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NURSING ETHICS
MR. KULTHE VIKRANT RATNAKAR
22/04/2020MR.VIKRANT KULTHE 1
INTRODUCTION :
 INTERNATIONAL CODE OF NURSING ETHICS  THE ICN CODE OF
ETHICS FOR NURSES  An international code of ethics for nurses
was first adopted by the International Council of Nurses (ICN) in
1953.
 Ethics is an integral part of the foundation of nursing. Nursing
has concern for the welfare of the sick, injured, and vulnerable
and for social justice. Individuals who become nurses are
expected to adhere to the ideals and moral norms of the
profession. A code of ethics makes explicit the primary goals,
values, and obligations of the profession.
22/04/2020MR.VIKRANT KULTHE 2
DEFINITION OF ETHICS:
“It is branch of knowledge that deals with moral
principles.”
OR
“Ethics or moral philosophy is a branch of philosophy that
involves systematizing, defending and recommending
concepts of right and wrong conduct.”
Moral principle that govern a persons behaviour or the
conducting of an activity.
22/04/2020MR.VIKRANT KULTHE 3
Definition :-
“A code of ethics is a set of ethical principles,
ideals and values shared by members of the group,
and serves as a standard for their professional
actions.”
22/04/2020MR.VIKRANT KULTHE 4
Purposes of Nursing Ethics :
To identify the ethical obligations
and duties for every individual
who enters the nursing profession.
To determine the ethical standard.
To express understanding of
nursing commitment to society.
22/04/2020MR.VIKRANT KULTHE 5
Nurses and
people
Nurses and
practice
Nurses and
profetion
Nurses and
co-worker
Nurses and
society Element
of code
of ethics
22/04/2020MR.VIKRANT KULTHE 6
CODE OF ETHICS FOR
NURSING
22/04/2020MR.VIKRANT KULTHE 7
1. Professional Responsibility and accountability
Appreciates sense of self-worth and nurtures it.
Maintains standards of personal conduct reflecting credit
upon the profession.
Carries out responsibilities within the framework of the
professional boundaries.
Is accountable for maintaining practice standards set by
Indian Nursing Council
Is accountable for own decisions and actions
Is compassionate
22/04/2020MR.VIKRANT KULTHE 8
2. Nursing Practice
 Provides care in accordance with set standards of practice
 Treats all individuals and families with human dignity in
providing physical, psychological, emotional, social and spiritual
aspects of care
 Respects individual and families in the context of traditional and
cultural practices and discouraging harmful practices
 Presents realistic picture truthfully in all situations for facilitating
autonomous decision-making by individuals and families
22/04/2020MR.VIKRANT KULTHE 9
3. Communication and Interpersonal
Relationships
 Establishes and maintains effective interpersonal
relationship with individuals, families and
communities
 Upholds the dignity of team members and maintains
effective interpersonal relationship with them
 Appreciates and nurtures professional role of team
members
 Cooperates with other health professionals to meet
the needs of the individuals, families and
communities
22/04/2020MR.VIKRANT KULTHE 10
4. Valuing Human Being
 Takes appropriate action to protect individuals from
harmful unethical practice
 Consider relevant facts while taking conscience
decisions in the best interest of individuals
 Encourage and support individuals in their right to
speak for themselves on issues affecting their health
and welfare
 Respects and supports choices made by individuals
22/04/2020MR.VIKRANT KULTHE 11
5. Management
 Ensures appropriate allocation and utilization of
available resources
 Participates in supervision and education of
students and other formal care providers Uses
judgment in relation to individual competence
while accepting and delegating responsibility
 Facilitates conducive work culture in order to
achieve institutional objectives
 Communicates effectively following appropriate
channels of communication
22/04/2020MR.VIKRANT KULTHE 12
6. Professional Advancement
 Ensures the protection of the human rights
while pursuing the advancement of knowledge
 Contributes to the development
 Participates in determining and implementing
quality care
 Takes responsibility for updating own
knowledge and competencies
22/04/2020MR.VIKRANT KULTHE 13
PRINCIPLES OF NURSING ETHICS:
22/04/2020MR.VIKRANT KULTHE 14
Autonomy & Accountability :
Autonomy means that individual
are able to act themselves to the level of
their capacity Accountability is the process
that mandates that individuals are
answerable for their actions and have an
obligation to act. Attributes of
accountability: answerability& responsibility
22/04/2020MR.VIKRANT KULTHE 15
Accountability Of Nursing Personnel :
 Provide safe & therapeutic environment  Deliver
competent & personalized care  Maintaining
adequate supplies of material in the ward 
Maintaining accurate and up to date records 
Maintaining good IPR  Protect client’s legal rights&
privacy  Work within ethical& legal boundaries 
Keep pace with changing health needs& developing
technology  Delivering
 care as per standards  Delegating responsibility
appropriately  Contribute to development of
profession
22/04/2020MR.VIKRANT KULTHE 16
Techniques For Being Assertive:
 Identify your personal rights, wants and
needs.  . Identify how you feel about a
particular Situation  Be direct  Own your
message  Avoid assumptions about others
thinking  Avoid statements that begins with
"why", "you".  Ask for feedback  Stop
apologizing all the time  Learn to take a
compliment  Act confident even if you don't
feel confident  Feel free to say no  Evaluate
your expectation
22/04/2020MR.VIKRANT KULTHE 17
Visibility Of Nurses
 A quality or fact of , degree of being
visible Degree of exposure to public
notice Nurses themselves are responsible
when they don't take a stand neither to
correct the distorted images not for the
visibility of the roles they have performed
in their health care.
