Ethics in Nursing Practice

ETHICS IN NURSING
PRACTICE
By: Sathish Rajamani M. Sc
(N)
Lecturer,
BKIN - Daudhar
INTRODUCTION
• Health care delivery system has undergone

notable changes during the last few
decades
1. Increased client participation
2. Shorter hospital stays
3. Restructuring services (outpatient
clinics, short-stay units, long-term
care and in home-care)
• Changes Contributed to the
development of new clinical
environment and expanded practice.
• Nurs es today frequently encounter
difficult s ituations involving decis ions
about the bes t cours e of action.
• Nurs es are obligated to provide ethical
and legal client care that demons trates
res pect for others .
CODE OF ETHICS
Code - “A code may be defined as
conventionalized set of rules or
expectations devised for a specific
purpose.”
Ethics-Word ethics is derived from the word
“Ethos”.
It is a Greek word and meaning of this word is
customs, character or conduct.
Ethics is the branch of philosophy that
examines the difference between right and
CODE OF ETHICS
• “A s pecific s et of profes s ional behaviors

and values the profes s ional interpreter mus t
know and mus t abide by, including
confidentiality, accuracy, privacy, integrity.”
• An ethical code is adopted by an
organization in an attempt to as s is t
thos e in the organization called upon
to make a decis ion (us ually mos t, if not
all) unders tand the difference between
'right' and 'wrong' and to apply this
unders tanding to their decis ion.
The ethical code therefore generally
implies documents at three levels :
• A code of ethics often focus es on
s ocial is s ues . It may s et out general
principles about an organization's
beliefs on matters s uch as mis s ion,
quality, privacy or the environment. It
may delineate proper procedures to
determine whether a violation of the
code of ethics has occurred and, if s o,
what remedies s hould be impos ed.
TYPES OF ETHICS
• The code of ethics links to and gives
rise to a code of conduct for
employees.
1.Employee Ethics
2.Professional Ethics
EMPLOYEE ETHICS
• A code of conduct is a document designed to
influence the behavior of employees.
• They set out the procedures to be used in specific
ethical situations.
• The effectiveness of such codes of ethics depends on
the extent to which management supports them with
sanctions and rewards.
• Violations of a code of conduct may subject the
violator to the organization's remedies which can
under particular circumstances result in the
termination of employment.
PROFESSIONAL ETHICS
• A code of practice is adopted by a profession
or by a governmental or non-governmental
organization to regulate that profess ion.
• A code of practice may be styled as a code of
professional responsibility, which will discuss
difficult issues, difficult decisions that will
often need to be made, and provide a clear
account of what behavior is considered
"ethical" or "correct" or "right" in the
circumstances .
CODE OF ETHICS FOR NURSES
• Ethics gives the profes sionals various
guidelines that how should they behave with
each other, with the public and with
governments.
• These are guideline which the professional
should follow when they are dealing with their
clients o
• Ethics also tell the public that what they can
expect from a professional and tells the
professionals that what the public expects
from them.
• “Nurs ing ethics refers to ethical is s ues that
occur in nurs ing practice”
• Nurs ing is a great profes s ion, giving a
healing touch to patients along with taking
care of their dis eas es and maintaining their
health.
• Strict following of the codes in s ome
countries leads to credibility of that
profes s ion and es teem of that profes s ion
ris es automatically.
• In India the Indian Nurs ing Council (INC) has
laid down code of ethics and profes s ional
conduct.
KEY WORDS
• As s urance: A promis e that you will
definitely do s omething.
• Health: A s tate of dynamic balance of an
individual’s ability to perform pers onally
valued roles and res pons ibilities , to deal
and cope with phys ical, biological,
ps ychological and s ocial s tres s es and
challenges throughout the life while
continuing to maintain a s ens e of well-
being.
KEY WORDS
• Nurse: Nurse is a person who has completed
prescribed course in Nursing from an institution
recognized by Indian Nursing Council and
registered herself/himself under the State
Nursing council as Nurse and midwife.
• Nursing: Nursing is a professional service for
enabling a person to maintain and sustain
health and wellbeing.
KEY WORDS
• Performance criteria: Selected behaviors
which illus trate how the s tandard is
achieved.
• Practice s tandards : Set of Activities
expected from profes s ional group of
workers .
• Pers onal etiquettes : Being polite & s oft
s poken, hones t, s incere, cheerful, dignified,
affectionate, compas s ionate and courteous .
KEY WORDS
