Search

The American Nurses Association (ANA)Code of Ethics for Nurses with Interpretive Statementsprovides guidance for all nurses, in all roles and in all settings. Familiarity with the provisions and the interpretive statements improves our ethical awareness and our ethical competence. Current events in our communities and across the globe require a response from nurses individually and collectively. Living in the Code enables us to form responses that are ethically sound. Advancing the profession through scholarly inquiry and establishing moral communities are other obligations that can be achieved by living in the Code.

Today there are many global volunteer opportunities for nurses and student nurses. While the intentions of volunteers may be good, the result may be harmful to the volunteer and/or the host, creating a situation of moral distress. An ethical code provides guidance and promotes moral agency. We discuss elements of the American Nurses AssociationCode of Ethics with Interpretive Statementsand apply them to the experience of global volunteering through a case study approach.

Substance use disorder is a serious problem in nursing that is often invisible and not well understood or well handled. It tears at the social contract between nursing and society and disrupts the trust so essential to that contract. The American Nurses Association

Modern American nursing arose during the Civil War and subsequently adopted the Nightingale educational model in the 1870s. By 1889, the journal Trained Nurse and Hospital Review had been established. It published a six-part series on ethics in nursing. With the establishment of the American Nurses Association in 1893, the articles of incorporation gave the organization its first charge: "to establish and maintain a code of ethics." While the rich and enduring tradition of nursing's ethics has been concerned about individual patients and their relational nexus, nursing ethics has from the beginning been a social ethics, intimately concerned both for the shape of society and for social change. This concern has been for health, conceived broadly and not focused specifically on disease and its treatment, but including the social causes of disease. Nightingale herself was an ardent social reformer, instituting a wide range of types of army sanitation reform, sanitation reform in India, and hospital and nursing reform. Despite her gender, her wealth and privilege granted her access to men in power who furthered her policy and reform agenda. From the start, then, modern nursing was imbued with a social reformist bias.

Members of the Ethics and Public Policy Committee of the International Society of Nurses in Genetics prepared this article to assist nurses in interpreting the American Nurses Association (2015) Code of Ethics for Nurses with Interpretive Statements (Code) within the context of genetics/genomics. The Code explicates the nursing profession’s norms and responsibilities in managing ethical issues. The nearly ubiquitous application of genetic/genomic technologies in healthcare poses unique ethical challenges for nursing. Therefore, authors conducted literature searches that drew from various professional resources to elucidate implications of the code in genetic/genomic nursing practice, education, research, and public policy. We contend that the revised Code coupled with the application of genomic technologies to healthcare creates moral obligations for nurses to continually refresh their knowledge and capacities to translate genetic/genomic research into evidence-based practice, assure the ethical conduct of scientific inquiry, and continually develop or revise national/international guidelines that protect the rights of individuals and populations within the context of genetics/genomics. Thus, nurses have an ethical responsibility to remain knowledgeable about advances in genetics/genomics and incorporate emergent evidence into their work.

Background Pending revisions to the Common Rule include topics consistent with respect for persons, justice, and beneficence for research subjects in studies using omics technologies and are relevant to omics research. Purpose Synthesize trends in bioethics, precision health, and omics nursing science for novice and experienced nursing scholars from which to consider bioethics questions. Methods Review topics addressed in the National Institute of Nursing Research (NINR) strategic plan, Common Rule pending revisions, and publications regarding human subjects protection policies. Discussion Omics research involves decisions regarding understandable informed consent, broad consent, data sharing, trust, equal benefit, equal access, societal variables, privacy, data security, and return of findings to participants. Conclusion Principles of respect for persons, justice, and beneficence as articulated in the Belmont report and reflected in the American Nurses Association (ANA) Code of Ethics provide guidance for human subjects protection procedures to advance omics and nursing science.

