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Nursing first began to discuss a code of ethics in 1896, when a group of nursing leaders met to discuss the practice of nursing in the United States. The forerunners to the official code of ethics were generally based on the (Florence) Nightingale Pledge, which was and is still administered to graduating nurses. That first organization to address the code of ethics for nurses eventually became the American Nurses Association (ANA), and the first official code of ethics for nurses, the Code for Professional Nurses, was accepted by the ANA House of Delegates in 1950.
The Code for Professional Nurses has been updated and revised over the years to the Code of Ethics for Nurses (the Code) we use today (Box 4.1). It reflects the moral traditions, values, and trust that the public has come to associate with nursing. The obligations that nurses have toward themselves, patients, and communities are guided by ethical principles. There are no right or wrong behaviors identified in ethical principles, only guidelines for the ethical practice of nursing.
The ANA first published the Standards of Nursing Practice in 1973. This document defined a generic level of competency common to all practicing nurses and used the nursing process as the framework. Since that time, there have been revisions and updates. In 2015, Nursing: Scope and Standards of Practice (3rd ed.) was published to guide nursing practice.
The scope of nursing practice describes the who, what, when, where, why, and how of nursing practice. Nursing today is practiced in many different settings requiring knowledge and skill in the biological, physical, social, and behavioral sciences. Registered nurses are licensed by the state in which they practice and work collaboratively with other health-care professionals.
Nursing is a science and an art, and the scope of nursing practice is a fluid interaction of the two that is foundational to the nursing profession.