The Nurses’ Deontological Code

I nurse promise you to:

· INTRODUCE MYSELF when I meet you the first time and to explain who I am and what I can do for you.
· UNDERSTAND who you are, recognize you and call you by your name and surname.
· IDENTIFY MYSELF through my uniform and my name tag.
· GIVE ANSWERS in a clear and understandable manner, or send you to the appropriate persons or organizations.
· PROVIDE INFORMATION that facilitates you contact with all the healthcare services.
· ENSURE you the best hygienic and environmental conditions.
· HELP you maintain your social and family relations.
· RESPECT your time and your routines.
· HELP you face in a more balanced and respectable manner your day, providing support for your daily activities, such as eating, washing, moving and sleeping when you are unable to do these things on your own.
· IDENTIFY your healthcare needs, share them with you, suggest you the possible solutions, work together to resolve problems.
· TEACH YOU which are the most appropriate behaviours to optimise your health status, while respecting your lifestyle choices.
· ENSURE YOU competence, skills and humanity while caring for you.
· RESPECT your dignity, your uncertainties and ensure your privacy.
· LISTEN TO YOU carefully and willingly when you need help.
· STAY CLOSE TO YOU when you suffer, when you are afraid, when medicine and technology are not enough.
· PROMOTE and take part in initiatives aiming at improving the nursing responses within the organization.
· REPORT to the appropriate organizations and persons any situation that may cause you harm and discomfort.

THE DEONTOLOGICAL CODE (May 1999)

Article 1. Preamble

1.1. A nurse is a health worker who, after holding a qualifying diploma and being registered in the professional registry, is responsible for nursing care.

1.2. Nursing is at the service of the single person and of the community. This is provided through specific interventions, autonomous and complementary, bearing a technical, relational and educational nature.

1.3. The nurse has the responsibility to attend and take care of the person, in the respect of life, health and of the individual’s freedom and dignity.

1.4. The deontological code guides nurses in the development of the professional identity and in undertaking an ethically responsible behaviour. It is a tool that informs the public on the type of behaviour you can expect from a nurse.

1.5. With the participation of their representative bodies, nurses express their belonging to a professional group, the acceptance of the values contained in the Deontological Code and the commitment to put them into practice in their daily life. 

Article 2. The ethical principles of the profession

2.1 The respect of the fundamental rights of mankind and of the ethical principles of the profession is an essential condition to take on the responsibility of nursing practice.

2.2. Nurses recognise health as a fundamental good of the individual and as the interest of the community and commit to protect it through prevention, caring and rehabilitation activities.

2.3. Nurses acknowledge that all people have the right to be considered in the same manner and cares for them independently from their age, social and economical status, and the causes of the disease.

2.4. Nurses act taking into account the religious, ideological and ethical values, as well as the culture, the ethnic group and the gender of the individual. 

2.5. In the vent of conflict caused by deep ethical diversities, nurses undertake to find a solution through dialogue. In the event of intentions deeply in contrast with the ethical principles of the profession and based upon personal conscience, nurses may avail of the right to raise a conscientious objection.

2.6. In their professional practice, nurses undertake to not cause any harm, direct their actions towards the autonomy and the good of the patient, and do their best to activate their resources even when they are disabled or disadvantaged.

2.7. Nurses contribute to a fair choice of the allocations, even through the optimal exploitation of the resources. If these are lacking, nurses set the priorities according to criteria shared by the professional community.


Article 3. General rules

3.1 Nurses update their knowledge by means of lifelong education, critical thinking on their experience and research, in order to enhance their competences.
Nurses found their practice on evidence-based and updated knowledge, in order to ensure people the most effective treatment and care.
Nurses take part in professional training, promote and start of researches, sees that the results are disseminated, with the aim of improving nursing.

3.2 Nurses take their responsibility according to the level of competence achieved and, if necessary, avails of the intervention or advice of experts. They are aware that integration is the best choice when facing patients’ problems; in addition they understand the importance of providing advice, by putting their knowledge and skills at the disposal of the professional community.

3.3 Nurses recognize the limits of their knowledge and skills and decline their responsibility when they realize they are unable to act safely. They have the right and the duty to obtain training and/or supervision for new practices or for which they do not have enough experience; they refrain from performing experiments without a guide that may represent a risk for the person. 

3.4 Nurses do their best to analyse the ethical dilemmas experienced during their daily practice and if necessary ask for professional and institutional advice, thus contributing to the continuous development of ethical thinking.

3.5 Professional practice must not be conditioned by personal pressures or interests on behalf of the beneficiaries, other workers, companies, associations or bodies. In case of conflict, the interests of the beneficiary must prevail. 
Nurses cannot make use of political or public appointments to draw advantages for themselves or for others.
Nurses may work as volunteers, but always in agreement with the law in force: they are free to provide their services for free, but only if this happens occasionally.

3.6 Nurses, in situations of emergency, are obliged to provide first aid and take action in order to ensure the necessary care. In case of a disaster, they must be at the disposal of the respective authorities.