The eighth edition of the Nephrology Nursing Scope and Standards of Practice, published by the American Nephrology Nurses Association (Gomez, 2017), defines the scope of nephrology nursing practice, and provides standards of practice and professional performance in an approach similar to the American Nurses Association (ANA) 2016 standards. ANNA's eighth edition of the Nephrology Nursing Scope and Standards of Practice incorporates competencies for graduate level-prepared nurses in addition to the registered nurse (RN) and advanced practice registered nurse (APRN). The section on how to use the standards in practice has been updated with user-friendly forms. This article provides an overview of the scope of practice, standards, competencies, and situations that require intervention by the nephrology nurse.

Nursing is the largest healthcare profession in the United States (U.S.). As principal frontline caregivers in the U.S. healthcare system, nurses have tremendous influence over a patient's healthcare experience. A growing body of evidence states that the nursing workforce has a direct impact on healthcare quality. A standardized approach to measuring nursing's contribution to patient care and safety using nursing-sensitive quality indicators assists in examining the extent to which nurses and nursing affect the quality and safety of health care. This article focuses on nursing-sensitive quality indicators and discusses healthcare quality indicators and nursing-sensitive indicators used in the U.S. A summary of the work of the American Nephrology Nurses' Association Task Force on Nephrology Nursing-Sensitive Quality Indicators (NNSQI) and an NNSQI exemplar are provided.

Updated several times a week with posts by a wide variety of authors, AJN's blog Off the Charts allows us to provide more timely-and often more personal-perspectives on professional, policy, and clinical issues. Best of the Blog will be a regular column to draw the attention of AJN readers to posts we think deserve a wider audience. To read more, please visit: www.ajnoffthecharts.com.

This discussion paper critically assesses the American Nurses Association’s stated arguments against nurse participation in assisted suicide, as found in its current (2013) position statement. Seven distinct arguments can be gleaned from the American Nurses Association’s statement, based on (1) the American Nurses Association’s Code of Ethics with Interpretive Statements and its injunction against nurses acting with the sole intent to end life, (2) the risks of abuse and misuse of assisted suicide, (3) nursing’s social contract or covenant with society, (4) the contention that nurses must not harm their patients, (5) the sanctity of life, (6) the traditions of nursing, and (7) the fundamental goals of nursing. Each of these arguments is evaluated, and none are found to be convincing. This is crucial because the American Nurses Association’s official stance on nurse participation in assisted suicide can have significant consequences for the well-being of nurses who care for patients in jurisdictions in which assisted suicide is legally available. The American Nurses Association should therefore have a strong and convincing justification for opposing the practice, if it is to take such a position. That it fails to evince such a justification in its official statement on the matter places a burden on the American Nurses Association to more strongly justify its position, or else abandon its stance against nurse participation in assisted suicide.

It has been nearly a year since the third edition of the Nursing Professional Development: Scope and Standards of Practice was released. During that time, many nursing professional development (NPD) departments across the nation have incorporated this foundational document into their practice. This column describes the activities of one NPD department to align their scope of practice with the NPD scope and standards and optimize their contributions to their organization.

The American Nurses Credentialing Center is embarking on a pilot project designed to award credit to RNs for achievement of outcomes-based professional development activities, regardless of time spent in the endeavor. This article explores the value of this approach in the current health care environment. J Contin Educ Nurs. 2017;48(3):97–98.

National leaders are calling for opportunities to facilitate the Future of Nursing. Opportunities can be encouraged through state nurses association Web sites, which are part of the American Nurses Association, that are well designed, with appropriate content, and in a language professional nurses understand. The American Nurses Association and constituent state nurses associations provide information about nursing practice, ethics, credentialing, and health on Web sites. We conducted usability evaluations to determine compliance with heuristic and ethical principles for Web site design. We purposefully sampled 27 nursing association Web sites and used 68 heuristic and ethical criteria to perform systematic usability assessments of nurse association Web sites. Web site analysis included seven double experts who were all RNs trained in usability analysis. The extent to which heuristic and ethical criteria were met ranged widely from one state that met 0% of the criteria for "help and documentation" to states that met greater than 92% of criteria for "visibility of system status" and "aesthetic and minimalist design." Suggested improvements are simple yet make an impact on a first-time visitor's impression of the Web site. For example, adding internal navigation and tracking features and providing more details about the application process through help and frequently asked question documentation would facilitate better use. Improved usability will improve effectiveness, efficiency, and consumer satisfaction with these Web sites.