22/04/2020MR.VIKRANT KULTHE 18
22/04/2020MR.VIKRANT KULTHE 19
Legal Considerations :
 1st nursing law : Nursing registration- 1903  Indian
nursing council act: enacted in 1947  Amended in
1957  LEGAL IMPLICATIONS:  Torts: Torts are when
others interfere in individuals' privacy  Assault:
Assault occurs when a person puts another person in
fear of a harmful or offensive contact  Battery: It is
an intentional touching of another's body without
the other's consent  Negligence: it is described as
lack of proper care and attention carelessness.
22/04/2020MR.VIKRANT KULTHE 20
Malpractice:
 Failure to meet the standards of acceptable care
which results in harm to another person.  Fraud:
It results from a deliberate deception intended to
produce unlawful gains.  False imprisonment: It
occurs when a client is not allowed to leave a
health care facility when there is no legal
justification to detain the client or when
restraining devices are used without an
appropriate clinical need.  Invasion of privacy: It
includes violating confidentiality intruding on
private client or family matters, and sharing
client information with unauthorized persons.
22/04/2020MR.VIKRANT KULTHE 21
Legal documents:
 Advance directive: Written document recognized by law
that provides directions concerning the provision of care
when a person is unable to make his or her own treatment
choices.
 Do not resuscitate orders: Written order by a physician
when a client has indicated a desire to be allowed to die if
the client stops breathing or the client's heart stops
beating.
 Informed consent: It is clients' approval [or that of the
clients' legal representative to have his or her body touched
by a specific individual.
22/04/2020MR.VIKRANT KULTHE 22
Nursing Liabilities And Preventive Measures
All nursing observations should be noted
carefully, describing accurately  Patients
complaints should be recorded as accurately and
specifically  Nurse must report through proper
channels  Authorities must be informed regarding
any kind of equipment, materials or supplies, which
for any reasons less than safe for use in the patient's
care  Insurance protection
22/04/2020MR.VIKRANT KULTHE 23
LEGAL RESPONSIBILITY :
Registration  Licensing is a mandatory procedure for practice of
nursing. Registration aims at protecting patients by providing
qualified nurses. The nurse is responsible to obtain registration in
the respective State Nursing Registration Council  Legal
Liability/Act Of Negligence  License of a nurse can be suspended
or cancelled for any act of negligence or mal practice, following a
specified procedure.  Medico — Legal case (M.L.C.)  A medico)
legal case is a patient who is admitted to the hospital with some
unnatural pathology and has to be taken care of in concurrence
with the police and/or court. Types of clients which are
categorized as MLC in a hospital are.  Road traffic accidents. 
Injuries inflicted during brawls/fights, shooting, bomb blasts etc. 
Suicide.  Burns.  Poisoning.  Rape victim.  Assault.
22/04/2020MR.VIKRANT KULTHE 24
NURSES ROLE IN A MEDICO-LEGAL CASE:
 Obtain complete history from patient or significant others 
 Inform the police officer/constable on duty in the hospital and the
CMO.
 When it is made a MLC, then record it on the patient's case sheet with
red ink at right hand top corner.
 Do not give any statement about patient's condition to police,
magistrate or media. Only a doctor has to give information.
 When a patient has to be discharged, inform the CMO only. After
clearance from them, he/she can be discharged.
 If a MLC patient absconds, inform the CM0 and the treating doctor
immediately
 No patient can leave against medical advice.
