CNO Code of Conduct: Nursing Ethics

The College of Nurses of Ontario (CNO) Code of Conduct

• Provides nurses with direction on acceptable conduct and professional behaviour.
• Helps nurses uphold the values and ethical commitments of the nursing profession.
• Guides nurses in all roles and practice settings.
• Applies to all categories of nurses in Ontario: Registered Nurses (RNs), Registered Practical Nurses (RPNs), and Nurse Practitioners (NPs).
• Not a substitute for legislation, regulations, or practice standards.
• Nurses are expected to be familiar with and integrate the principles of the Code of Conduct into their practice.
• Used by the College to assess a nurse’s conduct.
• Provides a framework for ethical decision-making in nursing practice.

Principles of the Code of Conduct

• Nurses respect the dignity of patients and treat them as individuals.
• Nurses work together to promote patient well-being.
• Nurses maintain patients’ trust by providing safe, competent, ethical and compassionate care.
• Nurses work to maintain public confidence in the nursing profession.

Principle 1: Nurses respect the dignity of patients and treat them as individuals

• Nurses recognize that each patient is unique and has the right to be treated with respect, regardless of their age, gender, race, religion, sexual orientation, or any other personal attribute.
• Nurses demonstrate respect by listening to patients, acknowledging their concerns, and involving them in decisions about their care.
• They maintain professional boundaries and avoid any behavior that could be perceived as exploitative or abusive.
• Nurses advocate for patient rights, including the right to privacy, confidentiality, and informed consent.
• They create a safe and supportive environment where patients feel comfortable expressing their needs and preferences.
• Nurses are aware of their own values and beliefs and how these may impact their relationships with patients.
• They avoid imposing their personal values on patients and respect patients’ choices, even when they differ from their own.
• Nurses address instances of disrespectful or discriminatory behavior by others in the health care setting.
• Nurses use a patient’s preferred name and title.
• Nurses respect the language, culture, spiritual beliefs, values, and traditions of individuals/groups.
• Nurses respect patients’ right to make informed choices and to be involved in all aspects of their care.
• Nurses respect patients’ decisions about accepting or refusing treatment.
• Nurses do not discriminate against or harass patients.
• Nurses do not engage in behaviour that is abusive, demeaning, intimidating, humiliating, or threatening.
• Nurses do not act in a way that is sexually suggestive, seductive, or exploitive.
• Nurses do not solicit or accept loans, gifts, or inheritances from patients.

Principle 2: Nurses work together to promote patient well-being

• Nurses collaborate with other health care professionals to provide coordinated and comprehensive care.
• They communicate effectively with colleagues, sharing relevant information and seeking input when needed.
• Nurses recognize the expertise of others and value their contributions to the team.
• They participate in interprofessional activities, such as team meetings and case conferences, to promote shared decision-making.
• Nurses contribute to a positive work environment by fostering mutual respect, trust, and open communication.
• Nurses address conflicts constructively and seek resolution through collaboration and negotiation.
• Nurses understand their roles and responsibilities within the health care team.
• They respect the roles and responsibilities of other team members.
• Nurses consult with and/or refer patients to other health care professionals appropriately.
• Nurses ensure the activities of unregulated care providers are safe and appropriate.
• Nurses share their knowledge and expertise with students and colleagues..
• Nurses provide patients with access to information that enables them to be more informed about their health care.
• Nurses advocate for organizational and/or system changes that improve patient care.
• Nurses understand policies related to conflict of interest and disclose any conflicts of interest that arise.
• Nurses do not promote, sell, or supply products or services to patients for personal financial gain.
• Nurses work in collaboration with patients, their support persons, and other health care providers to deliver the best possible outcomes.

Principle 3: Nurses maintain patients’ trust by providing safe, competent, ethical and compassionate care

• Nurses are committed to providing safe, competent, ethical, and compassionate care to all patients.
• Nurses are accountable for their actions and decisions and take responsibility for the quality of care they provide.
• They maintain their competence through ongoing education and professional development.
• Nurses adhere to professional standards and guidelines, including those related to medication administration, infection control, and documentation.
• Nurses practice within their scope of practice and seek assistance when needed.
• Nurses report errors and adverse events to prevent future harm.
• Nurses respect the confidential nature of the nurse-patient relationship and protect patient privacy.
• Nurses maintain accurate and complete patient records.
• Nurses act with integrity and honesty in all aspects of their practice.
• Nurses provide unbiased information allowing the patient to make an informed decision.
• Nurses recognize and address their own biases.
• Nurses provide care based on best practice.
• Nurses develop a plan of care in partnership with the patient based on patient needs.
• Nurses accurately represent themselves and their competence, qualifications, and experience to patients, employers, and colleagues.
• Nurses provide timely, respectful, and unbiased responses to patients’ requests for assistance.
• Nurses take appropriate action in situations where patient safety and well-being are compromised.
• Nurses report suspected abuse or neglect of patients according to legal requirements.
• Nurses recognize that being impaired by any substance or condition compromises their ability to provide safe patient care.
• Nurses take appropriate action if they become aware that a colleague’s practice is unsafe or compromises patient care.
• Nurses do not misappropriate patient property or engage in any behaviour that constitutes financial abuse.
• Nurses meet the standards of practice and expectations of the nursing profession.
• Nurses participate in ongoing learning to continually improve their knowledge, skills, and judgment.

Principle 4: Nurses work to maintain public confidence in the nursing profession

• Nurses uphold the reputation of the nursing profession through their conduct and behavior.
• Nurses act in a manner that is consistent with the values and ethical principles of the profession.
• They promote public trust by being honest, transparent, and accountable.
• Nurses avoid any behavior that could undermine public confidence in the profession.
• Nurses engage in activities that support the advancement of nursing practice and education.
• Nurses advocate for policies that promote health and well-being.
• Nurses participate in professional organizations and contribute to the development of nursing knowledge.
• Nurses understand their professional responsibilities and adhere to ethical and legal standards.
• Nurses meet their legal obligations as citizens.
• Nurses avoid any behaviour, on or off duty, that undermines public confidence in the nursing profession.
• Nurses do not engage in any conduct that would discredit the nursing profession.
• Nurses do not use their position as nurses to exploit patients, families, or colleagues for personal financial gain.
• Nurses co-operate with the College during the investigation of complaints about nursing practice.
• Nurses report concerns about the practice of a health professional to the appropriate regulatory body.
• Nurses advocate for organizational and/or system changes that improve patient care.
• Nurses participate in activities that promote and advance the nursing profession.
• Nurses are honest and trustworthy in their interactions with the public, employers, colleagues, and the College.