• Professional etiquettes: Being attentive listener,
keen observer, objective, non-judgmental,
empathetic, confident, assertive, disciplined,
prompt and efficient.
• Professional body or Regulatory body: Indian
Nursing Council / State Nursing Council is
statutory body which regulates the Nursing
E ducation and practice in India.
• Professional Worker: A person who confirms to a
level of practice that is expert and ethical after
completing an authorized educational programme.
KEY WORDS
• Provider: Same as nurse
• Quality Nursing Practice: Quality of nursing
practice is achieved when organization’s
processes and activities are designed and
implemented to meet the needs and
expectations of the receiver on a competent,
cons istent and continuous basis .
• Quality Assurance in Nursing: Quality
Assurance is a program for formal guarantee
for provision of quality nursing care against
set standards .
KEY WORDS
• Rationale: Reas oning for the s tandards .
• Receiver: Receiver(s ) refer to thos e
individual pers ons / families / groups /
communities who are in need of as s is tance
from Nurs e to maintain and s us tain their
health and well-being.
• Standards : Level of performance required
for obtaining a s pecified des ired outcome.
KEY WORDS
• Vulnerable: vulnerable persons are those who are
disadvantaged due to physical, emotional and
social and economic reasons e.g.,
 Mentally and physically challenged person.
 Emotionally traumatized persons.
 Women, children, marginalized groups.
• Well Being: It is an active state of a person with
maximum potential by maintaining balance and is
at peace with inner and outer world.
INC CODE OF ETHICS
• The code of profes s ional conduct for nurs es
is critical for building profes s ionalis m and
accountability.
• E thical cons iderations are vital in any area
dealing with human beings becaus e they
repres ent values , rights and relations hips .
• . The nurs e mus t have profes s ional
competence, res pons ibility and
accountability with moral obligations .
• Nurs e is obliged to provide s ervices
even if it is in conflict with her/his
pers onal beliefs and values .
PURPOSES
• To inform both the nurs e and the s ociety of
the minimum s tandard for profes s ional
conduct.
• It provides regulatory bodies a bas is for
decis ions regarding s tandards of
profes s ional conduct.
• Protect the rights of individuals , families
and community and als o the rights of the
Nurs e.
USES OF THE CODE
• Acknowledges the rightful place of Individuals in
health care delivery system.
• Contributes towards empowerment of
individuals to become responsible for their
health and well-being.
• Contributes to quality care.
• Identifies obligations in practice, research and
relationships.
• Informs the individuals, families, community and
other professionals about expectations of a
nurse.
INC CODE OF ETHICS FOR
NURSES IN INDIA
I) The nurse respects the
uniqueness of individual in
provision of care
1.1 Provides care for individuals without
cons ideration of cas te, creed, religion,
culture, ethnicity, gender, s ocio-
economic and political s tatus , pers onal
attributes , or any other grounds
NURSES IN INDIA
provision of care
1.2 Individualizes the care cons idering
the care cons idering the beliefs , values
and cultural s ens itivities .
NURSES IN INDIA
provision of care
1.3 Appreciates the place of the
individual in family and community and
facilitates participation of s ignificant
others in the care.
NURSES IN INDIA
provision of care
1.4 Develops and promotes trustful
relationship with individual(s).
1.5 Recognizes uniqueness of response of
individuals to interventions and adapts
accordingly.
NURSES IN INDIA
provision of care
1.5 Appreciates the place of the
individual in family and community and
facilitates participation of s ignificant
others in the care.
NURSES IN INDIA
2) The nurs e res pects the rights of
individuals as partner in care and helps
in making informed choices
2.1 Appreciates individual’s right to
make decis ions about their care and
therefore gives adequate and accurate
information for enabling them to make
informed choices .
NURSES IN INDIA
2) The nurs e res pects the rights of
individuals as partner in care and helps in
making informed choices
2.2 Res pects the decis ions made by
individual (s ) regarding their care.
2.3 Protects public from mis information and
mis interpretations .
2.4 Advocates s pecial provis ions to protect
vulnerable individuals /groups .
NURSES IN INDIA
3) The nurse respects individual’s right
to privacy, maintains confidentiality,
and shares information judiciously.
3.1 Res pects the individual’s right to privacy
of their pers onal information.
3.2 Maintains confidentiality of privileged
information except in life threatening
s ituations and us es dis cretion in s haring
information.
NURSES IN INDIA
4) Nurse maintains competence in order
to render Quality Nursing Care
