The Nursing Code of Ethics

The Nursing Code of Ethics serves as a guide for nurses to carry out nursing responsibilities with the profession’s ethical obligations, which is consistent with quality in nursing care. 

The formal code was created in the 1950s by the American Nurses Association (ANA). Due to its importance, it is revised by formal processes established by the ANA routinely. It serves as a foundation for nursing theory and practice in representing the values, morals, and obligations that shape and model nursing.

Ethics are the moral principles that command how a person will behave. Ethical principles are essential in nursing since nurses serve as caregivers. Many states include the ANA’s nursing code of ethics in their scope of practice statements. There may also be legal implications for not following the code of ethics.

Seven Ethical Principles

There are seven ethical principles that the Nursing Code of Ethics is based upon. 

  1. Beneficence: The act of doing what is good and right for the patient, such as attributes of kindness and compassion.
  2. Nonmaleficence: This means doing no harm, either intentional or unintentional. Nurses must care for patients that reflect standards to minimize risk to them. Nonmaleficence is selecting interventions and care that will cause the least damage to achieve a favorable outcome.
  3. Justice: There should be fairness in all nursing decisions and care. Nurses must be impartial and care for all patients equally, regardless of race, religion, or sexual orientation.
  4. Accountability: Accepting responsibility for one’s actions. Nurses are accountable for their behavior and actions.
  5. Autonomy: This is recognizing each patient’s right to self-determination and decision-making. The patient is seen as an individual with the right to their values, beliefs, and opinions. The nurse serves as a patient advocate and ensures that the patient receives all medical information, options, and education to make a constructive decision.
  6. Fidelity: The practice of being faithful to a person, belief, or cause. It involves being true to the nursing profession and being responsible for providing safe and competent care.
  7. Veracity: The principle of truth-telling. Nurses must be honest in their exchanges with patients and colleagues.

The ANA Code of Ethics

The ethical obligations of the nursing profession are illustrated as 9 provisions of the ANA Code of Ethics for Nurses. It guides nurses to carry out duties consistent with high-quality nursing care. Below is a list of each provision with a brief summary. 

  1. “The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person.”

    Nurses must respect human dignity. This means treating each patient as unique and allowing them to feel valued by others. It is important for nurses to develop relationships with patients. They may not always agree with a client’s choice or belief but should still respect their values. Respect for patients extends to the nature of their health, which may require supportive care, disease prevention, and/or the alleviation of suffering.

    Nurses need to recognize patient rights, such as the right to autonomy. Patients have a legal right to decide what treatments will be performed on them. Additionally, the nurse’s respect for others extends to colleagues as well. This code of ethics encourages nurses to commit to conflict resolution. They must treat peers and other employees with compassion.

  2. “The nurse’s primary commitment is to the patient, whether an individual, family, group, community, or population.”

    A nurse’s primary focus is on the patient and their interests. They should try to provide patients with opportunities to be involved in planning their care. Personal dislikes or discrimination against a group or culture are not grounds for withdrawal from patient care. At the same time, nursing ethics is recognizing and honoring professional boundaries. Nurses must maintain appropriate boundaries with patients.

    Nurses collaborate with other healthcare team members to achieve a shared goal in patient care. Effective patient care happens when there is an interdisciplinary collaboration of nurses in various roles who work together to teach skills and manage the healthcare environment.

  3. “The nurse promotes, advocates for, and protects the rights, health, and safety of the patient.”

    Nurses must protect a patient’s right to privacy and maintain confidentiality of patient information. They should never attempt to hide medical errors. Instead, they can collaborate with team members to promote patient health and safety. If they suspect a colleague is impaired, they should report this to their supervisor.

  4. “The nurse has authority, accountability, and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to provide optimal patient care.”

    Nurses can delegate care but are still accountable for the patient. They must oversee and monitor the care provided. Nurses need to show accountability for decisions or interventions made in nursing practice. They are responsible for knowing their scope of practice and accepting or rejecting assignments based on their competence.

  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.”

    Nurses ought to take time for themselves to prioritize self-care. By nurturing their well-being, they will maintain professional competence. Nurses should eat a well-balanced diet, exercise, and rest. They must use proper body mechanics to prevent injury when lifting or moving patients. They should seek help when facing burnout symptoms.

    Nurses should be honest and have strong moral principles. They must never agree to do anything that does not uphold integrity personally or professionally. With the constant change in healthcare, nurses commit to continue formal training and actively engage in professional development to ensure competence in nursing practice. Nurses are lifelong learners.

  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.”

    Nurses are responsible for creating and maintaining environments that support the growth of moral virtues. They create an environment for support and respect among patients and colleagues.

  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.”

    The ANA believes all nurses should contribute to advancing the nursing profession through knowledge development. Knowledge development is created through research and scholarly analysis. By using evidence-based practices, nurses can engage in scholarly activities. Nurses should advance their profession by contributing to leadership and activities in professional nursing organizations. They can participate at a local, state, or national level.

  8. “The nurse collaborates with other health professionals and the public to protect human rights, promote health diplomacy, and reduce health disparities.”

    Since health is a human right, nurses should focus on achieving health for the community. Some examples of participating in health diplomacy include maintaining culturally sensitive healthcare environments and promoting healthy lifestyles within their communities. They can also focus on social determinants of health such as hunger, poor sanitation, and homelessness.

  9. “The profession of nursing, collectively through its professional organization, must articulate nursing values, maintain the integrity of the profession, and integrate principles of social justice into nursing and health policy.”

    Professional nursing associations share mutual values with the nursing profession and the public. They are responsible for conveying the ethics and values of the profession and encouraging members to comply with them. These organizations are responsible for speaking on behalf of nurses collectively to share healthcare and promote social justice.

How the Nursing Code of Ethics Has Affected My Work as a Travel NP

Working as a nurse for over 15 years, my priority is always the patient, whether it’s ensuring they get their medications on time; changing their position every two hours to prevent pressure ulcers; or serving as their advocate. 

I am continuously practicing beneficence and implementing the Nursing Code of Ethics. Even when I delegate patient care to other healthcare personnel, I oversee the care and remain accountable for the patient.

There are ways to go above and beyond upholding these high standards of patient care as a nurse. In the workplace, I often offer to help train new nurses or be a preceptor. I am also involved in the American Nurses Association at the national and state levels. I ensure I stay competent in nursing by completing continuing education courses every few months and attending nursing conferences yearly.

Conclusions: The Guiding Ethics of Nursing

Ethics is a fundamental part of the foundation of nursing. Nursing encompasses the promotion of health, prevention of illness, and the alleviation of suffering. Nurses are expected to adhere to the morals of the profession and embrace them as a part of what it means to be a nurse. Having a code of ethics defines the profession’s primary goals, obligations, and values.

Sophia Khawly, MSN

Sophia Khawly, MSN


Sophia Khawly is a traveling nurse practitioner from Miami, Florida. She has been a nurse for 14 years and has worked in nine different states. She likes to travel in her spare time and has visited over 40 countries. Being a traveling nurse practitioner allows her to combine her love of learning, travel, and serving others. Learn more about Sophia at