Understanding the importance of ethics in nursing
This article was updated on April 11, 2024.
Written by Laurie Davies
This article was reviewed by Raelene Brooks, Dean, College of Nursing.
Understanding the ethics in any professional role provides individuals with a moral compass, set of principles and values needed to perform their job well. In a profession like nursing, upholding ethical standards is particularly important because of the level of medical care, compassion and high-risk situations that nurses navigate. Knowing the principles of ethics in nursing can not only help future nurses understand more about the profession, but it can also help them treat patients with the best care possible.
Read more to learn about the importance of nursing ethics, its history and some of its core principles.
What are ethics in nursing?
The Code of Ethics for Nurses establishes ethical principles in nursing. Far more than just words on paper, the code is nursing’s north star. It governs how nurses should behave during the vulnerable moments when patients place their trust, their care and perhaps even life and death decisions into their hands.
Established by the American Nurses Association (ANA), the Code of Ethics for Nurses “informs every aspect of the nurse’s life.” As such, the ANA Code of Ethics for Nurses is the profession’s non-negotiable standard.
It’s also a dynamic document, and one that has responded over time to healthcare, technological and social changes.
The origins of nursing ethics reach back to the late 1800s — a far different era when nurses weren’t viewed as valued members of a healthcare team as they are today. And concepts like justice in nursing? Well, let’s just say that wasn’t a thing back then. Times have changed.
Formally adopted by the ANA in 1950, the Code of Ethics is revised approximately every decade to keep pace with advances in healthcare and technology, greater awareness of global health, greater inclusivity and the expansion of nursing into advanced practice roles, such as family nurse practitioners. Today, there are four principles of nursing ethics and nine provisions that guide practice.
The importance of ethics in nursing
As you’ve likely gathered, prioritizing ethics in nursing is an important part of this career. Ethics serve as a guiding force behind the decisions nursing professionals make, and ultimately help nurses serve their patients with the utmost respect and care. The emphasis on patient-centered care, which you’ll read more about in the four principles of nursing ethics, allows nurses to prioritize the well-being of their patients in significant ways. Upholding ethical principles ensures that nurses can make the most-informed decisions while cultivating trust and professionalism.
Nurses provide a deep level of care, especially in moments when their patients are most vulnerable. As such, ethics play a vital role in maintaining patient confidentiality and promoting equity in healthcare. Nurses may often find themselves navigating the preferences of their patients while also navigating cultural differences.
We spoke with Raelene Brooks, PhD, RN, dean of the College of Nursing at UOPX, about the role and importance of ethics in nursing:
“Nursing ethics is the foundational core value that guides our practice. Ethics in nursing influences the framework of nursing education and can be witness in every core value in the College of Nursing: Leadership, Scholarship, Professional Practice, Safe Patient Care, Interprofessional Collaboration, and Caring.”
4 principles of nursing ethics
Nurses make ethical decisions daily. In fact, nurses often walk a line between advocating for patients while also adhering to ethical nursing principles.
The ANA’s ethical provisions can be categorized among four principles of ethics to guide nurses in this sacred charge. These principles are autonomy, beneficence, justice and nonmaleficence.
1. Autonomy
Autonomy in nursing means that patients have the right to make their own decisions based on their beliefs and values. According to an article published by the National Center for Biotechnology Information, this means a patient has the right to refuse medications, treatment, surgery or other medical interventions. The nurse must respect this choice.
2. Beneficence
Beneficence in nursing is not as intimidating as it sounds. The ANA defines it as “actions guided by compassion.” Examples of beneficence include helping a heart patient shower, keeping side rails up to prevent falls or providing medication in a timely manner. Brooks points out that beneficence can take other forms as well. For example, she recalls advocating in the 1990s for updated patient-to-nurse ratios that better supported patient care in the ICU. Her guiding force? Compassion.
“The patient depends on the ICU nurse to be their eyes, ears and advocate,” explains Brooks. “Patients are intubated, sedated and on life support. A nurse with more than two patients in the ICU can miss a critical sign/symptom indicating the patient is decompensating. Ethics and patient safety were my guiding principles when I decided to be a spokesperson in local nursing schools [advocating for the legislation] that changed the patient-to-nurse ratio in the state of California.”
3. Justice
Justice in nursing ethics implies that patients have a right to fair and impartial treatment. This means no matter what a patient’s insurance status or financial resources may be, or what gender identification, age or ethnicity they are, they have the right to fairness in nursing decisions.
4. Nonmaleficence
What is nonmaleficence in nursing? It simply means “do no harm.” In other words, nonmaleficence in nursing requires that nurses select interventions that can be beneficial without causing harm.
It’s not difficult to imagine that sometimes these principles of ethics can collide. For example, a nurse may find doing no harm is in conflict with a patient’s exercise of autonomy in refusing a lifesaving medication.
The ongoing realities of caring for patients during COVID-19 has also stretched nurses to their limits. However, according to an article in the American Journal of Nursing, an August 2020 survey of 4,000 people (1,000 of whom were nurses) revealed that “the crisis has resulted in some progress within the profession, accelerating changes in attitudes and expectations regarding nurses.”
