CONTENTS

CENTRAL OBJECTIVE SPECIFIC OBJECTIVE INTRODUCTION CODE OF ETHICS DEFINITION CODE OF NURSES ETHICAL PRINCIPLES THE ICN CODE OF ETHICS FOR NURSES OBJECTIVES THE ICN CODE ELEMENTS OF THE CODE SUGESTION FOR USE OF THE ICN CODE OF ETHICS FOR NURSES APPLYING THE ELEMENTS OF THE ICN CODE OF ETHICS FOR NURSES DISSEMINATION OF THE ICN CODE OF ETHICS FOR NURSES GLOSSARY OF TERMS USED IN THE ICN CODE OF ETHICS FOR NURSES ANA CODE OF ETHICS

CODE FOR NURSES IN THE NIGHTINGALE PLEDGE USE OF CODE OF ETHICS NURSES CODE OF PROFESSIONAL CONDUCT NATIONAL STUDENT NURSES ASSOCIATION, INC.CODE OF PROFESSIONAL CONDUCT REMODELLING THE CODE OF PROFESSIONAL CONDUCT RESPONSIBILITY FOR PERSONAL STANDARDS ROLE OF NURSES IN SAFEGUARDING THE PATIENT S RIGHTS ETHICS AND NURSING RESEARCH CONCLUSION

CENTRAL OBJECTIVE On completion of the seminar, the group will acquire knowledge regarding code of ethics, develop attitude of professional conduct and skill in practicing code of ethics in nursing. SPECIFIC OBJECTIVE On completion of the class, the student will be able to: define ethics state code for nurses enlist the ethical principles. explain ICN code of ethics for Nurses. enumerate the objectives of ICN. enlist the elements of the code. point out suggestion for use of ICN code. discuss applying the elements of ICN code of ethics for Nurses. describe the elements of the code. 3

state dissemination of code of ethics for nurses. explain ANA code of ethics. state the importance of code of Nurse s in Nightingale pledge. enlist the uses of code of ethics. explain the nurses code of professional conduct. state the elements of professional conduct. enlist the National Student Nurses professional conduct. Association Inc. code of

explain the role of nurse in safeguarding human rights. state the relation between ethics and research.

INTRODUCTION From the time you were very young you began to learn what was right and what was wrong behaviour. You learnt this from your parents,

relatives, friends, teachers and other authority figures. Much of what you learned was shaped by religious beliefs and the philosophy of life practiced in your home. By the time you became an adult you had a personal life of ethics to guide your behavior in daily life. As you relate to other people in your home, work and society, you try to live up to this set of ethics. You may believe, for example, that honesty is important and necessary. A high standard of honesty will then guide you in what you do and say. You will try to be honest because you believe it is right to do so . Being dishonest would then be wrong for you. This is ethical behavior. Just as you have a personal set of ethics, we have a set of ethics that is used by nursing. It may be written or unwritten but each profession has a 4

set of ethics usually called a code. This code tells the members what kind of conduct is expected of them as they practice.

CODE OF ETHICS ETHICS: The Word Ethics is derived from the Greek word ethos which means custom or guiding beliefs. Ethics are characteristics of a profession and are called as code. CODE OF ETHICS: A code of ethics is a standard ethical principle that is accepted by all members of a profession. The code of ethics will state what kind of conduct is expected from the members of a profession and the society as a whole. When a person becomes a member of a profession, he adopts or accepts the responsibilities of living upto the code of ethics of that profession. In nursing, code of ethics provide professional standard for nursing activities 5

which protect the nurse and patient. Code refers to holistic care to the individual, family and community. Code of ethics is not a strict set of rules. It is a guide. DEFINITION Ethics is a system of moral principles, rules of conduct recognized in respect to a particular class of human actions or to a particular group of people. Ethics is a branch of philosophy dealing with values relating to human conduct with respect to the right and wrong aspect of certain actions and to the goodness and badness of the motives and ends of such actions. Bioethics is principles and rules of conduct applied to living things. Bio medical ethics is the system applied to the areas of human endeavour in which health care is given. Ethics refers to the moral component of nursing knowledge that influences difficult decisions that must be made in the context of increasing by complex health services. The ethical code of nursing emphasizes principles of obligation through concepts of service to people and the respect for human life. This pattern of knowing necessitates understanding various philosophical orientations about what is right, good or desirable. CODE FOR NURSES  Ethical concepts applied to Nursing as its guide for professional conduct. Codes serve as guidelines to assist nurses and other professional groups when conflict or disagreement arises about

correct practice or behaviour. It provides a common foundation for nurses training.  The American Nurses Association (ANA) and the International Council of Nursing (ICN) have established widely accepted codes that you as a nurse to follow.