The Code of Ethics occupies a special place in the nursing profession. A code of ethical conduct, as Marsha Fowler notes, is of vital importance because it "stands as a central and necessary mark of a profession. It functions as a general guide for the professions members and as a social contract with the public that it serves."1 The Canadian Nurses Association explains that the code is a "statement of the ethical values of nurses and of nurses' commitments to persons with health-care needs and persons receiving care."2 Harold Sox calls codes of ethics "the tangible expressions of professionalism" and "arguably the way a profession defines itself to the public."3Establishing a code was a priority for the American Nurses Associa- tion (ANA) at its founding in 1896.4 Although ANA considered a Proposed Code in 1926 and a Tentative Code in 1940, it was not until 1950 that it ultimately adopted the Code for Professional Nurses.5 Three years later, the International Council of Nurses adopted its code of ethics (most recently revised in 2012).6 Since that time, numerous national and regional nursing organizations and regulatory bodies have adopted similar codes. We submit that a significant but unexplored factor in the ANA's adoption of the Code for Professional Nurses in 1950 was the role played by Edward L. Bernays, a widely known U.S. public relations expert who served as an ANA consultant from August 1947 to April 1949. As part of his efforts to achieve wider recognition for nursing as a profession, he pressed for the adoption of a code of ethics from the beginning of his brief tenure with ANA until his termination.Edward L. Bernays: "U.S. Publicist No. 1"Bernays's profound contributions to the field of public relations have been well documented by Stuart Ewen and Larry Tye among others.7 "To put it simply," in the words of Ewen, "Bernays' career-more than that of any other individual-roughed out what have become the strategies and practices of public relations in the United States and, increasingly, on a global scale."s Bernays was often called "the father of modern public relations"9 and "U.S. Publicist No. 1," a title attributed to him by Time magazine. Bernays, a nephew of Sigmund Freud, focused his efforts on shaping public opinion in support of his clients. He defined his basic approach as follows: first, "To intensify the favorable attitudes of a public we already have"; second, "To convert a public we do not have to our point of view, and to get them to undertake actions on our behalf"; and third, "To negate or blanket a public against us."10 He called this approach, which was based on propaganda techniques developed during the First and Second World Wars, "the engineering of consent."11 He prided himself on his ability to manipulate public opinion. His efforts went beyond merely seeking publicity for his clients. "I never visited newspapers," he told a reporter in his later years, "I created circumstances."12He "created circumstances" for a wide variety of clients, ranging from presidents and entertainers to major corporations and civic organizations. His campaign for the American Tobacco Company, which made smoking in public acceptable for women in the 1920s, tied smoking to women's social status and independence; it included a march of women holding lit cigarettes, described as "Torches of Liberty."13 To promote soap use among schoolchildren (on behalf of his client, Procter and Gamble, who hired him to boost sales of its Ivory Soap brand), he developed a National Soap Sculpture Contest with a noteworthy panel of judges.14 He helped increase flagging sales of hairnets by devising a campaign to link their use to workplace safety.15Bernays worked on behalf of the Committee on the Cost of Medical Care, a high-profile, foundation-supported initiative whose 1932 report included recommendations to reorganize health care services to make them more widely accessible. These recommendations included encouraging group medical prac- tices and voluntary or tax-supported medical insurance. …

The American Holistic Nurses Credentialing Corporation (AHNCC), the only national credentialing body for holistic nurses, has a responsibility to offer valid, reliable, and rigorous certification examinations and to grow and evolve as indicated by social and professional changes. This article describes four major changes in the work of AHNCC since 2004: a detection of an evolution in the domain of holistic nursing through review of the literature; clarification and specification of levels of practice by educational level; development of the nurse coach role in nursing, designed within the precepts of holistic nursing; and AHNCC’s response to the social paradigm shift for health care, and nursing’s advanced practice registered nurse consensus model. Each of these is discussed in detail describing the circumstances that perpetuated AHNCC’s consideration and the actions taken by AHNCC.

