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Hjh Ajimah Hassan AMN; PPN

Code : Systematic collection of statutes, body of laws so arranged as to avoid inconsistency and overlapping ; set of rules on any subject

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The term ethics derives from the Greek ethos meaning custom or character. Ethics refers to the practices, beliefs and standards of behaviour. Nurses are accountable to their ethical conduct.
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Nursing Codes of Ethics

A code of ethics is a formal statement of a groups ideals and values. It is a set of ethical principles that is shared by members of the group, reflects moral judgments over time, and serves as a standard for their professional actions.
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To inform the public about the minimum standard To provide a sign of the professions commitment to the public it serves. To outline the major ethical considerations of the profession To provide general guidelines for professional behavior. To guide the profession in self-regulation. To remind nurses of the special responsibility they assume when caring for clients.
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Autonomy is an essential element to professional nursing. Autonomy means that a person is reasonably independent and self governing in decision making and practice. Nurses attain increased autonomy through higher levels of education.
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Contd autonomy
Through clinical competence and diverse practice settings, nurses are increasingly taking on independent roles in nurse-run clinics, collaborative practice, and advanced nurse practice settings. Autonomy refers to self-determination and the right to make ones own decision.
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Accountability means that the nurse is responsible, professional and legally for the type and quality of nursing care provided. The nurse is accountable for keeping abreast of technical knowledge needed to perform nursing care. The nursing profession itself regulates accountability through nursing audits and standard of practice.
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Caring is about people with people, for people, to people and as people. This makes caring unique. Benner and Wrubel (1989) proposed caring as the central goal of nursing as well as a basis for nursing ethics. An ethic of caring is based on relationships. Caring theories stress courage, generosity, commitment and responsibility. Caring is a force for protecting and enhancing client dignity. E.g nurse use touch and truth telling.
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An Ethic of Care
Rita Maning (1998) describe five elements of caring that constitute a care ethics.
1. 2. 3. 4. 5. Moral attention. Sympathetic understanding. Relationship awareness. Accomodation Response Caring helps our clients to understand their illness and how to cope with it.
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Milton Mayerroff (1972) identified eight major components necessary for caring. Knowledge Alternating rhythms Patience Honesty Trust Humility Hope Courage
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According to Mayerroff : Commitment is essential to caring. For nurses, commitment can be perceived as a duty to care and directed by an ethic of care

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The FIVE Cs of Caring

1. Compassion 2. Competence 3. Confidence 4. Consience 5. Commitment

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Nursing Measures That Protect Nurses and Clients

Know your job description Follows the policies and procedures (IPP) Always identify clients before implementing nursing activities. Report all incidents or accidents involving clients. Maintain your clinical competence. Know your own strength and weakness.
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Question any order if a clients condition has changed since it was written. Question and record verbal orders to avoid miscommunication. Question standing orders if you are inexperienced in the particular area.
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Types of Regulation
Health care is regulated in many ways and influenced to varying, degrees by several types of rule or law. These can be broadly divided as follows :a) Objectives rules Law as commonly identified (i.e civil law and criminal law) Nursing registration Code of Professional Conduct
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2) Subjectives Rules Social Standards Cultural Standards Moral Standards Personal Standards

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Code of Professional Conduct is classified under Objective rules, which are characterized by being imposed, enforced and obligatory and applied to areas of professional work where a clear statement of guidance and control is required for reasons of safety and public policy.
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Each Registered Nurse shall act, at all times to :Safeguard and promote the interests of individual patients and clients. Serve the interests of society. Justify public trust and confidence Uphold and enhance the good standing and reputation of the profession.

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Code of Ethics
1. 2. 3. 4. 5.

Examples :American Nurses Association : Code for Nurses Australian Nursing Council Inc. Code of Ethics California Nurses Association : Code for Registered Nurses International Council of Nurses : Code for Nurses Lembaga Jururawat Malaysia : Code of Professional Conduct For Nurses, 1998
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Code of Ethics
1. American Nurses Association : Code for Nurses The Code for Nurses is based on belief about the nature of individuals, nursing, health and society. Nursing encompasses the promotion and restoration of health the prevention of illness and the alleviation of suffering. The statements of the Code and their interpretation provide guidance for conduct and relationship in carrying out nursing responsibilities consistent with the ethical obligations of the profession and quality in nursing care
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Code of Ethics
2. Australian Nursing Council Inc : Code of Ethics The purpose of this Code of Ethics is to : identify the fundamental moral commitments of the profession, provide nurses with the basis for professional and self reflection and a guide to ethical practice ; and indicate to the community the values which nurses hold. Nurses support and enable individual, families and group to maintain, restore or improve their health status, or to be cared for and comforted when deterioration of health has become irreversible.
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Code of Ethics
3. California Nurses Association : Code For Registered Nurses CNA recognizes the importance of a code for registered nurses that will foster high standards of nursing practice and promote quality patient care. The CNA code for Registered Nurses reflects the principles inherent in the Florence Nightingale Pledge
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Code of Ethics
4. International Council of Nurses : Code for Nurses The fundamental responsibility of the nurse is fourfold : to promote health, to prevent illness, to restore health and to alleviate suffering. The need for nursing is universal. Inherent in nursing is respect for life, dignity and rights for man. It is unrestricted by considerations of nationality, race, creed, color, age, sex, politics or social status. Nurses render health services to the to the individual, the family and the community and coordinate their services with those of related groups.
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Nursing contributes to the health and welfare of society through the protection, promotion and restoration of health; the prevention of illness, and the alleviation of suffering in the care of individuals, families and communities.
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In carrying out the above responsibilities, the nursing profession strives to safeguard the interest of society by ensuring that is practitioners abide by a code of professional conduct. Every registered nurse has a moral obligation to adhere to the profession's code of conduct. It offers guideline for professional behavior and practice and can be used as a standard against which complaints of professional misconduct are considered. It complements the Nurses Act and Regulations, 1985 ( Part V Practice and Part IV on Disciplinary Proceedings).
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Ministry of Health 3rd Floor, Block E1, Parcel E Federal Government Administrative Centre, 62250 Putrajaya Tel:03 8883 1336 Fax:03 8883 1346 Email : kpjljm@moh.gov.com.my

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