Ethical Principles All ethical problems involve moral principles. Such principles are necessary to provide guidance for thought because universal solutions cannot be reached in most ethical that can be rotely applied to another problem. Each ethical problem must be examined in the context of the particular circumstances. There are four guiding principles that are important in bioethics: 1. Self-determination 2. Nonmaleficence 3. Beneficence 4. Justice

Self

determination, or autonomy, is a basic social value. An

autonomous act is an act of intention that is independent of coercion by others. Those giving care must acknowledge and respect the autonomy of each client. It may be argued that the only permissible reason to remove a person s social or personal autonomy is to prevent harm to others. Respect for the client s autonomy and the opportunity for professional autonomy in medical practice involve possession of the threshold element of competence, the disclosure of information, and consent without duress. The presence of these three elements imposes an order on conflicting claims and offers finality, which is often sufficiently strong to override the law and preventing custom.

As a result of the Karen Anne Quinlan case of 1976 and the Nancy Cruzan case of 1989, focus on the autonomous rights of the patient has sharpened. These two cases also focused on the rights of families or surrogates to make choices for an incompetent patient. This enabled the patients rights to be maintained even when the patients were silent. The Patient Self-Determination Act of 1990 obligated hospitals that accepted payment from federal reimbursement plans to offer education to all patients about advance directives and to provide a means for the individual to execute an advance directive. These events led to the recognition that the decision-making power once accorded only to physicians was now to be shared by the individual patient and any number of other chosen surrogate decision makers. 8

To be able to make personal health care decisions, patients need to understand all options available to them, the possible consequences of acting on certain options, and the costs and benefits of the possible consequences. Patients must be able to relate these understandings to a personal framework of values and priorities. It must be remembered that disagreeing with recommendation of the physician or APN is not, singularly, grounds for determining that the patient is incapable of making a decision. Nonmaleficence is the concern for doing no harm or evil. Generally, the reference is to physical harm, pain, disability, and death, but harm can be defined both broadly and narrowly. Actions that inflict harm may be necessary for ultimate client well-being, but such actions always require moral judgement. Doing something and doing nothing are both actions determined by personal decision. As an example, withdrawal of treatment is often deemed a nonmaleficence decision. If letting die seems justifiable, the withdrawal of nutrition and hydration is usually seen as justified. The literature does not support the concept that cessation of artificial feeding and hydration is associated with pain or suffering, although there may be increased stress for caregivers and family. The principle of nonmaleficence requires an interpretation of values and the consideration of risks and benefits as part of a thoughtful and careful action. Beneficence is the act of promoting or doing good. This principle is action-oriented and requires the provision of benefits and the balance of harms and benefits. Ethical problems arise when benefits are conflicting. The principle of beneficence often appears at odds with the principle of veracity or truthfulness. As a professional, should one ever lie? Many believe that, although truthful alternatives must always be sought, intrinsically a lie may be a right choice if it is necessary to avoid greater evil. Specific criteria 9

have been offered to assist the individual to determine whether a paternalistic lie is justified. y The lie produces positive benefits for the person lied to that outweigh any evil that might result. y y y It is possible to describe the greater good that would occur. The individual would have wanted to be lied to All participants would always be willing to allow the violation of truthfulness. Justice requires weighing issues and responding to the facts that are present. Philosophically, no consensus exists about what constitutes justice. The nurse in advanced practice is responsible for exhibiting just behavior and distributing comparable treatment to each client; therefore, justice is an active process. Retributive justice demands that if a client is harmed, reparation, or a means by which to right the wrong, be applied.

