The American Nurses Association (ANA) created and implemented the first nationally accepted Code of Ethics for Nurses with Interpretive Statements. The Code of Ethics is a living document regularly updated by the ANA and establishes an ethical standard that is non-negotiable for nurses in all roles and settings.

The Code of Ethics provisions outline the nurse's duty to the patient, the healthcare team, the profession, and society. The Code's fundamental principles include advocacy, responsibility, accountability, and confidentiality.

Advocacy refers to applying a nurse's skills and knowledge for the patient's benefit; for example, a nurse may advocate for a patient's right to privacy by ensuring that sensitive medical information is discussed privately. In cases where a patient desires to keep certain details confidential, the nurse safeguards the patient's privacy throughout the care process by scheduling the discussions about the patient's medical condition in secured areas, such as private rooms or offices, rather than in public or communal spaces like hallways or waiting rooms. This careful planning prevents unauthorized personnel from overhearing sensitive information, upholding the patient's confidentiality and trust.

Responsibility in nursing refers to respecting professional obligations and following through on promises. A nurse demonstrates responsibility by staying informed about the latest medical advancements and evidence-based practices. When delegating tasks to other healthcare team members, the nurse ensures that those tasks align with each team member's competence and that the patient's well-being is prioritized.

Accountability implies being answerable to oneself and others for one's actions. It mandates that nurses are responsible for their actions and follow an ethical code based on fidelity and respect for patients' dignity and self-determination. For example, if a medication error occurs, a nurse takes accountability by promptly reporting the incident, taking corrective action, and participating in analyzing what went wrong. The consequences of not adhering to this principle could include legal action, damage to the nurse's professional reputation, and, most importantly, compromised patient safety. Accountability extends to openly communicating with the patient and healthcare team, emphasizing a commitment to learning and preventing future errors.

Confidentiality signifies respecting the patient's privacy and the nondisclosure of the patient's information. It is fundamental to the trusting relationship between the nurse and the patient. The federal legislation describes the rights and privileges of patients regarding privacy through the Health Insurance Portability and Accountability Act (HIPAA.) For example, when discussing a patient's condition during a handover with another nurse, the information is shared discretely and securely, ensuring that only those presently involved in the patient's care are privy to the details.

The practical application of these principles ensures a patient-centered approach, fostering a trusting and collaborative relationship between nurses and patients. Additionally, these principles guide nurses in navigating complex ethical dilemmas, such as respecting patients' autonomy in decision-making, maintaining dignity during end-of-life care discussions, and advocating for vulnerable populations with limited access to healthcare resources. The Code of Ethics for Nurses is a guideline empowering nurses to provide high-quality, ethical care within the constantly evolving healthcare landscape.