ETHICS AND IMPAIRED PRACTICE

The public puts its faith in nurses, and it is every nurse’s duty to assure safe practice. Ethical practice is the cornerstone for patient safety and quality of care in nursing. The American Nurses Association’s Code of Ethics for Nurses (ANA, 2015) states, “The nurse’s duty is to take action designed both to protect patients and to ensure that the impaired individual receives assistance in regaining optimal function.” It further addresses impaired practice, focusing on the nurse’s ethical duty to protect the patient, the public, and the profession from potential harm and to ensure the impaired individual receives assistance.

Protecting Patients

Provision 3.4 of the Code describes nurses’ professional responsibility to promote patient health and a culture of safety. This includes reporting any errors, near misses, or concerns for the health and safety of patients.

Provision 3.5 of the Code similarly addresses nurses’ ethical responsibility to protect patients by acting on questionable practice:

Nurses must be alert to and must take appropriate action in all instances of incompetent, unethical, illegal, or impaired practice or actions that place the rights or best interests of the patient in jeopardy . . . and when [such practice] is not corrected and continues to jeopardize patient well-being and safety, nurses must report the problem to appropriate external authorities such as practice committees of professional organizations, licensing boards, and regulatory or quality-assurance agencies.

Supporting Colleagues

Provision 3.6 addresses nurses’ ethical responsibility to protect one another from harm due to impaired practice. It calls for nurses to approach impaired colleagues in a supportive and compassionate manner during identification, remediation, and recovery due to impairment. This includes:

• Helping the individual access appropriate resources
• Following employer policies, professional guidelines, and relevant laws
• Advocating for appropriate assistance, treatment, and access to fair institutional/legal processes
• Supporting the individual to return to practice after recovery

Nurses who report impaired practice should likewise be protected from retaliation or other negative consequences (ANA, 2015).