ANA Revised Code of Ethics

Nurses Activism

Published

ANA HOUSE OF DELEGATES PASSES REVISED CODE OF ETHICS

Profession's guiding document addresses 21st Century health care issues

http://www.nursingworld.org/pressrel/2001/pr0630a.htm

Washington, DC -- Members of the American Nurses Association (ANA) House of Delegates (HOD) today voted overwhelmingly to pass a revised Code of Ethics for Nurses that more accurately reflects the issues facing modern-day nurses in the nation's current health care environment as well as their unchanging mission to provide quality care.

"The Code of Ethics for Nurses has always been a key guiding document for the nursing profession as well as a strong support for individual nurses who are involved in principled actions in controversial situations," said ANA President Mary Foley, MS, RN. "But with the revisions that have been adopted, this new Code will serve the profession even more efficiently because it clearly explains the mission of nursing in society and how nurses partner with the public with regard to health promotion, patient recovery and illness prevention."

It is also expected that the 2001 Code, which acknowledges the reality of managed care and other health care policy initiatives, "will better serve nurses involved in legal challenges, as well as strengthen nurses' rights in collective bargaining and workplace advocacy situations," Foley added.

The ANA Code of Ethics for Nurses, which functions as the blueprint for nursing's professional goals and values, includes nine provisions and interpretive statements that have been revised periodically since 1950. The Code was last updated in 1985, and although this version embodies nursing's core values, it was determined that the document no longer provides timely guidance for practice.

A key aspect of the revision is new language that acknowledges the myriad challenges in the nurse's work environment in the 21st century. The new Code, while retaining the timeless values inherent in the nursing profession over the past 100 years - including the identification of important virtues, duties and responsibilities of the nurse - also emphasizes subtle changes in health care relationships, as well as the nurse's right to practice in an environment that is safe and which protects patients' rights and the rights of nurses as health care professionals.

For example, the first provision of the 1985 version of the Code declares the nurse's respect for the dignity, worth and uniqueness of each "client." In the revised Code, "client" is replaced by "patient" and "individual." Also, a section has been added stating that "the principal of respect for persons extends to all individuals with whom the nurse interacts," including "colleagues and others."

Among other changes in the Code is the addition of language in the second provision that addresses the primacy of the patient's interests, conflicts of interest for nurses and collaboration within the health care setting. And the third provision has been altered to establish a greater foundation of patient advocacy and health promotion among nurses, particularly with regard to patient privacy and confidentiality.

"This new language addresses such issues as the development of policies and review mechanisms designed to promote safety and reduce the likelihood of errors, " Foley noted, "with both environmental system factors and human factors that present increased risk to patients being considered."

Also included in the Code is language asserting that nurses should not participate in the direct act of assisted suicide. This language, while reinforcing that ANA supports pain relief at the end of life, even if it hastens the patient's death, further clarifies ANA's stance with regard to such issues as end-of-life cancer care and other situations which have resulted in a public outcry for better relief of suffering.

"This change, and other similar language changes, reflect the nurse's role as a patient advocate and our obligation to protect the health of the public as a whole," Foley said. The process of revising the new Code is a culmination of years of fine tuning and careful decision-making about the final language. Throughout this revision process, the Task Force attempted to seek the opinions and suggestions of a wide range of nurses, individuals and groups. Reviews were conducted through regional conference calls, presentations, extensive field reviews, and numerous individual and group discussions.

"We are excited about the new 2001 Code and expect that it will be enthusiastically adopted by the nursing community, the health care community and the public at large as the premier guiding document of the nursing profession," Foley asserted.

The newly revised Code of Ethics for Nurses with Interpretive Statements will be published later this summer. It can be purchased by calling 1-800-637-0323 and asking for publication CEN21HA1. The price is $11.95 for ANA members and $14.95 for nonmembers.

The bottom line really is that you cant stand the ANA & will find fault with everything we do there. So be it.

The Code of Ethics is a guideline for the nursing profession. The ANA isnt going around with a baseball bat threatening all nurses who dont follow it but it will be used as a guideline for nurse professionalism & who better to develop those guidelines than the national professional organization of nursing? Before you throw out your numbers & the famous 93% you keep telling us about, remember that even with those numbers, the ANA is STILL the largest organization for nurses in this country & speaks for the interests of professional nurses, and as such, has an obligation to have ethical guidelines in place for the practice of this profession.

Youre free to not follow the Code of Ethics if you dont want to.

Specializes in CV-ICU.

"Jenny P, Are you saying the employees of the ANA did not form a union in 1994? Are

you saying that they formed a union needlessly because the ANA was addressing

their concerns and not treating them the same way many nurses are being treated

today and in the past? Are you saying that the Mass. State Nursing Associtation has

been withholding funds since evedently before 1994?"