THE ICN CODE OF ETHICS FOR NURSES The first code of ethics called the International code of Nursing Ethics , was adopted by the Grand council of the International council of Nurses at Sao Paulo, Brazil in 1953. It was later revised in Frankfurt, Germany in 1965 and then became known as the ICN Code of Ethics. It has been revised and reaffirmed at various times since, most recently with this review and revision completed in 2005. OBJECTIVES y Nurses have four folds fundamental responsibilities:  To promote health 10

 To prevent illness  To restore health  To alleviate suffering y The need for nursing is universal. y Inherent in nursing is respect for human rights including:  Cultural rights  the right to life and choice  to dignity and to be treated with respect y Nursing care is respectful of and unrestricted by considerations of age, colour, creed, culture, disability or illness, gender, sexual orientation, nationality, politics, race or social status. y Nurses render health services to the individual, the family and the community and coordinate their services with those of related groups. THE ICN CODE The ICN code of ethics for Nurses has four principal elements that outline the standards of ethical conduct. ELEMENTS OF THE CODE 1. NURSES AND PEOPLE 2. NURSES AND PRACTICE 3. NURSES AND PROFESSION 11

4. NURSES AND CO-WORKERS

1. NURSES AND PEOPLE  The nurse s primary professional responsibility is to people requiring nursing care.  In providing care, the nurse promotes an environment in which the human rights, values, customs and spiritual beliefs of the individual, family and community are respected.  The nurse ensures that the individual receives sufficient information on which to base consent for care and related treatment.  The nurse holds in confidence personal information and uses judgement in sharing this information.  The nurse shares with society the responsibility for initiating and supporting action to meet the health and social needs of the public, in particular those of vulnerable populations.  The nurse also shares responsibility to sustain and protect the natural environment from depletion, pollution, degradation and destruction. 2. NURSES AND PRACTICE  The nurse carries personal responsibility and accountability for nursing practice, and for maintaining competence by continual learning. 12

 The nurse maintains a standard of personal health such that the ability to provide health is not compromised.  The nurse uses judgement regarding individual competence when accepting and delegating responsibility.  The nurse at all times maintains standards of personal conduct which reflect well on the profession and enhance public confidence.

3. NURSES AND PROFESSION  The nurse assumes the major role in determining and

implementing acceptable standards of clinical nursing practice, management, research and education.  The nurse is active in developing a core of research based professional knowledge.  The nurse, acting through the professional organization,

participates in creating and maintaining safe, equitable social and economic working conditions in nursing. 4. NURSES AND CO-WORKERS  The nurse sustains a cooperative relationship with co-workers in nursing and other fields.

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 The nurse takes appropriate action to safeguard individuals, families and communities when their health is endangered by a co-worker or any other person. SUGGESTIONS FOR USE OF THE ICN CODE OF ETHICS FOR NURSES  The ICN code of Ethics for Nurses is a guide for action based on social values and needs.  It will have meaning only as a living document if applied to the realities of nursing and health care in a changing society.  To achieve its purpose the code must be understood,

internationalized and used by nurses in all aspects of their work.  It must be available to students and nurses throughout their study and work lives. APPLYING THE ELEMENTS OF THE ICN CODE OF ETHICS FOR NURSES The four elements of the ICN Code of Ethics for Nurses: nurses and people, nurses and practice, nurses and the profession, and nurses and coworkers give a framework for the standards of conduct. The following chart will assist to translate the standards into action. Nurses and nursing students can therefore: Study the standards under each elements of the code.

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Reflect on what each standard means to you. Think about how you can apply ethics in your nursing domain: practice, education, research or management. Use a specific example from experience to identify ethical dilemmas and standards of conduct as outlined in the code. Identify how you would resolve the dilemmas. Work in groups to clarify ethical decision making and reach a consensus on standards of ethical conduct. Collaborate with your national nurses association, co-workers and others in the continuous application of ethical standards in nursing practice, education management and research. Discuss the code with co-workers and others.

