Code of Conduct
New Code of Conduct for nurses
The Nursing Council has published a new Code of Conduct setting out the standards of behaviour that nurses are expected to uphold in their professional practice.
The Code both advises nurses and tells the public what they can expect of a nurse in terms of the professional role. It also provides a yardstick for evaluating the conduct of nurses.
Most nurses will have already internalised many of its fundamental values and core principles, and treat their patients with respect and build relationships of trust. The Code supports this by reflecting and articulating the values and principles at the heart of competent nursing.
The Council has produced the new Code, to replace the previous (now outdated) Code, in line with its statutory role to protect the health and safety of the public by setting standards of clinical competence, ethical conduct and cultural competence for nurses. Please see the documents in the right hand downloads box on this page.
The Code is framed around four core values – respect, trust, partnership and integrity – and eight primary principles. It is a practical document that clearly describes the conduct expected of nurses. Without the public's trust and confidence in the profession, nurses cannot fulfil their role effectively. This means that what is personal and what is professional will inevitably overlap.
Professional development on the Code of Conduct and the Guidelines: Professional Boundaries needs to be completed by end of July 2015. Nurses are expected to include this information on their professional development record which will be assessed as part of their PDRP or may be requested by the Council if they are selected for the recertification audit.
The Council requirement to complete professional development on the Code of Conduct and Professional Boundaries is a one off requirement.
E-Learning Package (Developed by Canterbury and West Coast District Health Board)
All Nurses are also able to access an e-learning package on the Code developed by the Canterbury and West Coast District Health Boards.
To access the course users will need to:
1. click the link above then select the 'login as guest' option
2. type code of conduct in the search box and select go
3. choose the second result 'guest access only course'
4. work your way through the online package following the instructions outlined in the package.
Guidelines: Professional Boundaries
The booklet Guidelines: Professional Boundaries discusses the sometimes challenging but critical issue of professional boundaries in more detail. It is designed to be read alongside the Code.
The key message of both documents is that nurses must make the care of patients their first concern. To do this effectively, they must maintain professional boundaries.
Nurses are expected to familiarise themselves with the Code and the Guidelines and incorporate these standards in their practise. Over the next three years, as part of the continuing competence requirements, all nurses will be required to complete professional development on the Code of Conduct and professional boundaries. Nurses are also able to access an e-learning package on the Code developed by the Canterbury and West Coast District Health Boards. To access the course users will need to select the 'login as guest' option.
A series of interactive presentations is currently being planned around the country to support nurses in meeting this requirement and to foster examination and discussion of the new principles and guidance. Online learning is also being explored as a way of making education available to all nurses, whatever their place or time of work.
Guidelines: Social Media & Electronic Communication
Guidelines: Social Media & Electronic Communication is a new guidance document to help nurses think about their use of social media and electronic communications in relation to standards of professional conduct. The new guidelines explore the benefits and pitfalls of social media providing detailed guidance to expand on the principles and standards of behaviour outlined in the new Code of Conduct for nurses, published in the middle of 2012. Of the eight principles in the Code, four directly intersect with the use of social media and electronic communications.
Clear direction is given to nurses. For example in relation to protecting patient privacy, nurses are reminded to be aware that patient emails, answer phone messages and texts may be accessed by others. In relation to maintaining professional boundaries, nurses are advised that boundaries could be breached when health consumers are made ‘friends’ on personal social media websites. The new guidance document is the second in a series of guidelines expanding on the Code and follows the release of guidelines on professional boundaries.
What has become clear is that even when social media is used with good intentions, patient confidentiality and privacy can be inadvertently breached. Patients don’t have to be named to be identifiable and even with the strictest privacy settings, information can forwarded and shared in potentially ever-expanding networks. Similarly deleted content may remain accessible.
Developing the Code and Guidelines
The Code has not had a substantial review since its initial development in 1994–1995. Since then there have been major changes in society, technology, nursing practice, and the healthcare and legislative environments. These changes needed to be reflected in a new Code.
The project began by reviewing these changes and analysing the former Code of Conduct and competencies for registered nurses against the more recent Codes of Conduct that have been developed by other nursing (UK and Australia), medical (New Zealand and Australia) and midwifery (New Zealand) regulatory bodies. Information from disciplinary investigations and findings was also examined.
The resulting draft (which was sent out for consultation) was significantly different from the former Code. The four original principles were changed and extended to seven, to emphasise the needs and rights of the health consumer and to make more explicit the values of respect and trust as the foundations of ethical relationships and behaviour. More information was included on privacy and confidentiality, health consumer rights and documentation of care. New areas were included – for example, working with others in the health care team, and professional boundaries.
Developing the guidelines began as a joint project by the Council and the Australian Nursing and Midwifery Council. In the end, however, the Council was not satisfied that this effectively reflected our specific New Zealand context, and decided to develop a separate New Zealand guidance document.
The consultation process
Between November 2011 and February 2012, the Council consulted with nurses, the wider health sector, Māori and consumer organisations.
Three focus groups were held with nurses and health consumers. The Council received 74 submissions on the Code, 40 from organisations and 34 from individuals. Of the 22 submissions received on the Guidelines, 21 were from groups and organisations. The Council’s Māori Advisors also provided feedback.
The majority of submissions were positive about the changes to the Code, seeing it as a relevant and more useful document. Most submissions on the Guidelines were also positive. Two submissions thought the guidance on professional boundaries could have been included in the Code.
There was widespread support for the move to making standards of professional behaviour more explicit. Many suggestions were made about rewording and many of these were incorporated in the final draft, which went to the Council in April 2012. Particular attention was paid to the wording of the principles, to keep them in alignment with the values.
The most significant change was the addition of a new principle about respecting the cultural needs and values of health consumers. In line with this, a guidance box on working with Māori to improve health outcomes was removed. The content was made more relevant to individual nurses and integrated with the standards under the new principle. Definitions of “culture”, “cultural safety” and “kawa whakaruruhau” now appear in the guidance box on cultural safety. "Culture" is given a broad definition.
Another change to the Code was the removal of a guidance box on social media. This issue is now addressed under the principles of confidentiality and privacy, and professional boundaries. Advice on social media was added to the guidance box on professional boundaries and included in the Guidelines: Professional Boundaries.
Other smaller changes were made to ensure that the standards align with the Code of Health Consumer Rights (1996). The Code of Rights is now included in the Introduction to the Code.
Consultation with young people on the Code of Conduct
A new report providing valuable insight into the views of young people about what matters to them when receiving nursing care has been released by the Nursing Council and the Office of the Children’s Commissioner. In developing the new Code of Conduct and the Guidelines: Professional Boundaries, the Council sought to consult widely and enlisted the assistance of the Office of the Children’s Commissioner to reach young people. Focus groups were held with a diverse range of young people aged 14–18, some of whom had considerable experience of nursing services.
One of the key findings of the consultation was the importance of the role nurses play in young people’s positive experience of health care.
The young people spoke about the importance of respect, being informed about their health situation, and the need for their information to be kept confidential when receiving health care from nurses.
They would like nurses to build relationships with young people to get the best health outcomes for them. They want to be consulted and included in all decisions to do with their health needs.
Young people stressed the importance of receiving information that is clear, easy to understand, non-judgemental, and given with a good dose of patience and warmth.