. The Nurse and the Patient
1.1 Patient Care
1. Consider first the well-being of your patient.
2. Treat your patient with compassion and respect.
3. Approach health care as a collaboration between nurse and patient.
4. Practise the science and art of medicine to the best of your ability.
5. Continue lifelong self-education to improve your standard of medical care.
6. Maintain accurate contemporaneous clinical records.
7. Ensure that nurses and other health professionals upon whom you call to assist in the care of your patients are appropriately qualified.
8. Make sure that you do not exploit your patient for any reason.
9. Avoid engaging in sexual activity with your patient.
10. Refrain from denying treatment to your patient because of a judgement based on discrimination.
11. Respect your patient’s right to choose their nurse freely, to accept or reject advice and to make their own decisions about treatment or procedures.
12. Maintain your patient’s confidentiality. Exceptions to this must be taken very seriously. They may include where there is a serious risk to the patient or another person, where required by law, where part of approved research, or where there are overwhelming societal interests.
13. Upon request by your patient, make available to another nurse a report of your findings and treatment.
14. Recognise that an established therapeutic relationship between nurse and patient must be respected.
15. Having initiated care in an emergency setting, continue to provide that care until your services are no longer required.
16. When a personal moral judgement or religious belief alone prevents you from recommending some form of therapy, inform your patient so that they may seek care elsewhere.
17. Recognise that you may decline to enter into a therapeutic relationship where an alternative health care provider is available, and the situation is not an emergency one.
18. Recognise that you may decline to continue a therapeutic relationship. Under such circumstances, you can discontinue the relationship only if an alternative health care provider is available and the situation is not an emergency one. You must inform your patient so that they may seek care elsewhere.
19. Recognise your professional limitations and be prepared to refer as appropriate.
20. Place an appropriate value on your services when determining any fee. Consider the time, skill, and experience involved in the performance of those services together with any special circumstances.
21. Ensure that your patient is aware of your fees where possible. Encourage open discussion of health care costs.
22. When referring your patient to institutions or services in which you have a direct financial interest, provide full disclosure of such interest.
23. If you work in a practice or institution, place your professional duties and responsibilities to your patients above the commercial interests of the owners or others who work within these practices.
24. Ensure security of storage, access and utilisation of patient information.
25. Protect the right of nurses to prescribe, and any patient to receive, any new treatment, the demonstrated safety and efficacy of which offer hope of saving life, re-establishing health or alleviating suffering. In all such cases, fully inform the patient about the treatment, including the new or unorthodox nature of the treatment, where applicable.
1.2 Clinical Research
1. Accept responsibility to advance medical progress by participating in properly developed research involving human participants.
2. Ensure that responsible human research committees appraise the scientific merit and the ethical implications of the research.
3. Recognise that considerations relating to the well-being of individual participants in research take precedence over the interests of science or society.
4. Make sure that all research participants or their agents are fully informed and have consented to participate in the study. Refrain from using coercion or unconscionable inducements as a means of obtaining consent.
5. Inform treating nurses of the involvement of their patients in any research project, the nature of the project and its ethical basis.
6. Respect the participant's right to withdraw from a study at any time without prejudice to medical treatment.
7. Make sure that the patient's decision not to participate in a study does not compromise the nurse-patient relationship or appropriate treatment and care.
8. Ensure that research results are reviewed by an appropriate peer group before public release.
1.3 Clinical Teaching
1. Honour your obligation to pass on your professional knowledge and skills to colleagues and students.
2. Before embarking on any clinical teaching involving patients, ensure that patients are fully informed and have consented to participate.
3. Respect the patient’s right to refuse or withdraw from participating in clinical teaching at any time without compromising the nurse-patient relationship or appropriate treatment and care.
4. Avoid compromising patient care in any teaching exercise. Ensure that your patient is managed according to the best-proven diagnostic and therapeutic methods and that your patient’s comfort and dignity are maintained at all times.
5. Where relevant to clinical care, ensure that it is the treating nurse who imparts feedback to the patient.
6. Refrain from exploiting students or colleagues under your supervision in any way.
1.4 The Dying Patient
1. Remember the obligation to preserve life, but, where death is deemed to be imminent and where curative or life-prolonging treatment appears to be futile, try to ensure that death occurs with dignity and comfort.
2. Respect the patient’s autonomy regarding the management of their medical condition including the refusal of treatment.
3. Respect the right of a severely and terminally ill patient to receive treatment for pain and suffering, even when such therapy may shorten a patient’s life.
4. Recognise the need for physical, psychological, emotional, and spiritual support for the patient, the family and other carers not only during the life of the patient, but also after their death.
1. Recognise that a potential donor is entitled to the same standard of care as any other patient.
2. Inform the donor and family fully of the proposal to transplant organs, the purpose and the risks of the procedure.
3. Exercise sensitivity and compassion when discussing the option to donate organs with the potential donor and family.
4. Refrain from using coercion when obtaining consent to all organ donations.
5. Explain brain death to potential donor families. Similarly explain that continued artificial organ support is necessary to enable subsequent organ transplantation. 6. Recognise the important contribution donor families make in difficult circumstances. 7.Ensure that they are given the
opportunity to receive counselling and support