Element of the Code # 1: NURSES AND PEOPLE

Practitioners and Managers Educators and Researchers National Nurses Associations Develop position

Provide care that respects In curriculum include human rights and is references to human

statements and guidelines that support human rights and ethical standards.

sensitive to the values, rights, equity, justice, customs and beliefs of all solidarity as the basis people. Providing education issues. in for access to care continuing Provide teaching

and Lobby for involvement of

ethical learning opportunities for nurses in ethics review ethical issues and committees.

decision making

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Provide information to

sufficient Provide teaching/learning Provide

guidelines,

permit opportunities related to position statements and continuing related consent. and Introduce into curriculum Incorporate issues of and to education informed

informed consent and the informed consent. right to choose or refuse treatment. Use recording

information management concepts of privacy and confidentiality systems that ensure confidentiality.

privacy into a national code of ethics for nurses.

confidentiality. Develop and

monitor Sensitive students to the Advocate for safe and of in social healthy environment. current

environmental safety in importance the work place. action concerns.

Element of the Code # 2: NURSES AND PRACTICE

Practitioners and Managers Establish standards Educators and Researchers of Provide teaching National Nurses Associations or Provide access to

care and a work setting learning opportunities that continuing that promotes safety and poster quality care and lifelong learning through for conferences, education etc.

education, journals distance

competence

practice.

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Establish professional

systems

for Conduct and disseminate Lobby

to

ensure education

appraisal, research that shows links continuing

continuing education and between systematic renewal

continual opportunities and quality

of learning and competence care standards. to practice.

licensure to practice

Monitor and promote the Promote the importance of Promote healthy lifestyles personal health of personal health and for nursing professionals.

nursing staff in relation to illustrate its relation to Lobby for healthy work their practice competence for other values. places nurses. and services

Element of the Code # 3: NURSES AND PRACTICE

Practitioners and Managers Sets standards Educators and Researchers National Nurses Associations

for Provide teaching/learning Collaborate with others to in for setting set standards for nursing nursing education research, research and management. practice, and

nursing practice, research opportunities education management. and standards practice, education management.

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Foster workplace support Conduct, of the conduct, and utilize

dissemination Develop research the to statements,

position guidelines

dissemination utilization of

and advance research profession.

nursing and standards related to nursing research.

related to nursing and health

Promote participation in Sensitive learners to the Lobby for fair social and national association so nurses importance of professional economic as to nursing associations. condition Develop in working nursing. position

create favourable socio economic conditions for nurses.

statements and guidelines in workplace issues.

Element of the Code # 4: NURSES AND CO-WORKERS

Practitioners and Managers Educators and Researchers National Nurses Associations Stimulate cooperation with other related disciplines.

Create awareness of specific Develop understanding and overlapping function and the potential for interdisciplinary tensions. Develop work place systems that support common Communicate nursing ethics to other of the roles of other workers.

Develop awareness of ethical issues of other

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professional ethical values and behaviour Develop mechanism to safeguard the individual, family or community when their care is endangered by health care personnel

professions

professions.

Instill in learners the need to safeguard the individual

Provide guidelines, position statements and discussion related to safeguarding people when their care is endangered by health care personnel.

DISSEMINATION OF THE ICN CODE OF ETHICS FOR NURSES To be effective, the ICN code of Ethics for Nurses must be familiar to nurses. ICN encourage to help with its dissemination to schools of Nursing, practicing nurses, the nursing press and other mass media. The code should also be disseminated to other health professions, the general public, consumer and policy making groups, human rights organization and employers of nurses.

GLOSSARY OF TERMS USED IN THE ICN CODE OF ETHICS FOR NURSES Co- Worker Other nurses and other health and non-health related workers and professionals. A professional relationship based on collegial and reciprocal actions and behaviour that aim to achieve certain goals. 19

Co-operative Relationship

Family

A social unit composed of members connected through blood, kinship, emotional or legal relationships. A nurse, as a health professional and a citizen, initiates and supports appropriate action to meet the health and social needs of the public. Mental, physical, social and spiritual well being of the nurse. Information obtained during professional contact that is private to an individual or family, and which, when disclosed, may violate the right to privacy, cause inconvenience, embarrassment, or harm to the individual or family. Other nurses, health, care workers or other professionals providing service to an individual, family or community and working toward desired goals.

