Code of Ethics in Nursing:

Bid to ensure patient's rights

by Mallika de Silva

Ethics is a discipline studied in almost all professional fields including medicine and nursing. In the broadcast sense, ethics are the principles that guide an individual, group or profession in conduct. It deals with the actions of being right and wrong what is good and what is bad.

The Code of Ethics in Nursing is closely linked with patients' rights. For example the International Council of Nurses (ICN) code of ethics established in 1953, makes it clear, inherent in nursing is respect the human rights including the right to life to dignity and to be treated with respect at all times. In 1973 the American Hospital Association initially developed a patient's Bill of Rights to protect the individual rights of the patient, and by law a patient must be informed their rights upon being admitted to the hospital.

The Code of Ethics in Nursing stipulates that people must be given the rights to assist in their own decision making. This ethical concept has led to the need for informed consent. Informed consent is more than simply getting a patient to sign a written consent form.

Communication

It is a process of communication between the patient and the physician that results in the patient's agreement or authorisation to undergo any surgical or medical intervention. In turn the patient should have the opportunity to ask questions to elicit better understanding of the treatment or procedure so the patient can make informed decision to proceed or refuse a particular treatment. Informed consent is a very important part of nursing ethics that is taught throughout all levels of nursing programs.

As a leading partner in care it is the nurses' responsibility and obligation to respect the rights of individual and assist him/her to make informed consent (choice) by providing adequate and accurate information of care that patient will receive following such medical or surgical intervention.

Over the past 100 years, nursing has evolved in to a very complex professional field.

In 1953 the International Council of Nurses established the International Code of Ethics in Nursing. The ICN Code of Ethics is revised regularly in response to the realities of nursing and health care in changing society.

The ICN Code of Ethics is revised regularly in response to the realities of nursing and health care in a changing society. The ICN Code of Ethics in Nursing has served for nurses worldwide.

The ICN Code of Ethics clearly illustrates the responsibility of nurses in using the principles enshrined in the code to safeguard the health and well-being of the public.

The ethics of nursing has shifted more towards the nurses obligation to respect human rights, dignity, integrity, privacy and confidence of the patient and these concepts are reflected on a number of professional code of ethics in nursing in many countries.

For example in the United Kingdom Code of Conduct for Nurses refers to a set of British rules developed by the Nursing and Midwifery Council (NMC).

The Code of Conduct (NMC.UK) issued a set of standards describes the behaviour, ethics, performance, that must be adopted by nurses and midwives. The code highlights four principles.

1. Patient becomes important in all decisions and activities, and nurses must respect the patient as an individual who deserves his/her dignity.

2. Nurses must protect the well-bring of the sick by treating them with care.
3. Nurses must diagnose, treat, and monitor patients in the highest standard of care.

4. Each Nurse has the responsibility to uphold the reputation of profession and act with integrity. The N.M.C. (UK) Code clearly describes, the failure to comply with the code may bring nurses fitness to practice in to question and endanger registration as a nurse.

Confidentiality

The American Nurses Association (ANA) is the largest organisation in the US that provides an ethical code of conduct for the nursing profession, and stipulates guidelines under nine provisions what nurses should understand about their ethical responsibilities. The code lets the public know what is expected of nurses, and tells the nurses what the public expects from them. ANA code of ethics states the nurses who follow the code of ethics are destined to improve the quality of care that they provide, promote the profession of nursing and increase their degree of professionalism. The code provision number one states that nurse should respect the dignity of each patient and family member as well as co-worker. Provision two states that the nurses’ primary responsibility is to the patient. The patient may be an individual, group or community. Nurses have a duty to protect the rights of their patients including right of confidentiality and privacy. The ANA Code provision four states the nurses are completely responsible and accountable for their nursing practice to provide optimal care. Provision nine states that nurses are responsible for making sure nursing maintains a good name in the community.

Nursing is a great profession giving a healing touch to patients along with taking care of their diseases and maintaining their health. Hence strict following the code of ethics, in some countries lead to the credibility of the nursing profession and esteem of the profession rises automatically.

Principles

The majority of the countries nursing experts have drawn their attention to develop Code of Ethics for their nurses, by focussing the main aim to protect the health and well-being of the people through maintaining professional standards of the nurses. They believe like any other profession nursing also must have clear regulatory principles for nurses to follow. As a result the principles are set down in the code as standard of conduct, performance and ethics for nurses. Nurses are committed to apply these principles in to practice everyday. As an important principle in the code of ethics, all nurses have to comply with nurse patient relationship and to maintain the confidentiality of each patient's treatment and care plan to protect the fundamental trust between the nurse and the patient.

As a whole many code of ethics in nursing indicate the protection and advocacy role of the nurse. It describes the nurses who have strong collaborative relationship with attending physicians could have more influence on their ability to act as advocates for the patients. The advocacy role is more important as nurses work more closely with patients. To develop this professional ability the nurses need to be competent in all aspects of human relationship. As an advocate for the patient the nurses must be alert and take appropriate action regarding any instance of incompetent, unethical, illegal, or impaired practice by any member of the health care team or any action on the part of others that places the rights or best interest of patients in jeorpady.

The Code of Ethics in Nursing in many countries refer to etiquette to be practised by all nurses when dealing with people to maintain the professional behaviour of the nurses. The etiquette are valuable and essential in the nursing field for cultivating good relationship among the public. More than most careers, nursing is is characterised by professional relationship among different people in numerous settings. Exercising professional etiquette doesn't take a lot of time or effort, so that the nurse makes it part of her every day practice. For example, when speaking with a patient, the nurse may treat the patient with sincere smile to denote warmth and friendliness.

Behaviour

It is equally important to understand what happens psychologically to patients when they are admitted to a hospital.

Except for childbirth and elective surgeries, hospital admissions are always not by choice but by circumstance beyond a patient's control. Patient feel vulnerable, out of control and fearful with many of them facing potentially fatal or disastrous outcomes. Their families and significant others share in these feelings with them.

The Code of ethics supports the notion that is important to help the patient to maintain as much control over their environment as possible by allowing them choices for scheduling and other component of their treatment.Nursing is a people-oriented career and it is a primary responsibility of the nurse to make sure that each patient/client is getting the highest possible quality care at all times, no matter how stressful the situation is.

The writer is a former Principal of the School of Nursing.