Florence Nightingale, undoubtedly the world's most famous nurse, lent her name to
the first version of the Nursing Code of Ethics in 1893, when the "Nightingale
Pledge" was first issued. The American Journal of Nursing first published a draft of
the code in 1926, although it was not formally ratified by the American Nursing
Association (ANA) until more than 30 years afterwards, in 1960. Since that time, the
Code of Ethics has been amended a few times, though the core principles remain the
same to this day.
Of course, Nurses are expected to perform their job duties with integrity, while they
do the best job possible. She is not only a caregiver; but is also expected to have a
wide range of other skills too, including tact, patience and strong communications
ability. Because the Code language changes from time to time, and may be amended,
all nurses need to stay on top of any updates. The duties of a nurse have become much
more challenging in recent times, due to things like cost-conscious hospitals, the
nursing shortage in some areas and more complex medical treatments provided in
Most people understand what ethics are, as we are forced to make ethical decisions
every day. Pedagogically, ethics is really a branch of philosophy - the word ethics is
derived from the Greek word ethos which means "habitual usage, custom, conduct
and character". Ethics are the guidelines which should guide an individual or a group
in their daily behavior.
The first three paragraphs of the Code are probably the most significant. They go
over the basics as the nurse's commitment to her patient, general respect for human
dignity and the responsibility to ensure the privacy of all patients. Nurses put these
principles into practice every day by doing things like fully explaining procedures,
guarding privacy and making sure that they have a patient's full consent before taking
The Code of Ethics is closely linked with a patient's rights and a section of the Code
deals with this potentially touchy subject. A comprehensive patients' bill of rights is
actually a recent concept. The Patients Bill of Rights was not enacted by the American
Hospital Association until 1973 and was subsequently revised in 1992. Under the law,
a patient has to be informed of their rights when they are admitted to the hospital.
The Code of Ethics also states that nurses must take personal responsibility not only
for their actions, but also for the actions of other nurses as well. The Code states that a
nurse must take action if he or she sees others doing, "incompetent, unethical, illegal
or impaired" activities. The nurse is also encouraged, and expected, to report such
behavior, which is not always the easiest thing to do.
Most hospitals have ethics committees or may even have an ethicist on the hospital
staff. He or she can be called upon when a life or death decision needs to be made, a
decision that most of us do not like to make. Often the question of ethics comes up in
situations in which the health care team is considering the removal of life support and
allowing a terminally ill patient to die.
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