Wildtime, please don't try to put words in my mouth either. I didn't say any of that stuff you put in there and said I did.

ANA has been writing the Code Of Ethics for Nurses since it was first published. I'm glad they have done it. Some of us have tried to follow an ethical plan at work and also in our personal lives; and I have had long serious discussions with nurses through the years on different aspects of nursing and the life and death continuum which have affected my ideas on how I practice nursing.

At which point are we lengthening the process of living; and at what point are we lengthening the dying process? I don't have those answers for each patient I care for, but the Code of Ethics gives me a place to start when I have questions like that.

He might think that code is unimportant & something to laugh at but the ANA's Code of Ethics just came to the rescue of 6 nurse whistleblowers.

Score one for the good guys!.....

Court Ruling Protects Nurse Whistleblowers -

WASHINGTON, July 11 /U.S. Newswire/ --

The American Nurses Association (ANA) and its constituent member, the New Mexico Nurses Association (NMNA), applauded the Third Judicial District Court ruling of the Hon. Thomas Cornish July 10, which provides protection for six registered nurses who acted as whistleblowers against a physician who allegedly acted incompetently and unprofessionally, and whose actions, according to the plaintiffs, resulted in the

death of a patient.......

Although the parties await the written order, the judge ruled on July 6, 2001, that he would grant the plaintiffs' motion for rules governing the questioning of nurse witnesses. The ANA had filed an amicus brief in support of the nurses, in which the association detailed the importance of the Code of Ethics and patient advocacy in the context of nursing practice.......

ANA's argument was presented by the association's nursing practice counsel, Winifred Y. Carson.......

"The nurses in this case adhered to the profession's Code of Ethics," said ANA General Counsel Alice Bodley. "Under this Code, they are REQUIRED to stand up, speak out and protect their patients. The judge's ruling is a victory for the workplace advocacy efforts of the ANA." ........

The six nurses are members of NMNA and are, or had been, employees of Memorial Medical Center in Las Cruces, NM. Based on ethical grounds, they testified in support of the patients in a lawsuit brought forth by Thomas Smith and Irene Dockray against Lorraine Martinez, D.O. Martinez is accused of negligence and incompetence involving Smith's wife, Deborah, who died from sepsis, a massive infection, after Martinez allegedly failed to treat her.......

She is also accused of permanently harming Dockray during a medical procedure.......

The court ruled that the Memorial Medical Center could not require its employed nurses to speak only through or with hospital attorneys. Over the hospital's objections, the judge included a charge nurse within the scope of the court's protective ruling for the staff nurses........

This ruling not only provides protections for the nurses involved in the case, it also reveals the importance of nurses' ethical requirements and the need for state law and judicial proceedings to protect nurses who speak out on behalf of quality patient care.....

In addition, the court held the hospital accountable for any retaliation against the nurses, stating that retaliatory action will be considered contempt of court..........

"This case sends a message in New Mexico and throughout the country that nurses can and will stand up and make their concerns known about inadequate or deficient patient care," said NMNA President Judith Dunaway, RNC, MSN, HNC. "The nurses tried to work internally through the hospital system; but, that system didn't work.........

When nurses express concern over inadequate care, their concerns should not be ignored. Now the barriers have been removed that would hinder nurses in New Mexico from speaking out for their patients." .......

ANA President Mary Foley, MS, RN, was also happy about the ruling. "Nurses should never feel that their jobs or licenses are jeopardized because they speak out against poor medical practice or unsafe patient care," said Foley. "It's our responsibility as nurses to advocate on behalf of our patients."

http://www.ana.org

Specializes in CV-ICU.

I knew that Code of Ethics was good for something......

This was an interesting case because of the way the hospital was trying to bully the nurses into only being able to speak through the hospitals' lawyers, even though the hospital did not support the nurses viewpoint. I hadn't heard about how the case was progressing until I read this today. Thanks, Julie, for the update.

Jenny- it seems to me that you talked only to MARN nurses. Have you talked to any MNA nurses to get the other side of the Mass disaffiliation picture? I am one who went and voted to disaffiliate at 3 different meetings. Most of the crew that has formed the ANA affiliated MARN haven't done bedside nursing in years and have no clue as to what you and I have to contend with each day.They are educators, administrators and entrepeneurs. Their issues were not MY issues. I feel ANA has been very late in addressing the issues of MOT, staffing ratios etc. I hope that Maine, Mass and California have not shot themselves in the foot....many of us are trying very hard and sacrificing a great deal (Brockton Mass nurses out on strike for 50 days now) to make health care safer for you,me and the public.:confused:

Specializes in CV-ICU.

