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Practical use of the Nursing Code of Ethics: Part II.

Article Excerpt
In the January/February 2009 issue of MEDSURG Nursing, I discussed the first four provisions of the Code of Ethics for Nurses with Interpretative Statements (The Code) (American Nurses Association (ANA), 2001). In this column, I will continue this practical discussion on the remaining five provisions. The goal of this article is to provide the clinical nurse with practical application of each of these provisions.

Understanding the Essence of Code Provisions

Provision V. The nurse owes the same duties to self as to others, including the responsibility to preserve integrity and safety, to maintain competence, and to continue personal and professional growth (ANA, 2001, p. 18).

First, this provision addresses the idea that nurses owe to themselves the same moral duties they owe others. Self-respect, or seeing the self as deserving of worth, is the foundation of this fifth provision. As Mark Twain said, "The worst loneliness is to not be comfortable with yourself" (Wisdom Quotes, 2009). Self-respect is fundamental for a happy life. A person who lacks self-respect will be insecure and strive to be someone he or she is not (Pettinger, 2008). The Roland and Foxx (2003) model of self-respect prominently includes such components as independence, tenacity, and dignity. In this model, the sources and constituents of self-respect basically are internal to the actor. Roland and Foxx treat self-respect as a form of self-evaluation that depends on commitment to moral ideals and on living up to personal principles. Acting courageously probably assumes some nominal level of self-esteem, and having acted courageously is even more likely to promote increased self-respect. Without this self-respect, nurses may not have the moral courage to act to protect others.

Humility involves having a proper assessment of personal worth. In any case, overestimation of self-worth is clearly an important moral phenomenon as traditional accounts of humility emphasize, but so too is underestimation of self-worth. In fact, most people have the tendency to underestimate rather than overestimate their value. To prevent this underestimation, this provision encourages nurses to include professional growth and maintenance of competence, wholeness of character, and preservation of integrity.

Second, professional growth and maintenance of competence require continuous acquisition of knowledge and skills relevant to a chosen specialty. For medical-surgical nurses, the array of possible subjects is vast; therefore, unit specialties within medical-surgical services have emerged. Continued growth might include advanced degrees in medical-surgical nursing and certification (certified medical-surgical nurse [CMSRN]). Scope and Standards of Medical-Surgical Nursing Practice (Academy of Medical-Surgical Nurses, 2000) provides the medical-surgical nurse...

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