A tool that managers can use for guidance in ethical problem solving is a professional code of ethics. A code of ethics is a set of principles, established by a profession, to guide the individual practitioner. The first code of ethics for nurses was adopted by the ANA in 1950 and has been revised many times since then. The ANA Code of Ethics outlines the important general values, duties, and responsibilities that flow from the specific role of being a nurse. It is also important to remember that the ANA Code of Ethics is not legally binding. Instead, it functions as a guide to the highest ethical practice standards for nurses. The code also explicitly details that the nurse’s most fundamental accountability is to the patient, whether an individual, family, group, or community. Another document that may be helpful specifically to the nurse–manager in creating and maintaining an ethical work environment is The Scope and Standards of Practice of Nursing Administration Practice, published by the ANA. 

When Would You Betray a Confidence?

Under what circumstances would you betray a confidence? Suppose your best friend confided in you that she used recreational drugs most weekends. You both have a nursing clinical on Monday mornings. You have told her that she should not use drugs the day before her clinical as it could impair her judgment. Yet her behavior has continued.

Should you tell your clinical instructor or keep your friend’s secret?

What would you do? Is it ever okay to break your vow of confidentiality?