Hardknox, last year at the ANA convention, I sat directly behind the Mass. delegates and watched and attempted to talk to both sides of the delegation. It was interesting, to say the least. The various politicing that went on in the Mass. Nurses Assoc. was very obvious to all of us. I felt as though your then president, Karen Daly (whom I'd met the previous year) was being paraded around like a captive prisoner by her own delegation. I also watched as one of the more radical and vocal leaders voted twice- once at his own seat, and once at an empty seat- on several different votes and then denied it when confronted with that fact.

Yes, I did talk to bedside nurses from MARN this year. And also some educators and also Barbara Blakney (but I'm not sure what position she holds, although I do know that she is a nurse). I also talked with nurses from other states to see what their issues are across the country. I find that I get my information from nurses across the country at ANA conventions and am empowered by listening and talking with nurses who work in similar (or better or worse) facilities and environments as mine.

As nurses, we are all concerned about safe staffing, nurse-patient ratios, and the future of nursing. Since when did changing job titles mean that educators or administrators NOT care about nursing? Those that are active in ANA are just as concerned about these issues as bedside nurses are; if they no longer feel that these issues are important, they usually are not in this organization any more because this has been the focus of ANA over the past 4-5 years.

Just because a nurse is no longer at the bedside does not mean that they do not care about what is happening at the bedside. If only bedside nurses are allowed to be part of a nursing organization, what happens to the nurse who really is dedicated to the organization and has to leave the bedside because of an injury, or she decides to go to school, or whatever? Do we throw that nurse and her talents away? Should she be banned from the nursing organization because she wants to be a Nurse Practitioner or educator? Or because that nurse was injured (maybe a contaminated needlestick, like Karen Daly, who contracted both Hepatitis and HIV) and can't work at the bedside anymore? I hope not. These nurses have energy (maybe more than those at the bedside-- after all, the bedside nurse is the one who is so burnt out that she can't handle one more thing), and commitment, and talent that could be used by the organization for the betterment of nursing as a whole.

One thing more, Hardknox, what did you personally do about any of the issues you brought up- the MOT, staffing ratios, etc. over the past 4-5 years? You see, I think we are ALL guilty of helping cause these problems. Mandatory overtime hasn't been allowed in my contract for about 14 years, but as far as short staffing, I picked up shifts frequently in the past when the hospital was short because I wanted the extra $$$$! And I would allow myself to do things that were not in my job description (ie: empty trash, clean rooms, etc.) just so the unit would flow better so we could receive an extra patient. We did these things and contributed to some of these abuses ourselves because we wanted to help out. And now we have reached our breaking points. We are all angry because we are tired and disrespected and poorly paid and unappreciated. We have caused a lot of our own problems by being nice guys and trying to help out. All while the CEO's and other top administrators of hospitals and insurance companies have pocketed the $$$$. And young people were no longer interested in going into the job of being everybody else's slave.

I could go on, but it is my bedtime now, so I'll quit for tonight.

Jt , this is my first attempt at posting messages here. I do understand Wildtimes frustration, and have ranted and raved about how little our nursing organizations have done for us. I would have liked earlier in my career to have seen true representation by these organizations, however it seemed to me that anytime a nursing organization passed a position on a subject it seemed to make my job harder not easier. Rules of conduct, that was all taught to us in Nursing School under the heading "Nursing Trends" Elitism has definitely been promoted by

the "Degreed R.N.'s" of these particular Org's. I wouldn't have enough room here to cite all the examples I personally know of. Do any of you out there have examples other the "changes in language" That have helped make our jobs easier, and less complicated?? Has the ANA or any other Nursing Organization ever negotiated better salaries, and benefit packages?? If so I am definitely in the dark about that. If someone is representing you should they try to divide the masses,or unite the masses? Does the promotion of "elitism" 2yr, vs 3yr, vs 4yr etc.?? help or hurt? Being that this is my first post here, I think I've asked some questions that I believe need to be answered, to help me understand where

our Nursing Org.'s are coming from. Jayrborn

One thing more, Hardknox, what did you personally do about any of the issues you

brought up- the MOT, staffing ratios, etc. over the past 4-5 years? You see, I think we

are ALL guilty of helping cause these problems. Mandatory overtime hasn't been allowed

in my contract for about 14 years, but as far as short staffing, I picked up shifts

frequently in the past when the hospital was short because I wanted the extra $$$$! And

I would allow myself to do things that were not in my job description (ie: empty trash,

clean rooms, etc.) just so the unit would flow better so we could receive an extra patient.

We did these things and contributed to some of these abuses ourselves because we

wanted to help out. And now we have reached our breaking points. We are all angry

because we are tired and disrespected and poorly paid and unappreciated. We have

caused a lot of our own problems by being nice guys and trying to help out. All while the

CEO's and other top administrators of hospitals and insurance companies have pocketed

the $$$$. And young people were no longer interested in going into the job of being

everybody else's slave.