22/04/2020MR.VIKRANT KULTHE 25
Correct identity
 A nurse/midwife is responsible to make sure that all
babies born in hospital are correctly labeled at birth
and handed over to right parent. 
Unknown/unconscious patients must be labeled as
soon as their identity is known.  Patients who have to
undergo surgery should be appropriately identified
and labeled.  Site of operation to be correctly
marked particularly where symmetrical sides or
organs are there:  Operation theatre (O.T.): scrub
nurse has to see all the instruments/ swabs are
returned. She has to say OKAY' before closure by the
surgeon
22/04/2020MR.VIKRANT KULTHE 26
Left Against Medical Advice (L.A.M.A.):
 Inform medical officer in charge. Signatures of both
patients and witness to be taken as per institutional
policy.  Patient's Property  Inform patient on admission
that hospital does not take responsibility of his
belongings.
 All related documents should be kept confidential and
safe.
 Poison case
 Do not give either verbal or written opinion.
 Do not allow to take photos unless special permission is
granted by appropriate authority.
22/04/2020MR.VIKRANT KULTHE 27
Nurses role to prevent complications :
 Review nursing practice periodically. Update knowledge and improve
skill by attending short term courses, in- service education and
continuing education programmes.
 Should have complete knowledge of all rules and regulations of
hospital and know their descriptions {duties and responsibilities). 
 Follow nursing practice standards/protocols. 
 Be a keen observer. 
 Written instructions must have rules and code of practice laid down to
ensure the safety and well-being of patients and nurses.
 All hospitals must have rules, a code of practice laid down to ensure
the safety and well-being of patients and nurses.
 Maintain records and reports of the unit properly.
22/04/2020MR.VIKRANT KULTHE 28
Nurses role to prevent complications :
 Review nursing practice periodically. Update knowledge and improve skill by
attending short term courses, in- service education and continuing education
programmes.
 Should have complete knowledge of all rules and regulations of hospital and
know their descriptions {duties and responsibilities). 
 Follow nursing practice standards/protocols. 
 Be a keen observer. 
 Written instructions must have rules and code of practice laid down to ensure
the safety and well-being of patients and nurses.
 All hospitals must have rules, a code of practice laid down to ensure the
safety and well-being of patients and nurses.
 Maintain records and reports of the unit properly.
22/04/2020MR.VIKRANT KULTHE 29
22/04/2020MR.VIKRANT KULTHE 30
22/04/2020MR.VIKRANT KULTHE 31

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Ethics of nursing 2020

  • 1. NURSING ETHICS MR. KULTHE VIKRANT RATNAKAR 22/04/2020MR.VIKRANT KULTHE 1
  • 2. INTRODUCTION :  INTERNATIONAL CODE OF NURSING ETHICS  THE ICN CODE OF ETHICS FOR NURSES  An international code of ethics for nurses was first adopted by the International Council of Nurses (ICN) in 1953.  Ethics is an integral part of the foundation of nursing. Nursing has concern for the welfare of the sick, injured, and vulnerable and for social justice. Individuals who become nurses are expected to adhere to the ideals and moral norms of the profession. A code of ethics makes explicit the primary goals, values, and obligations of the profession. 22/04/2020MR.VIKRANT KULTHE 2
  • 3. DEFINITION OF ETHICS: “It is branch of knowledge that deals with moral principles.” OR “Ethics or moral philosophy is a branch of philosophy that involves systematizing, defending and recommending concepts of right and wrong conduct.” Moral principle that govern a persons behaviour or the conducting of an activity. 22/04/2020MR.VIKRANT KULTHE 3
  • 4. Definition :- “A code of ethics is a set of ethical principles, ideals and values shared by members of the group, and serves as a standard for their professional actions.” 22/04/2020MR.VIKRANT KULTHE 4
  • 5. Purposes of Nursing Ethics : To identify the ethical obligations and duties for every individual who enters the nursing profession. To determine the ethical standard. To express understanding of nursing commitment to society. 22/04/2020MR.VIKRANT KULTHE 5
  • 6. Nurses and people Nurses and practice Nurses and profetion Nurses and co-worker Nurses and society Element of code of ethics 22/04/2020MR.VIKRANT KULTHE 6
  • 7. CODE OF ETHICS FOR NURSING 22/04/2020MR.VIKRANT KULTHE 7
  • 8. 1. Professional Responsibility and accountability Appreciates sense of self-worth and nurtures it. Maintains standards of personal conduct reflecting credit upon the profession. Carries out responsibilities within the framework of the professional boundaries. Is accountable for maintaining practice standards set by Indian Nursing Council Is accountable for own decisions and actions Is compassionate 22/04/2020MR.VIKRANT KULTHE 8