Article 4. Relating with the patient

4.1 Nurses promote, through education, healthy lifestyles and disseminate the culture of health; for this reason they activate and maintain the network of relations between the services and the workers.

4.2 Nurses listen, inform and involve people and assess their healthcare needs, also to explicit the level of guaranteed care and allow the beneficiary to express his/her own choices. 

4.3 Nurses, by respecting the indications given by the beneficiary, facilitates his/her relations with the community, as well as the persons the beneficiary considers as the most important ones, and involved them in the care plan.

4.4 Nurses have the right to be informed on the therapeutic diagnostic program, due to the influences this has on the care plan and the relation with the person.

4.5 Nurses, by helping and supporting a person in his/her therapeutic choices, ensures information on the care plan and adjusts the level of communication to the patient’s ability to understand. Nurses do their best so that the beneficiary receives global and not just clinical information, and recognises the right of choosing to not be informed.

4.6 Nurses ensure and protect the confidentiality of the information concerning the person. In gathering, managing and passing the data, nurses should only limit themselves to what is pertinent to their care plan.

4.7 Nurses ensure the continuity of care also through an effective handling of the computer tools.

4.8 Nurses respect professional secrets, not just because they are obliged by the law, but because they are deeply convinced that this is the most appropriate way to pay back the trust the patient places in them.

4.9 Nurses promote in every healthcare setting the best possible conditions of psychological and physical safety both for the patient and his/her family.

4.10 Nurses do their very best so that the recourse to physical and pharmacological constriction occurs only in case of an exceptional and motivated event, and does not become a routine method of nursing. Nurses consider constriction an acceptable choice when this is done in the interest of the person and unacceptable when it is the response to an institution need. 

4.11 Nurses do their best so that the opinion of a minor is taken into consideration as to the therapeutic choices, according to his/her age and level of maturity.

4.12 Nurses do their best to promote the protection of people in conditions that limit their own development or expression, whenever the family and the context are not appropriate for their needs.

4.13 Nurses who discover abuses or deprivations against the person, must use all their means to protect that person and alert, when necessary, the competent authorities. 

4.14 Nurses do their best to relieve symptoms, especially those that can be prevented. They limit themselves to resort to placebos only for cases that have been attentively evaluated and upon specific medical indication.

4.15 Nurses care for the person, whatever his/her clinical condition may be and until the end of that person’s life, understanding the importance of the environmental, physical psychological, relational and spiritual comfort. Nurses advocate for the right to set limits to diagnostic and therapeutic excesses that are not consistent with the patient’s conception of quality of life.

4.16 Nurses help the patient’s relatives, and especially when the patient dies, in arranging the funeral.

4.17 Nurses do not take part in treatments aiming at causing the death of a patient, even of this request is made by the patient, the family members or others.

4.18 Nurses consider the donation of blood, tissues and organs an expression of solidarity. They do their best to circulate information and support to people involved in donating and receiving.

Article 5. Professional relations with colleagues and other workers

5.1 Nurses collaborate with colleagues and other workers, by recognising and respecting their specific contribution within the team.
In the scope of their knowledge, experience and professional role, they contribute to the development of the nursing competences.

5.2 Nurses protect their own dignity, as well as that of their colleagues, through a behaviour based on respect and solidarity. They do their best so that any divergence of opinion does not hamper the care plan.

5.3 Nurses have the right to self-evaluation and to check their practice, also with the aim of improving the profession.

5.4 During their independent practice, nurses follow the behavioural rules set by the IPASVI Colleges.

5.5 Nurses protect the honour of their name and professional qualification, even through the respect of the regulations of healthcare advertisement.

5.6 Nurses are expected to inform their Colleges if become aware of any abuse or behaviour that goes against the deontology carried out by a colleague.

Article 6. Relating with Institutions

6.1 At different levels of responsibility, nurses contribute to the orientation of the policies and the development of the healthcare system, in order to ensure the respect of the patients’ rights, the just exploitation of the resources and the enhancement of the professional role.

6.2 Nurses make up for the shortages of a centre through cooperation in the interest of the public and of the institution. Nurses have the right to abstain from making up when such shortages are no longer an exception or when their prior professional mandate is jeopardised. 

6.3 At different levels of responsibility, in cases of shortages or inefficiency, reports about the situation and tries to restore the most favourable situation.

6.4 Nurses refer to the competent person or to the professional authority any circumstance that may compromise nursing and the quality of care, with particular attention on the effects on the person.

6.5 Nurse have the right and the duty to report to the College any situation that includes circumstances or persist conditions that limit the quality of care or the dignity of professional practice.

Article 7. Final instructions

7.1 The deontological regulations contained in this code are binding: their non-observance is liable to punishment through sanctions made by the professional College.

7.2 The IPASVI Colleges ensure, for the good of the person and the public, the qualification of every single professional and the competences acquired and maintained.