Nurse shares with society

Personal health

Personal information

Related groups

ANA CODE OF ETHICS  The nurse, in all professional relationships practices with compassion and respect for the inherent dignity, worth and uniqueness of every individual, unrestricted by consideration of social or economic status, personal attributes, or the nature of health problems.

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 The nurse primary commitment is to the patient, whether an individual, family group or community.  The nurse promotes, advocates for and strives to protect whether an individual, family group or community.  The nurse promotes, advocates for and strives to protect the health safety and rights of the patient.  The nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation for tasks consistnat with the nurses obligation to provide optimum patient care.  The nurse owes the same duties to self as to others, including the responsibility to preserve integrity and safety to maintain competence and to continue personal and professional growth.

 The nurse participates in establishing, maintaining and improving health care environment and conditions of employment conductive to the provision of quality health care and consistent with the values of the profession through individual and collective action. 21

 The nurse collaborates with other health professional and the public in promoting community, national and international efforts to meet health needs.  The profession of nursing as represented by associates and their members is responsible for articulating nursing values for maintaining the integrity of the profession and its practice and for shaping social policy.

CODE FOR NURSES IN THE NIGHTINGALE PLEDGE Some of the standards given in the Code for Nurse are also in the Nightingale Pledge which is universally known. As a professional nurse,

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we have a responsibility to know, understand and practice the accepted ethics of the nursing profession. The Nightingale pledge I solemnly, pledge myself before God and this assembly to practice my profession faithfully . .

I will not take or knowingly administer any harmful drug. I will do all in my power to elevate the standards of my profession and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling. With loyalty I will Devote myself to the Welfare of those committed to my care. The pledges are personal promises which are more specific and much more limited in content than the code. The code holds the nurse responsible for behavior only when acting in a professional capacity. The pledge reflect the role of women in society and the achievement of the nursing profession as it becomes a more free, independent and self governing profession. It can be used as a checklist for own professional standards of behavior. You might want to ask the following questions.

Do I practice high moral standards? Am I practicing my profession faithfully? Is my work accurate and honest? 23

Do I continue to learn about new developments as I should? Is my professional conduct ethically correct? Am I keeping away from anything that harms my health? Am I taking or giving any harmful drugs? Do I keep confidences that are entrusted to me? Do I co-operate with other members of the health team? Do I really devote myself to the welfare of those in my care? Am I working only for the purpose of caring money? Am I really dedicated to meeting the health needs of others? One of the greatest adjustments for the nursing student is that of accepting responsibility for professional conduct.

Use of code of Ethics

y A code of ethics is used to guide professional behavior.

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y In nursing education, the code help, teachers to know what must be taught. y If can be used to parent a nurse from practicing if his/ her conduct is poor and clearly below the standards set by the code. y It can be used to protect a nurse who is falsely accused of doing something wrong. y It can also be used as a guide for direction when legal action must be taken in a law suit.

Nurse s Code of Professional Conduct.

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Nurses follow a professional code of conduct to insure safe and fair patient care. Nurses play a vital role in health care and medical organizations. Nurses provide direct care to patients in need at hospitals, community centers, physician offices, nursing homes and schools. The job of a nurse demands a caring nature but most of all a nurse must abide by a professional code of conduct. The nurse s code of conduct encourages practicing nurses to provide fair, safe and ethical treatment for all patients. 1. Commitment to Respect 2. Complete Patient Care 3. Right to privacy 4. Accountability and Responsibility 5. Practice Good Health 1. Commitment to Respect y The nurse s code of professional conduct stipulates that all nurses must treat patients with dignity, respect and comparison regardless of the nature of their health condition, economic states, gender, race or personal attributes. y The code strictly enforces that all patients are worth the dignity and rights of human beings and so should not be discriminated against for any reason while under a nurse s care.

