneficence dictates that each medical personnel should always act for the patient’s good. According to the American Nurses Association, this principle is defined as actions guided by compassion. They incorporate taking care of the patient, including attributes such as kindness and charity (Stievano & Tschudin, 2019). The principle of justice indicates the element of fairness and equality in providing care and when making any medical decision. Each patient in any healthcare facility should be treated like others regardless of their financial status, gender, culture, sexual orientation, race, or religion. The main principle of nursing ethics out of the four is nonmaleficence. When deciding on the medical intervention, the nurse should choose one with the best outcome and most minor damage to the patient.

Importance of Ethics in Health Care

Ethics play a significant role in the healthcare sector as they give direction in taking action, and this aids in solving any moral dilemmas encountered in healthcare. In healthcare, ethics are used in three main aspects: the philosophical ethics that outline the patient’s lifestyle, culture, and conduct, the life-religious ethics that indicate the religious manner and moral behavior. Ethics are applied broadly in providing patient care and conducting medical research.

Respect is considered a basic essential when delivering care to patients. Ethical standards outline how care should be provided, and through the principle of autonomy, each patient is respected. The rights and wishes of each person are complied with when making any medical decision. It facilitates a cordial interaction between the nurses, patients, family members, and other medical personnel (Stievano & Tschudin, 2019). Ethics, therefore, provide a conducive and friendly environment for working.

Ethics facilitates an improvement of the general outcomes of medical interventions. This is due to the strict guidelines it outlines to be followed while providing care. The principle of nonmaleficence indicates that all decisions made should be associated with the highest possible outcome and should not cause any harm to the patient. This promotes a better prognosis for the patient and quick recovery. Generally, the patients’ quality of life is improved as there are minimal chances of complications developing.

Ethical standards also play a significant role in promoting patient satisfaction. The code of ethics indicates how nurses should act while in the profession. Besides respecting each patient’s rights and wishes, they must be fair. Each patient is to receive the same quality of care as any other in the facility. The code of ethics eliminates discrimination regardless of one’s social background, race, gender, culture, sexual orientation, age, or economic status (Stievano & Tschudin, 2019). Observing equality and justice in healthcare gives the patients a sense of being loved and cared for, making them satisfied by the care provided.

The code of ethics has promoted the provision of efficient healthcare. Aspects of integrity and morality have been enhanced and incorporated into healthcare. In nursing, the principle of ethics is termed a non-negotiable standard (Dellasega & Kanaskie, 2021). This indicates that the caregivers have no option but to comply with the required levels of care. Failure to abide by the rules may result in punishment and dismissal from the profession. This regulation laid by the ANA promoted the concept of moral accountability in nursing practice.

Nursing was previously considered an art, but it has transformed to be a science with time. This has therefore led to a need for scientifically approved practices. To achieve the goal, nurse researchers have been trained to conduct studies and provide findings to ensure evidence-based care. The code of ethics plays a significant role in directing medical research and experiments. Research is done with strict adherence to ethical standards to ensure no harm is caused to anyone.

Code of Ethics Provisions

The American Nurses Association ethical provisions are based on quality, professional, academic and interpersonal relations. According to Haddad & Geiger, (2018) the nine provisions of the nursing code of ethics are:

The nurse practices with compassion and respect for every person’s inherent dignity, worth, and uniqueness

This provision is based on the aspect of respectful relationships. The nurse should practice respect for human dignity as it is a vital issue in ethics. Each patient should be handled as a unique being with competence. Nurses should also develop a cordial relationship between them and the patient. Each person’s interests and values should be addressed without any prejudice. The provision also takes into account the nature of health. The nurses should always recognize the worth of the patient’s life and advocate for care to promote their health status. Each intervention should primarily aim at health restoration, alleviating any suffering, and minimizing unwanted complications. The provision outlines the respect for the patient’s right to self-determination. Informed consent should be obtained before conducting any medical procedure. Lastly, the provision requires that the nurse always extend compassion and respect to other colleagues. It preserves the commitment to integrity-preserving compromise and respect. Any form of harassment, prejudice, or disregard for others is not tolerated.