  • 9. 2. Nursing Practice  Provides care in accordance with set standards of practice  Treats all individuals and families with human dignity in providing physical, psychological, emotional, social and spiritual aspects of care  Respects individual and families in the context of traditional and cultural practices and discouraging harmful practices  Presents realistic picture truthfully in all situations for facilitating autonomous decision-making by individuals and families 22/04/2020MR.VIKRANT KULTHE 9
  • 10. 3. Communication and Interpersonal Relationships  Establishes and maintains effective interpersonal relationship with individuals, families and communities  Upholds the dignity of team members and maintains effective interpersonal relationship with them  Appreciates and nurtures professional role of team members  Cooperates with other health professionals to meet the needs of the individuals, families and communities 22/04/2020MR.VIKRANT KULTHE 10
  • 11. 4. Valuing Human Being  Takes appropriate action to protect individuals from harmful unethical practice  Consider relevant facts while taking conscience decisions in the best interest of individuals  Encourage and support individuals in their right to speak for themselves on issues affecting their health and welfare  Respects and supports choices made by individuals 22/04/2020MR.VIKRANT KULTHE 11
  • 12. 5. Management  Ensures appropriate allocation and utilization of available resources  Participates in supervision and education of students and other formal care providers Uses judgment in relation to individual competence while accepting and delegating responsibility  Facilitates conducive work culture in order to achieve institutional objectives  Communicates effectively following appropriate channels of communication 22/04/2020MR.VIKRANT KULTHE 12
  • 13. 6. Professional Advancement  Ensures the protection of the human rights while pursuing the advancement of knowledge  Contributes to the development  Participates in determining and implementing quality care  Takes responsibility for updating own knowledge and competencies 22/04/2020MR.VIKRANT KULTHE 13
  • 14. PRINCIPLES OF NURSING ETHICS: 22/04/2020MR.VIKRANT KULTHE 14
  • 15. Autonomy & Accountability : Autonomy means that individual are able to act themselves to the level of their capacity Accountability is the process that mandates that individuals are answerable for their actions and have an obligation to act. Attributes of accountability: answerability& responsibility 22/04/2020MR.VIKRANT KULTHE 15
  • 16. Accountability Of Nursing Personnel :  Provide safe & therapeutic environment  Deliver competent & personalized care  Maintaining adequate supplies of material in the ward  Maintaining accurate and up to date records  Maintaining good IPR  Protect client’s legal rights& privacy  Work within ethical& legal boundaries  Keep pace with changing health needs& developing technology  Delivering  care as per standards  Delegating responsibility appropriately  Contribute to development of profession 22/04/2020MR.VIKRANT KULTHE 16
  • 17. Techniques For Being Assertive:  Identify your personal rights, wants and needs.  . Identify how you feel about a particular Situation  Be direct  Own your message  Avoid assumptions about others thinking  Avoid statements that begins with "why", "you".  Ask for feedback  Stop apologizing all the time  Learn to take a compliment  Act confident even if you don't feel confident  Feel free to say no  Evaluate your expectation 22/04/2020MR.VIKRANT KULTHE 17
  • 18. Visibility Of Nurses  A quality or fact of , degree of being visible Degree of exposure to public notice Nurses themselves are responsible when they don't take a stand neither to correct the distorted images not for the visibility of the roles they have performed in their health care. 22/04/2020MR.VIKRANT KULTHE 18
  • 20. Legal Considerations :  1st nursing law : Nursing registration- 1903  Indian nursing council act: enacted in 1947  Amended in 1957  LEGAL IMPLICATIONS:  Torts: Torts are when others interfere in individuals' privacy  Assault: Assault occurs when a person puts another person in fear of a harmful or offensive contact  Battery: It is an intentional touching of another's body without the other's consent  Negligence: it is described as lack of proper care and attention carelessness. 22/04/2020MR.VIKRANT KULTHE 20
  • 21. Malpractice:  Failure to meet the standards of acceptable care which results in harm to another person.  Fraud: It results from a deliberate deception intended to produce unlawful gains.  False imprisonment: It occurs when a client is not allowed to leave a health care facility when there is no legal justification to detain the client or when restraining devices are used without an appropriate clinical need.  Invasion of privacy: It includes violating confidentiality intruding on private client or family matters, and sharing client information with unauthorized persons. 22/04/2020MR.VIKRANT KULTHE 21