2. Complete Patient Care y A nurse s role responsibility is to provide the best care for her patients. 26

y The

nurse s

code

of

professional

conduct

supports

this

responsibility and reinforces that a nurse s primary commitment is to the patient, his family and community. y Primarily, this means that a nurse should respect a patient s wishes when compiling medical care plans, even when it poses a personal conflict of interest. y Just as a customer is the first priority in a retail store, patients come first in a medical setting. 3. Right to Privacy y Not only do medical privacy laws protect a patient s rights to privacy but so does the nurse s professional code of conduct. y All nurses have a duty to maintain the confidentiality of each patient, his treatment and care plans to protect the fundamentals trust between a patient and his nurse. y According to the code, only date relevant to a patient s care should be disclosed to the medical team and the patient s family. 4. Accountability and Responsibility. y On a regular basis, someone s life is in the hands of a nurse. y A nurse s professional code of conduct stipulates that nurses bear the role responsibility for patient care includes maintaining professional licenses and participating in containing education courses that will enhance a nurse s practice.

5. Practice Good Health

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y Nurses act as role models to their parents. The nurse s code of professional conduct encourages nurses to model good health habits for the patients they care for on a daily basis. y Good health habits include:y Relaxation and recreation time y Exercise y Regular health care check ups y Nutritious meals y Adequate sleep y Strong hygienic habits and cleanliness are absolutely necessary to promote healthy lifestyle at a medical facility. NATIONAL STUDENT NURSES ASSOCIATION, INC. CODE OF PROFESSIONAL CONDUCT As a member of the National Student Nurses association, I pledge myself to y Maintain the highest standard of personal and professional conduct. y Actively promote and encourage the highest level of either within nursing, education, the profession of nursing, and the student nurses association. y Uphold all by laws and regulations relating to the student nurses association at the chapter, state and national levels reserving the right to criticize rules and laws constructively but respecting the rules and laws as long as they prevail. y Strive for excellence in all aspects of decision making and management of all levels of student nurses association. 28

y Use only legal and ethical principles in all association decisions and activities. y Ensure the proper use of all association funds. y Serve all members of the student nurses association impartially, provide no special privilege to any individual member, and accept no personal compensation from another member or non-member. y Maintain the confidentiality of privileged information entrusted or known to me by virtue of an elected or appointed position in the association. y Refuse to engage in, or condone, discrimination on the basis of race, gender, age, citizenship, religion, national origin severed orientation, or disability. y Refrain from any form of cheating or dishonesty, and take action to report dishonorable practices to proper authorities using established channels. y Always communicate internal and external association statements in a truthful and accurate manner by ensuring that there is integrity in the date and information used by the student nurse s association. y Cooperate in every reasonable and proper way with association volunteers and staff and work with them in the advocacy of student rights and responsibilities and advancement of the profession of nursing. y Use only opportunity to improve faculty understanding of the role of the student nurses association.

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y Promote and encourage entering nursing students to joint and become active in NSNA. y Promote and encourage graduating serious to continue their involvement by joining professional nurses associations upon licensure as Registered Nurses.

REMODELLING THE CODE OF PROFESSIONAL CONDUCT 1. Should be professionally qualified for the posts to which they are appointed and currently registered with the respective state nursing registration council. 2. Should maintain a current knowledge and should be responsible for updating their knowledge and skills in the area of practice through ongoing education to make and maintain themselves capable of providing best possible nursing care to the consumers such as patient, families community and society. 3. Should aim their practice at health conservation, health maintenance, health promotion, illness prevention, care in sickness, health restoration and rehabilitation in sickness. 4. Should be able to demonstrate in their practice of nursing are sufficient knowledge necessary skills and adequate level of competence in their performance. 5. Should be responsible for keeping the nursing care consumers informed about the process, purpose and outcome of nursing care intervention.

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6. Must ensure that their dealings and actions should enhance the trust and respect of the nursing care consumers. 7. Should not disclose the confidential personal information of nursing care consumers until and unless the information has a therapeutic purpose. 8. Should ensure that nursing intervention are always made in the best must be supported by accurately written protocols and document. 9. Should ensure that their practice must reflect the respect towards the personality, attitude, beliefs and custom of nursing are consumers. 10. Should ensure that nursing care is not influenced by the gender, personality, religion, economics, political and social status of the consumer. 11. Should consciously avoid negligence and unethical or wrongful acts in performing nursing care practice. Any such practice by nursing or other health care givers should be immediately brought to the notice of the authority concerned. 12. Should ensure cost effective and oriented nursing practice. 13. Should ensure that the nursing practice act is incorporated into the national health care policy and is centered on total health care needs of the nursing care consumers.