Specifically, leadership opportunities, professional advancement and influence into decision-making seemed to be higher among those who spent more than half their time caring for COVID-19 patients than those who spent less than half their time doing so.
What are the codes of ethics for nurses?
In addition to the characterization of nursing ethics as described above, nurses must abide by a Code of Ethics.
From patient dignity and confidentiality to a safe environment and work setting, nurses are to abide by the nine provisions of the Nursing Code of Ethics, according to the ANA.
- Provision 1: The nurse practices with compassion and respect for the inherent dignity, worth and unique attributes of every person.
- Provision 2: The nurse’s primary commitment is to the patient, whether an individual, family, group, community or population.
- Provision 3: The nurse promotes, advocates for and protects the rights, health and safety of the patient.
- Provision 4: The nurse has authority, accountability and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to promote health and to provide optimal care.
- Provision 5: The nurse owes the same duties to self as to others, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence and continue personal and professional growth.
- Provision 6: The nurse, through individual and collective effort, establishes, maintains and improves the ethical environment of the work setting and conditions of employment that are conducive to safe, quality healthcare.
- Provision 7: The nurse, in all roles and settings, advances the profession through research and scholarly inquiry, professional standards development and the generation of both nursing and health policy.
- Provision 8: The nurse collaborates with other health professionals and the public to protect human rights, promote health diplomacy and reduce health disparities.
- Provision 9: The profession of nursing, collectively through its professional organizations, must articulate nursing values, maintain the integrity of the profession and integrate principles of social justice into nursing and health policy.
Learn more about nursing ethics and careers at UOPX
Interested in pursuing a career that allows you to positively influence the lives of others daily? University of Phoenix can help you prepare for advanced roles in nursing.
Brooks shares: “The College of Nursing provides real-life case studies and scenarios that place the nursing student in a situation where they have to make a critical decision using ethics as a guiding principle. We have students review state policies surrounding nursing practice and provide a critical thinking response on how the policy will impact their professional practice.”
Learn more about our online nursing degrees and earn your bachelor’s, master’s or doctoral degree. Nursing degree programs include:
- Registered Nurse to Bachelor of Science in Nursing: This program teaches and sharpens post-licensure nursing skills, covering health administration, business management for nursing professionals, safe care coordination and case management. It also covers critical thinking, communication, leadership, holistic nursing and much more. For this program specifically, students are only required to physically attend class one day a week.
- RN to Bachelor of Science in Nursing (Competency-Based): This program is designed for working professionals with their RN license and one year of professional experience. If you qualify, your experience can help you focus on learning new skills by demonstrating what you already know from experience and education. This program is ideal for self-disciplined individuals who work well independently.
- Master of Science in Nursing with a concentration in Nurse Education: This program prepares registered nurses to become leaders in nursing education and to function as nurse educators in various practice and educational settings. In this program, students gain the qualifications required to teach in schools, colleges and universities, and hospitals.
- Master of Science in Nursing with a concentration in Informatics: Learn how to analyze data to inform decision-making and patient outcomes. This program prepares you to function in nursing informatics leadership roles, specialize in the design and use of electronically stored data to influence quality in care delivery, and provide evidence of meeting quality, compliance, and regulatory standards and requirements.
- Master of Science in Nursing with a concentration in Nurse Administration: This program prepares students to pursue a role as a hospital, health system or healthcare leader. Develop your knowledge with key courses covering topics like nursing theory, research and applied statistics for quality improvement, and the healthcare leader’s role during organizational change.
- Master of Science in Nursing/Psychiatric Mental Health Nurse Practitioner: This program prepares individuals to become an advanced practice registered nurse (APRN) specializing in neuropsychiatric care and treatment. Learn skills such as neuropsychiatric disorder prevention, assessment, self-care management, psychotherapeutic intervention, pharmacological management and addiction services.
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Learn about the types of financial aid University of Phoenix has to offer, federal financial aid options, or grants and scholarships available to students. A degree in nursing offers professionals the opportunity to make a difference in the world of healthcare. Consider enhancing your career today!
ABOUT THE AUTHOR
A journalist-turned-marketer, Laurie Davies has been writing since her high school advanced composition teacher told her she broke too many rules. She has worked with University of Phoenix since 2017, and currently splits her time between blogging and serving as lead writer on the University’s Academic Annual Report. Previously, she has written marketing content for MADD, Kaiser Permanente, Massage Envy, UPS, and other national brands. She lives in the Phoenix area with her husband and son, who is the best story she’s ever written.
ABOUT THE REVIEWER
Dr. Raelene Brooks, dean of the College of Nursing, has been a registered nurse for more than 25 years and practiced extensively in the areas of ICU, trauma and critical care. Her publications include a focus on nursing education, critical care and diversity, equity and inclusion. She is a leader in creating, guiding and launching innovative curriculum.