The nurse’s primary commitment is to the patient, whether an individual, family, group, community, or population

The provision is built in four aspects: the primacy of patient needs, conflict of interest between nurses, collaboration, and professional boundaries. According to the provision, the nurse’s paramount commitment is the patient’s needs (Haddad & Geiger, 2018). During planning and implementing care, the nurse should involve the patent and ensure they consent. The obligation to patient care should always remain steadfast even when in disagreement with the client or family members. Caregivers should always address any interpersonal conflicts they have with their colleagues and patient family members on the type of care to be provided or the patient’s values.

According to the ANA, a nurse should withdraw if the conflict complicates and becomes unresolvable. It is salient to understand that the whole healthcare fraternity, including the doctors, radiographers, and subordinate staff share a common goal of improving the patient’s life and health status. Nurses, therefore, should work in collaboration with each of them professionally. The code of ethics also stipulates that nurse recognize and honor professional boundaries (Haddad & Geiger, 2018). The nurse-patient and nurse-colleagues relationship should be respectful and established on professional grounds.

The nurse promotes, advocates for, and protects the patient’s rights, health, and safety

Nurses serve as patient advocates and should always guarantee their clients’ privacy and confidentiality. During care provision, they should always provide an environment that provides both physical and auditory privacy. During experimental or observational medical studies, the participation of patients should consent. Nurses should advocate the use of vulnerable patients such as children and aged adults from engaging due to their increased risk of complications (Haddad & Geiger, 2018). Nurses also have the responsibility of maintaining the required standards of professional practice. They should take part in the formulation of policies and review mechanisms. The provision always provides for patient protection from impaired practice. As advocates to the patient, nurses should ensure no harm comes to their clients by preventing any compromised colleagues from providing care.

The nurse has authority, accountability, and responsibility for nursing practice decision making and taking actions consistent with the role of promoting healthcare

This provision directs that, nurses should take accountability and responsibility for their actions. All actions taken should always be within the scope of practice. Each nurse should always make decisions consistent with the code of ethics (Haddad & Geiger, 2018). If they are assigned any role that is outside their jurisdiction or one that they do not know, they should reject them. Nurses in leadership positions should always oversee and monitor how care is provided, and they should orient and train new members.

The nurse owes the same duties to themself as others

The ANA Code of ethics indicates that a nurse should always prioritize individual well-being and others. This can be achieved through promoting competence, preserving the integrity, and focusing on professional growth. However, care providers should promote professionalism, the provision advocates for wholeness of character (Haddad & Geiger, 2018). An individual’s personal and professional identities should be incorporated together. Every professional should strive to maintain competence at work and work towards professional and personal growth.

The nurse establishes, maintains, and improves the ethical environment conducive to safe and quality health care through individual and collective efforts

The provision indicated that nurses should possess attributes of morality such as courage, compassion, and honesty. The environment of the care facility should be blended to promote a safe and moral setting. ANA suggests that nurses create a conducive hospital setup that allows caregivers to perform their ethical obligations (Haddad & Geiger, 2018). The nursing leadership should execute their role effectively and advocate for justice and fairness in the various work units.

In All Roles and Settings, The Nurse Advances the Profession Through Research and Scholarly Inquiry, Professional Standards Development, And the Generation of Both Nursing and Health Policy

Nursing is a science, and its practice should entirely be evidence-based. Therefore, all nurses should research to promote professional advancements through knowledge seeking and dissemination (Haddad & Geiger, 2018). ANA aims to empower nurses to engage in formulating, implementing, and monitoring professional standards. All nurse educators should be competent enough and train nurses who are qualified and with the recent skills. The code of ethics also encourages American nurses to actively participate in leadership and other national and international initiatives that influence the nursing profession.

