Nursing Code of Ethics: What You Need to Know

Nursing Code of Ethics: What You Need to Know

Nurses adhere to a code of ethics, a social contract that outlines the moral obligations of patient care, developed by the American Nurses Association (ANA). Four main ethical principles make up the nursing code of ethics: autonomy, beneficence, justice, and non-maleficence. In this post, we’ll learn more about the ANA, the Code of Ethics for Nurses with Interpretive Statements, and real-life scenarios for considering ethical and moral standards.


Nursing Code of Ethics
Jennifer Brady


July 25, 2023

What Is the ANA?

The ANA is a national organization representing the interests of nearly 4 million nurses in the United States. Its mission is to improve healthcare quality by advocating for safe nursing practices, amplifying the voices of nurses as decision-makers, and providing guidance for ethical, moral, and honest nursing care for patients.

What Is the Nursing Code of Ethics?

You may have recited the Florence Nightingale Pledge during your nursing pinning ceremony or graduation. This pledge confirms that nurses will practice with veracity and fidelity and will consistently seek to do no harm to themselves or their patients. It may, then, come as no surprise that for 20 consecutive years, nurses have held the top spot on an annual public poll for the most trusted profession, with the highest perceived levels of professional ethics and honesty.  

Before God and those assembled here, I solemnly pledge;
To adhere to the code of ethics of the nursing profession;
To co-operate faithfully with the other members of the nursing team and to carry out faithfully and to the best of my ability the instructions of the physician or the nurse who may be assigned to supervise my work;
I will not do anything evil or malicious and I will not knowingly give any harmful drug or assist in malpractice.
I will not reveal any confidential information that may come to my knowledge in the course of my work.
And I pledge myself to do all in my power to raise the standards and prestige of the practical nursing;
May my life be devoted to service and to the high ideals of the nursing profession.

Nurses are governed by a body of ethical conduct perpetuated through the work of the ANA, which is called the Code of Ethics for Nurses. It comprises the ethical principles nurses have sworn to uphold as licensed healthcare professionals and helps to inform every aspect of a nurse’s life. The Code of Ethics for Nurses was formally adopted in 1950 and is revised about once a decade with input from current nurses to consider advancements in technology, changes in law, and updates to professional licensure and credentialing.

The Code of Ethics for Nurses is governed by four main principles: autonomy, beneficence, justice, and nonmaleficence.


Autonomy is when a person makes decisions based upon their own beliefs, feelings, and ideas without the undue influence of the desires of others. Allowing patients to operate autonomously or in accordance with their morality and values is a way for nurses to exhibit the traits of veracity in nursing. 

Nurses have a professional and moral obligation to respect their patients’ autonomy. This is done by providing each patient with the factual information required for informed decision-making without feeling pressure to conform to the wishes of family, friends, and even other healthcare professionals.


Beneficence is the act of being kind and taking mercy upon others. As a nurse, you are granted the gift and charged with the tremendous responsibility of providing care to the most vulnerable among us. Performing duties with kindness, mercy, and charity are ways to uphold the ethical principle of beneficence in nursing.


Justice in nursing is when we provide optimal care to all, regardless of socioeconomic status, race, religion, ethnicity, sexual orientation, or other attributes. This leads to fidelity in nursing – faithfulness to those seeking care by demonstrating equality and fairness to all.


You may have heard the phrase, “first, do no harm.” This refers to the ethical principle of nonmaleficence, where nurses are sanctioned to prioritize patient safety above all else. When delivering medications, treatments, and other patient care, it’s imperative to ensure that the patient benefits from care delivery and has the highest likelihood of a positive outcome. 

How You Can Use the Nursing Code of Ethics

In theory, the Code of Ethics for Nurses sets the standards for nursing conduct and ethical practice. But how are these principles applied in the real world?

Following are real-life examples from my nursing career that help demonstrate the application of the nursing code of ethics and how you, too, might use them as future nurses.

Hospice and end of life care

As a hospice nurse, I provided care to individuals diagnosed with a terminal illness and given less than six months to live. These patients had exhausted all their treatment options and decided to focus on the quality of their life rather than the quantity of time they had left. 

Sometimes there was a disagreement between family members and the patient on the decision to enter hospice care. As a nurse, it was my ethical duty to honor the patient’s wishes, regardless of challenging family dynamics and disagreements, and to respect their autonomy to make decisions regarding their healthcare. 

Veracity in nursing means truth-telling.

When a patient has a poor prognosis, and no treatment options are available, a nurse upholds their side of the social contract by not offering the patient or family false hope. 

Intellectual and developmental disability nursing

I spent more than five years as an RN Case Manager for individuals with intellectual and developmental disabilities. The idea of justice, fairness, and equality in healthcare was an overarching theme throughout my experience in this healthcare field.  

Individuals with disabilities have faced much discrimination and neglect throughout modern history.

Nurses have a moral, ethical, and legal obligation to provide care, advocacy, and justice for all.

School nursing

My very first job after nursing school was as a school nurse. I was inexperienced, and every day was an adventure, to say the least. I was not a seasoned nurse; but kindness, compassion, and care do not require an advanced skill set. Unlike the things you’ve learned in school, these are human qualities that are developed through life lessons and experiences. 

When you graduate from nursing school and embark on your career journey, draw upon the ethical principles of beneficence and nonmaleficence.

Seek to show mercy, perform works of charity for your patients, and always prioritize patient safety, so you do no harm.

Code of Ethics for Nurses and Why It’s Important 

The Code of Ethics for Nurses is not something that you have to memorize, but you should be aware of it, understand what it means for you as a nurse, and know how to apply the principles in your care delivery. The ANA has the Code for Ethics for Nurses with Interpretive Statements available on its website, and you can also purchase a copy of it.  

Be mindful of the ethical principles that guide your work as a nurse and how these standards of conduct permeate all aspects of your life. We don’t break the social contract when we clock out at the end of our shifts. These values are woven into the fabric of our lives; they inform how we treat ourselves, our families and friends, and our neighbors.

We've been there.
We get it.

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