4.1 Nurs ing care mus t be provided only by
regis tered nurs e.
4.2 Nurs e s trives to maintain quality nurs ing
care and upholds the s tandards of care.
4.3 Nurs e values continuing education,
initiates and utilizes all opportunities for s elf
development.
NURSES IN INDIA
4) Nurse maintains competence in order
to render Quality Nursing Care
4.4 Nurse values research as a
means of development of nursing
profession and participates in
nursing research adhering to
ethical principles.
NURSES IN INDIA
5) The nurse is obliged to practice
within the framework of ethical,
professional and legal boundaries
5.1 Adheres to code of ethics and code of
profes s ional conduct for nurs es in India
developed by Indian Nurs ing council.
5.2 Familiarizes with relevant laws and
practices in accordance with the law of the
s tate.
NURSES IN INDIA
6) Nurse is obliged to work
harmoniously with the members of the
health team.
6.1 Appreciates the team efforts in
rendering care.
6.2 Cooperates, coordinates and
collaborates with the members of the
health team to meet the needs of the
people.
NURSES IN INDIA
7) Nurse commits to reciprocate the
trust invested in nursing profession by
society
7.1 Demons trates pers onal etiquettes in
all dealings .
7.2 Demons trates profes s ional
attributes in all dealings .
INC CODE OF PROFESSIONAL
CONDUCT FOR NURSES IN INDIA
1. Professional Responsibility and
accountability
1.1 Appreciates sense of self-worth and nurtures
it.
1.2 Maintains standards of personal conduct
reflecting credit upon the profession.
1.3 Carries out responsibilities within the
framework of the professional boundaries.
accountability
1.4 Is accountable for maintaining practice
standards set by Indian Nursing Council
1.5 Is accountable for own decisions and actions
1.6 Is compassionate
1.7 Is responsible for continuous improvement of
current practices
accountability
1.8 Provides adequate information to individuals
that allows them informed choices
1.9 Practices healthful behavior
2. Nursing Practice
2.1 Provides care in accordance with set
standards of practice
2.2 Treats all individuals and families with human
dignity in providing physical, psychological,
emotional, social and spiritual aspects of care
2.3 Respects individual and families in the
context of traditional and cultural practices and
discouraging harmful practices
2. Nursing Practice
2.4 Presents realistic picture truthfully in all
situations for facilitating autonomous decision-
making by individuals and families
2.5 Promotes participation of individuals and
significant others in the care
2.6 Ensures safe practice
2.7 Consults, coordinates, collaborates and follows up
appropriately when individuals’ care needs exceed
the nurse’s competence.
3. Communication and Interpersonal
Relationships
3.1 Establishes and maintains effective interpersonal
relationship with individuals, families and communities
3.2 Upholds the dignity of team members and maintains
effective interpersonal relationship with them
3.3 Appreciates and nurtures professional role of team
members
3.4 Cooperates with other health professionals to meet the
needs of the individuals, families and communities
4. Valuing Human Being
4.1 Takes appropriate action to protect individuals
from harmful unethical practice
4.2 Consider relevant fact s while taking conscience
decisions in the best interest of individuals
4.3 Encourage and support individuals in their right
to speak for themselves on issues affecting their
health and welfare
4.4 Respect s and supports choices made by
individuals
5. Management
5.1 Ensures appropriate allocation and utilization of
available resources
5.2 Participates in supervision and education of
students and other formal care providers
5.3 Uses judgment in relation to individual
competence while accepting and delegating
responsibility
5.4 Facilitates conducive work culture in order to
achieve institutional objectives
5. Management
5.5 Communicates effectively following appropriate
channels of communication
5.6 Participates in performance appraisal
5.7 Participates in evaluation of nursing services
5.8 Participates in policy decisions, following the
principle of equity and accessibility of services
5.9 Works with individuals to identify their needs
and sensitizes policy makers and funding
agencies for resource allocation
6. Professional Advancement
6.1 Ensures the protection of the human rights while
pursuing the advancement of knowledge
6.2 Contributes to the development
6.3 Participates in determining and implementing
quality care
6.4 Takes responsibility for updating own knowledge
and competencies
6.5 Contributes to the core of professional knowledge
by conducting and participating in research

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ETHICS IN NURSING

• Health care delivery system has undergone

• “A s pecific s et of profes s ional behaviors

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