The Nurse Collaborated with Other Health Professionals and The Public to Protect Human Rights, Promote Health Diplomacy and Reduce Health Disparities

According to the WHO, health is universal, and nurses should promote health and human rights at all times. Patients should have timely access to health care whenever they need it. Caregivers should also act as health diplomats and ensure that every person attains sustaining health that can enable them to lead their lives to the fullest. Nurses are encouraged to enrol in various professional organizations to empower themselves and fight for equitable healthcare to achieve fairness. The nurse can also promote human rights by acknowledging and respecting every patient’s background, culture and beliefs (Haddad & Geiger, 2018). This will aid in managing incidents of disparities experienced in health care. Finally, according to this provision, it is the responsibility of the nurses to monitor and assess the community and its members for any possible health threat.

The Nursing Profession, Collectively Through its Professional Organizations, Must Articulate Nursing Values, Maintain the Integrity and Integrate Social Justice Principles into Nursing

This provision deals with the formation of nursing professional bodies and their role in nursing practice. Each body should educate its members and the public on nursing values. These organizations also mandate to embrace the code of ethics by encouraging their nurses to uphold ethical standards when executing their roles. The public should also recognize the uniqueness of the nursing profession and its roles. The concept of social justice should be integrated into the practice in the interest of the patients, nurses, and the public.

Integrity in Carroll University

The health care sector is grounded on professional integrity and ethics. Before joining any profession as qualified staff, each person has to study in an accredited institution such as the university of Carroll. The traits of truthfulness, hard work, accountability, and morality are gained through one’s life, especially during learning (Emmanuel et al., 2021). Carroll university focuses on the concepts of honesty. It does not tolerate lying, plagiarizing, falsifying papers, or making excuses from its nursing student as it aims to uphold moral standards. The university focuses on training nurses who embrace the concept of integrity. As the student graduates, the institute hopes to have produced a well-skilled and morally upright nurse who can transform the nursing practice and improve patients’ lives.

Principle of Nonmaleficence

In nursing practice, nonmaleficence is an ethical principle that bars anyone from inflicting harm intentionally. It is doing what is best for the patient without complicating their condition (Devine & Chin, 2018). This principle is considered the most important one of all as it aims specifically at improving the patient’s health status and alleviating any possible threat. According to ANS, the principle is built on core concepts: an act is not intrinsically wrong, a sound effect is intended, a good effect is not a result of a harmful effect, and the good outweighs the bad. However, this principle is enhanced by observing the principle of autonomy and justice.

Impacts of Failing to promote Patient Safety

The general outcome of healthcare to a patient is based on a culture of safety and excellence. Nursing students’ failure to protect patient safety in the clinical setting can have various adverse effects. This could include deterioration of the patient’s condition following poor care. The patient’s financial burden increases as they end up staying in the facility longer than expected. Complications and disabilities may develop as the infections affect major body organs. Failure to ensure patient safety can also result in patient dissatisfaction with the care provided. In a severe case, negligence may lead to the patient’s death.


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Dellasega, C., & Kanaskie, M. L. (2021). Nursing ethics in an era of a pandemic. Applied Nursing Research, 62, 151508. Web.

Devine, C. A., & Chin, E. D. (2018). Integrity in nursing students: A concept analysis. Nurse Education Today, 60, 133-138. Web.

Emmanuel, E., Fielden, J., & Miller-Rosser, K. (2021). Why should we care about academic integrity in nursing students? J Nurs Educ Pract, 11(5), 46-53. Web.

Haddad, L. M., & Geiger, R. A. (2018). Nursing ethical considerations. In: StatPearls. StatPearls Publishing, Treasure Island (FL); PMID: 30252310.

Stievano, A., & Tschudin, V. (2019). The ICN code of ethics for nurses: a time for revision. International Nursing Review, 66(2), 154-156. Web.

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