  • 22. Legal documents:  Advance directive: Written document recognized by law that provides directions concerning the provision of care when a person is unable to make his or her own treatment choices.  Do not resuscitate orders: Written order by a physician when a client has indicated a desire to be allowed to die if the client stops breathing or the client's heart stops beating.  Informed consent: It is clients' approval [or that of the clients' legal representative to have his or her body touched by a specific individual. 22/04/2020MR.VIKRANT KULTHE 22
  • 23. Nursing Liabilities And Preventive Measures All nursing observations should be noted carefully, describing accurately  Patients complaints should be recorded as accurately and specifically  Nurse must report through proper channels  Authorities must be informed regarding any kind of equipment, materials or supplies, which for any reasons less than safe for use in the patient's care  Insurance protection 22/04/2020MR.VIKRANT KULTHE 23
  • 24. LEGAL RESPONSIBILITY : Registration  Licensing is a mandatory procedure for practice of nursing. Registration aims at protecting patients by providing qualified nurses. The nurse is responsible to obtain registration in the respective State Nursing Registration Council  Legal Liability/Act Of Negligence  License of a nurse can be suspended or cancelled for any act of negligence or mal practice, following a specified procedure.  Medico — Legal case (M.L.C.)  A medico) legal case is a patient who is admitted to the hospital with some unnatural pathology and has to be taken care of in concurrence with the police and/or court. Types of clients which are categorized as MLC in a hospital are.  Road traffic accidents.  Injuries inflicted during brawls/fights, shooting, bomb blasts etc.  Suicide.  Burns.  Poisoning.  Rape victim.  Assault. 22/04/2020MR.VIKRANT KULTHE 24
  • 25. NURSES ROLE IN A MEDICO-LEGAL CASE:  Obtain complete history from patient or significant others   Inform the police officer/constable on duty in the hospital and the CMO.  When it is made a MLC, then record it on the patient's case sheet with red ink at right hand top corner.  Do not give any statement about patient's condition to police, magistrate or media. Only a doctor has to give information.  When a patient has to be discharged, inform the CMO only. After clearance from them, he/she can be discharged.  If a MLC patient absconds, inform the CM0 and the treating doctor immediately  No patient can leave against medical advice. 22/04/2020MR.VIKRANT KULTHE 25
  • 26. Correct identity  A nurse/midwife is responsible to make sure that all babies born in hospital are correctly labeled at birth and handed over to right parent.  Unknown/unconscious patients must be labeled as soon as their identity is known.  Patients who have to undergo surgery should be appropriately identified and labeled.  Site of operation to be correctly marked particularly where symmetrical sides or organs are there:  Operation theatre (O.T.): scrub nurse has to see all the instruments/ swabs are returned. She has to say OKAY' before closure by the surgeon 22/04/2020MR.VIKRANT KULTHE 26
  • 27. Left Against Medical Advice (L.A.M.A.):  Inform medical officer in charge. Signatures of both patients and witness to be taken as per institutional policy.  Patient's Property  Inform patient on admission that hospital does not take responsibility of his belongings.  All related documents should be kept confidential and safe.  Poison case  Do not give either verbal or written opinion.  Do not allow to take photos unless special permission is granted by appropriate authority. 22/04/2020MR.VIKRANT KULTHE 27
  • 28. Nurses role to prevent complications :  Review nursing practice periodically. Update knowledge and improve skill by attending short term courses, in- service education and continuing education programmes.  Should have complete knowledge of all rules and regulations of hospital and know their descriptions {duties and responsibilities).   Follow nursing practice standards/protocols.   Be a keen observer.   Written instructions must have rules and code of practice laid down to ensure the safety and well-being of patients and nurses.  All hospitals must have rules, a code of practice laid down to ensure the safety and well-being of patients and nurses.  Maintain records and reports of the unit properly. 22/04/2020MR.VIKRANT KULTHE 28
  • 29. Nurses role to prevent complications :  Review nursing practice periodically. Update knowledge and improve skill by attending short term courses, in- service education and continuing education programmes.  Should have complete knowledge of all rules and regulations of hospital and know their descriptions {duties and responsibilities).   Follow nursing practice standards/protocols.   Be a keen observer.   Written instructions must have rules and code of practice laid down to ensure the safety and well-being of patients and nurses.  All hospitals must have rules, a code of practice laid down to ensure the safety and well-being of patients and nurses.  Maintain records and reports of the unit properly. 22/04/2020MR.VIKRANT KULTHE 29