To answer the above qoute, Jenny P., for the last 22 years I have been on the Nurses Committee at my hospital for the MNA Bargaining unit. I have written to my legislators, both state and federal. I have written to local papers and the Boston papers, trying to educate the public as to what was going on in health care. I have filed grievances where violations have occurred, filed unsafe staffing reports and protested unsafe assignments.I have also walked the picket line at Brockton Hospital in support of the nurses there who are working on the very issues facing most of us. An yes, I have crawled home so tired after an horrific day at work that I fell asleep before supper. Yes, I have bitched and moaned! But I have tried to work on problems in my little corner of the world. I am a preceptor in my specialty and have never had a complaint about eating my young! I think you can put MOST nurses right along with me in their efforts. I agree that nurses, being people who "take care of everyone but themselves",have

let ourselves be taken advatage of by the CEO's, administrators and insurance companies. However--NURSES ARE NOT THE PROBLEM:( :( I disagree with you that ANA is the answer. They should have seen this coming LONG before so many nurses had left the field. Now that it is common knowledge, this small, elitist group of nurses are going to solve our problems?? I agree with wildtime...and I'll be interested to see what plays out here.

You are very articulate and knowledgable and I enjoy and have learned a lot from your posts, but don't think you are the only one doing something about nursing issues. Try walking the picket line at Brockton Hospital with a nurse who has been out of work for 50 days. There is your hero--not some fat cat at ANA!

Specializes in CV-ICU.

Hardknox, I HAVE walked a picket line at my own hospital, some 17 years ago when my bargaining unit was my state nursing assoc. (MNA also, but Minnesota). We didn't go on strike this time, but 1350 nurses here in the Twin Cities did walk. I did not walk the picket lines myself this time, due to a hip injury, but I did make picket signs and I did give finacial and emotional support as best I could while their strike was on. I never meant to imply that I'm the only one doing anything about the problems in nursing.

I happen to work in a unit with some strong and vocal personalities who are always telling me that "MNA should do this" or "ANA should be doing that" but when it comes to actually doing something about a problem, these same people are "too busy" or "too tired" to do it themselves or "not interested" in being involved in making these changes themselves. I get extremely frustrated when this happens and am in the habit of telling them to get off their duffs and get involved to make the changes they want, because I'm changing the things that are important to me in nursing. You see, I see MNA and ANA as being VOLUNTEER organizations, and if the volunteers are interested in changing things about their state and national organizations, they HAVE to do the changes themselves. Yes, we pay dues to run these organizations and have people which we have hired to run the offices, do the collective bargaining, lobby, direct programs and assist committees and do the paperwork, etc.; but they are organizations which are directed and focused on what the VOLUNTEER wants and needs. So sometimes the volunteers have been mostly managers and educators; if we, as bedside nurses, are not involved (or interested!) in running these organizations, who will be managing the directions that these organizations go? This is what the problem has been: the bedside nurse has been too tired or uninterested (or maybe, too outnumbered or intimidated) to be involved, and the "elitist" (as you called them) nurses have decided that what were their own personal priorities were the priorities of the association! Because WE did not speak up or get involved! That is what has changed- the bedside nurse is now involved and becoming more involved. The managers and educators who are still involved are hearing the bedside nurses these days and acting on what is being said.

I think that the whole past problems that people keep referring to (the BSN thing, for instance) were due to the fact that the bedside nurses were not vocal in what we felt at that time. The idea made sense, so "why should I argue with it? I'm just a bedside nurse what gives me the right to say anything when all of these "ANnies, FAANies and PhuDs" say this is needed?" But we were offended by it, and that is why it didn't go through on a national level (BTW, the BSN is the entry level of RN's in North Dakota, and they have more RNs per capita than any other state-- makes you wonder if we would have a shortage if it had gone through so many years ago, doesn't it?).

Jay Levan, ANA has never bargained for contracts, etc., but the state levels of the organization has in 28 (I think) states that are not right-to-work states. I didn't look to see where you are from, but if you are in a right-to-work state, ANA just passed some changes for workplace advocacy for use in those states.

And to Think-about-it, some of the problems that have occurred in nursing have also been caused by our being too compliant; should ANA focus its' anger at us? Yes, I am angry that greedy people make money off others' illnesses and I think it is wrong. Hospitals are where we work at this point of time, and we need a complete overhaul of the health care system to change some of these things; and I don't know how to do this unless we work through the political and social structures that are currently in place. I guess I'm more the type who works through the system for change than one who supports complete anarchy.

+ Add a Comment