Originally named parish nursing because of its beginnings in the Christian faith, the term faith community nursing (FCN) has been adopted to encompass nurses from other faiths. The American Nurses Association recognized parish nursing as a nursing specialty and, in collaboration with the Health Ministries Association, published the Scope and Standards of Parish Nursing Practice in 1998 (revised in 2005). In this article, the authors explore the philosophy, objectives, growth, and practice of this specialty.

Maintaining competence is a professional responsibility for nurses. Individual nurses are accountable for their practice, as outlined in the American Nurses Association's Nursing: Scope and Standards of Practice. Nurses across clinical settings face the sometimes daunting challenge of staying abreast of regulatory mandates, practice changes, equipment updates, and other workplace expectations. In the complex, evolving perioperative setting, professional development is a priority, and the need for ongoing education is critical. However, nurses' efforts to engage in their own development can be hampered by a lack of time, limited access to educational resources, or cost concerns. This article provides an overview of nursing professional development and offers some resources to help individual nurses maintain or enhance their knowledge, skills, and attitudes.

The authors in this article retrospectively analyze the community change process undertaken by an American Nurses Association appointed Steering Committee mandated to revise the 2001 Code of Ethics for nursing. The authors identify the community change phases as the following: organizing for diversity of thinking; scanning the horizon of ethical thought; developing unifying discourse; creating new languaging; anticipating an emerging future; and, bearing witness to community innovation. The humanbecoming community change processes are used to expand understanding of these phases of change.

AHNA Past-President Carla Mariano recently had the privilege of serving on the American Nurses Association's (ANA) Nursing Scope and Standards Revision Workgroup. Representing the specialty practice of holistic nursing, Carla's presence within this workgroup contributed greatly to the inclusion of holistic principles and values throughout the new 2015 Nursing: Scope and Standards of Practice, 3rd edition, the foundational document that informs and guides professional nursing practice within the United States. This is a significant step forward for holistic nursing and an indicator of our growing influence as specialty practice.

We have had multiple occasions to notice the array of credentials that nurse faculty and clinicians use to display their accomplishments. Despite clear, comprehensive details presented by the American Nurses Credentialing Center (ANCC, 2013) and other professional organizations, confusion abounds in both the academic and practice communities.Nurses may use six types of credentials after their names: degree, licensure, state designation/requirement, national certification, awards/honors, and other miscellaneous certifications by credentialing agencies. In addition, a range of academic credentials can be used. These include the relatively new Doctor of Nursing Practice (DNP) and the now retired (at least by most individuals and all schools) DrNP. We also now have a number of EdD programs that are focused on nursing education, in contrast to the EdD programs many nurses attended in the past (other than the Teachers College, Columbia University program). As an aside, it is worth pointing out that the DNP is the wrong title for the professional doctorate in nursing. No other discipline has practice in the degree title, even those that are comparable professional disciplines, such as pharmacy, with the PharmD degree, physical therapy, with the DPT, and, of course, medicine (MD) and dentistry (DDS).Some individuals list all their academic degrees, from the baccalaureate through the doctorate. With today's emphasis on lifelong learning and the likelihood that nurses will have more and more degrees, it is worth asking if we need to list BSN, MSN, and PhD, when all are in nursing. What does one do if the academic degree is in another discipline? For example, it has become customary to list degrees such as MBA (Masters of Business Administration) or MPA (Masters of Public Administration), especially among those who are in management and leadership positions.Some nurses list their credentials in the order in which they were obtained. For example, a nurse who received a diploma in nursing and then obtained a higher degree may want to list the RN credential first.Questions have also been raised about whether to list honorary doctorates. For the individual who has one or two honorary degrees, it may be reasonable to list them. After all, they represent recognition of one's stature in the scholarly community. But if an individual has five or more honorary degrees, as some distinguished nurse leaders do, perhaps listing a few is sufficient.Clinical credentials are even more confusing because they are influenced by both state licensing requirements (which, of course, differ by state) and national certifying bodies. The only credentials that nurses must use for practice are those required by the states in which they practice. For example, what difference is there between an ACNPC, credentialed by the American Association of Critical Care Nurses, and the ACNP-BC, credentialed by the ANCC? …