Although the need for a nursing code of ethics was recognized in the mid-1800s as modern nursing became more formalized, it took a backseat to more pressing issues for the newly created American Nurses Association (ANA) in 1896. The ANA’s first priorities were tackling issues such as nursing registration, accreditation of nursing schools, and the well-being of working nurses. Without a formal code of ethics to follow at the time, nurses “used Gretter’s Nightingale Pledge, akin to medicine’s Hippocratic Oath, to guide their practice.”
Eventually, the ANA published the first “suggested” code of ethics for nurses in 1926 which provided formal guidance regarding what ethical behavior should look like for nurses. Then in 1940, the ANA drafted a “Tentative Code” which included many of the same provisions from the 1926 suggested code. But this time, the Code discussed these provisions as they related to a nurse’s relationship with patients, their colleagues, and the profession itself. It also defined nursing as a profession.
In 1968, the ANA revised the Code and developed interpretive statements to help nurses understand how the different provisions and ethical principles such as veracity could be applied to their practice. The previous 17 provisions were also reduced to 10 provisions in this update of the Code.
The nursing code of ethics we have today has been developed by nurses for nurses. It is the gold standard that all nurses use to make decisions and it serves as an ethical guide, regardless of a nurse’s role or where they work. Whether on or off the job, nurses are expected to uphold all seven ethical principles that form the basis of the Code, including veracity.