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RESPONSIBILITY FOR PROFESSIONAL STANDARDS If nurses are to be accountable for their care in a professional sense, they also have a duty to keep up to date in the knowledge base of their profession. It is not sufficient that a nurse pass her final examinations, qualify and then never consider it necessary to continue her education. Nurse must be responsible for the care they give, and it cannot be claimed that because nurses work according to doctors orders they are example, if a nurse thinks that a doctor s prescription contains the wrong does of the drug, there is a duty to question it, and if there is still doubt, to refuse to give the drug. Nurses, along with the doctor, might be charged with negligence if they failed to recognize the incorrectly prescribed dosage of a commonly known drug such as digoxin. In order to maintain professional standards, then, nurses must inform themselves of a advances in knowledge of nursing care. Not only must the profession ensure that its new recruits achieve a certain standard before they are allowed to practice, but it must make certain that its established members maintain those standards. Indeed, because nurse training involves a substantial amount of learning on the job, it is imperatives that qualified practitioners keep themselves up to date so that the learners are exposed to practice of the right standard.

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ROLE OF NURSE IN SAFEGUARDING THE PATIENT S RIGHTS The basic or fundamental rights of a patient are: 1. The right to obtain safe and competent care. The nurse as members of the health team have an important role in protecting the patient form unethical and incompetent practices. 2. The patient has the right to considerate and respectful care. 3. The patient has the right to be adequately informed about the disease that he is suffering from, the meaning of various investigations carried out, the mode of treatment and the prognosis. The patient has to feel that his care and the well being are in the hands of competent people, so that no harm will occur. 4. The patient has the right to privacy and confidentiality of information. Any information collected about the patient or from his relatives or from other sources should be kept secret and without permission of the patient, it should never be told to anyone even to his relatives. 5. The patient has the right to accept or to refuse the treatment. The medical team (doctors, nurses, technicians, paramedical staff stc.) requires written consent from the patient or his relatives to ensure that the patient has agreed legally to undergo operations and certain investigations, particularly those procedures that are carried out under general anesthesia. The patient only is consenting to that which he clearly understands what is being done, its benefits and possible risks. 6. The patient has right to refuse or participate in the performance of human experimentation affecting his care and treatment.

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7. The patient has the right to practice his own religion. The patient has the right to obtain helps of the ministries of his religion at the time of emergency. ETHICS AND NURSING RESEARCH One area of practice that has been of considerable concern to nurses from an ethical point of view is research that involves human beings as subjects. Both the American and Canadian Nurses Association have developed position papers regarding this matter. The CAN paper, Ethics of Nursing Research in its preamble states that: Respect for the value of human life, for the worth and dignity of human beings, and their rights to knowledge, privacy and self determination must underlie research practices in nursing as in other health disciplines. The legitimacy of involving human subjects in nursing as in other health disciplines. The legitimacy of involving human subjects in nursing research must be assessed within the context of these values. The right of the subjects to informed consent, confidentiality, positive risk value, and competence of the investigator must be assessed. The American Nurses Association has two position papers on research, one clearing with the rights of nurses in conducting research and other concerning the rights of patients participating in research studies. The latter states that: The relationship of trust between the patient and nurse has always been as essential element of the professional code of ethics. In research, the relationship of trust between subject and investigator requires that the investigator assume special obligations to safeguard the subjects in several 34

way. The subject needs to be assured that his rights will not be violated without his voluntary and informed consent. Secondly the investigator guarantees that no risk, discomfort, invasion of privacy, or threat to personal dignity beyond that initially stated in describing the subjects role in the study will be imposed without further permission being obtained. Finally, the subject is assured that if he does not wish to participate in the study, he will neither be subjected to harassment or will the quality of his care be influenced by this decision.

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CONCLUSION A code of Ethics states what kind of conduct is expected of the members of a profession. The nurse is personally responsible to give the best care possible, to continue learning and to judge skills in self or others. One of the greatest adjustments in nursing is accepting responsibility for your own professional behavior.

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