What Are The Ethical Codes And Legal Regulations Which Inform Modern Nursing?


Nursing is a very rewarding profession in which you will be supported every day by your colleagues and respected by your patients. However, to deliver the best possible care, there are legal and ethical considerations that all nurses must keep in mind while they work. These are woven into nurse training, so they soon become second nature. They ensure a nurse can advocate for themselves, as well as their patients, should the need arise.

What are the legal regulations that a practicing nurse should be aware of?

Each state has its own set of laws when it comes to nursing, but these are all presented as part of the Nurse Practice Act. The act is used as a guide by states as they create or modify regulations in facilities under their jurisdiction. As part of a direct entry MSN program at Elmhurst University, students will learn more about this and every other aspect of nursing practice. The course has been designed for graduates from different fields who want to work in healthcare, and it can be completed in 20 months. The NPA is just one area of law that affects nurses, but as they move through school, the details of each will be explained to them. Here’s a look at some of the regulations which influence the work of nurses every day.

The Nurse Practice Act

Every law and guideline licensed nurses are asked to follow in their state is drawn from the Nurse Practice Act. It will include the specifications for training a nurse and the limitations of their role in that territory. As nurses are trained to have specific healthcare skills, they may only be able to practice in that area unless they take further certifications. For instance, if they have not been trained to take a blood sample, they will not be permitted to attempt that procedure. To remain compliant, nurses should tell a nurse manager or a physician in their clinic if they are involved in a process they are not certified for. Failing to do so would constitute a violation of the act. As a result, the nurse could lose their license and job. Furthermore, their employer might choose to file a lawsuit against them.

Maintaining patient confidentiality

One of the most important parts of nursing is maintaining the confidentiality of the people being cared for. As part of the Health Insurance Probability and Accountability Act (HIPAA) 1996, nurses are obliged to safeguard the electronic records of their patients and allow patients to have control over the health information which can identify them. Nurses have a close and trusting relationship with their patients, and part of this involves access to their health records. Whether this information is related to their digital data, insurance record, or another healthcare process, a nurse must protect the details. By neglecting to do so or by choosing to share the details with an unauthorized person in any way, the nurse could face legal action.

Advocating for their patients

It is not just part of the job. Nurses have a legal duty to advocate for the people in their care in a hospital, a clinic, an emergency ward, or any other situation. A nurse can act as a go-between, facilitating positive physician and patient interactions. Furthermore, they are legally obliged to monitor their patients and check that no complications, reactions, or abnormalities have occurred throughout their treatment. Should such a situation arise, they will contact a physician or a more senior nurse to deliver immediate assistance to the patient.

Correctly administering medication

Not all nurses are certified to administer medication, but those who are must carry out this procedure in an accurate and timely manner. Interpreting the charts to view patients’ data, updating their files and understanding the side effects of their medication is another legal responsibility. Should an allergic reaction go unnoticed, or if an incorrect dosage is given to the patient, they risk a serious health incident or even death. In either case, the patient would have the grounds to proceed with a medical malpractice suit against the individual nurse involved and the facility where they were being treated.

Giving a patient the right standard of care

When a nurse is given responsibility for a patient, they are expected to monitor the person regularly. Patients might need assistance with eating, moving, or personal hygiene, and in each case, the nurse has a legal duty to help. Should a nurse fail to give the care that is required or neglect to monitor a patient, they could be acting illegally. This law is in place to safeguard patients. They might, for instance, try to get out of bed to visit the restroom alone and fall as a result. This could leave them with further injuries. In the same way, a patient could come to harm if a medication they are taking causes them to become drowsy. Neither event should happen if the patients’ nurses are paying close attention to their health.

Ensuring a patient’s consent forms are complete

Every treatment a patient receives should be explained to them beforehand. This includes an explanation of lab results and medications. Nurses should let the patient know what is happening and tell the family if they have been authorized. Before surgery, the patient will be asked to sign a consent form, but the nurse will also have to go over the pros and cons of the related treatments, such as anesthesia. Once the patient or their family understand what will happen, they must sign a consent form confirming they are aware of what the procedure entails and the possible risks. Should a complication occur and the form has been left unsigned, the nurse in question could be open to legal consequences.

Nurses keep up with legal issues as part of lifelong learning

These are just a few of the most common legal issues that affect and inform the work of a nurse throughout their career. To avoid the pitfalls, they keep informed of their legal duties and any changes to existing regulations. Part of being a nurse is being familiar with and understanding the state and national laws, so they can be sure to uphold these regulations at all times.

How does a code of ethics benefit working nurses?

Ethics are slightly different from laws as they represent more of a personal code that guides nurses. They help medical professionals differentiate between right and wrong in complex situations and standardize their conduct when dealing with patients. Ethics might not be legally enforceable per se, but many ethics-related issues do have legal implications because they relate to care. The nursing code of ethics is named after the woman who is considered to have founded modern nursing, Florence Nightingale. The Nightingale Pledge is like the Hippocratic Oath, which physicians take, and is still a part of each nurse’s graduation ceremony.

A more formal code

In the 1950s, a more formal type of code was developed by the American Nurses Association. Since then, the four cornerstones, autonomy, beneficence, justice and nonmaleficence, have been modified and adapted to suit the changing world of medicine. In modern times, the most significant change was the addition of nine provisions designed to assist in a nurse’s decision-making process.

Autonomy – respecting the patient’s rights as an individual

Nurses are asked to recognize that every patient they interact with is an individual, which means they have a right to make decisions concerning their care. As advocates, it falls to nurses to ensure a patient has all the information they need about their medication, their treatment, and other options they might consider in the future. By knowing the benefits, as well as the potential risks, they can make a better, more informed decision about what they want to do.

Once the patient is happy, the healthcare team around them can formulate a plan that takes into account their wishes. With the plan in hand, a nurse will support a patient in having their wishes respected and remind the larger team of these when necessary. Occasionally, nurses may have to advocate for a patient in difficult circumstances, for instance, when the medical team is not in agreement with their wishes. Differences of opinion can occur because of a patient’s culture, faith, age, and gender. These and many more factors can influence a patient’s refusal or acceptance of treatment.

Beneficence – being kind and acting for the benefit of patients

A nurse should be guided by compassion and the well-being of their patients. This includes treating the people in their care with kindness and understanding.

Justice – delivering the same quality of care to all

Regardless of a patient’s race, gender, religion, or sexual orientation, a nurse will care for them to the best of their ability. The nurse’s decisions will remain fair and unbiased, even if a patient is in a difficult financial position. That’s why diabetes screening and flu clinics are often provided for free and are staffed by nurses.

Nonmaleficence – do no harm

Probably the most recognizable of the nursing codes, this principle advises nurses to choose a care path that will cause the least harm and achieve the best outcome. It prizes the safety of individual patients and the community in their experience of healthcare.

What provisions were added in 2015?

In 2015, the American Nurses Association created nine additional provisions, which are divided into sets of three, with each set addressing a different aspect of the profession.

Provisions one to three

This section helps to inform the way nurses care for their patients and highlights the fundamental commitments they make. Provision one states that a nurse should work with respect for the worth, dignity, and uniqueness of every patient they encounter. The second provision relates to the nurse’s commitment to each patient, whether they are an individual or a family, or they make up a community or even the population as a whole. Provision three advises nurses to prioritize the rights, safety, and health of their patients and to advocate for these.

Provisions four to six

This section deals with the issue of loyalty and guides nurses in terms of having boundaries in their work. Provision four reminds the nurse of their responsibility and authority for their nursing practice. The decisions they make should promote excellence in health and care. In provision five, the focus shifts to the duty a nurse has to themselves. This includes remaining competent, taking care of their health, and continuing their professional, as well as personal growth. Provision six relates to workplace safety and mentions the importance of a safe and ethical medical setting. It suggests nurses work individually and collectively, to achieve this goal.

Provisions seven to nine

These provisions look beyond a nurse’s interactions with individual patients and seek to provide guidance on the broader aspects of their work. Provision seven calls on nurses to grow their profession through research, academic inquiry, and professional development. In the same vein, provision eight advises nurses to collaborate with colleagues in the profession, as well as the public, to safeguard human rights. Specifically, they should strive to cut health disparities and nurture health diplomacy. Finally, provision nine relates to maintaining the profession’s integrity and values, as well as being mindful of social justice in their daily work.

How are legal responsibilities and the code of ethics adhered to on a daily basis?

Nurses work within their legal obligations and ethical commitments on every shift, even if they are not thinking about them. These codes and regulations are not just put into action when the situation is extreme. Rather, they are familiar, everyday measures. Knowing them and using them guides nurses through their working life and supports them with the more complex aspects of healthcare.

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