Autonomy in Nursing: Nursing Code of Ethics Breakdown

• Introducing NCC’s Nursing Ethics breakdown with Autonomy in Nursing. Learn the ins and outs of what it means to be an autonomous nurse.
• Overview the six other ethics of nursing: accountability, justice, nonmaleficence, beneficence, fidelity, and veracity. 
• Understand the benefits of autonomy in nursing, examples you can implement in your own practice, and how to become more autonomous. 

As a nurse, you make several decisions regarding patient care. In fact, it is so routine that you probably do not think twice about it.  

Did you know that the decisions you are making every day are a part of your nursing autonomy? Are you a nurse who often delegates to other staff members? This is also an important aspect of nursing autonomy.  

What am I talking about? Autonomy sounds fancy, but it is just another way of describing the authority a nurse must make regarding decisions based on their medical knowledge and experience.  

Charge nurses are a great example of medical professionals who are entrusted to make several decisions every day, requiring critical thinking skills regarding staffing issues, conflict, patient care, safety, and more.  

Let’s discuss autonomy in further detail and how important it is in the nursing world.  

Evolvement of Autonomy

The concept of nursing ethics started in the nineteenth century. These ethics refer to character traits that a nurse should be able to demonstrate as a medical professional. These ethics help to ensure that nurses are providing a high-quality of care to the patients in which they care. The seven ethics of nursing are listed below: 

Accountability 

Accountability is one of the most important ethical principles in nursing. Each nurse must be responsible for their own choices and actions during patient care. Nurses who hold themselves accountable often provide higher-quality patient care. 

Justice 

Every nurse has a responsibility to make decisions that are based only on the facts and not on other factors such as the patient’s age, ethnicity, religion, socioeconomic status, or sexual orientation. To uphold this principle, nurses should act as fairly and objectively as possible, which can help patients feel more valued. Treating each patient fairly, regardless of their circumstances, is essential for helping patients accept and participate in their own health care. 

Nonmaleficence 

Nonmaleficence means to do no harm. Nurses have a critical responsibility to prevent further harm to all of their patients. Each nurse must take action to prevent harm.  

Autonomy  

Each nurse should be able to perform their duties using their own knowledge and professional judgment appropriate for each patient. Nurses must act only within their scope of practice while continuing to provide high-quality nursing care. Autonomy is an essential aspect of nursing practice and assists nurses in making appropriate decisions based on critical thinking.  

Beneficence 

Beneficence involves actions that are performed with the intention of benefiting other people. An example of this would be a nurse caring for a patient, placing the patient’s needs above their own, and maintaining the best interests of the patient at all times.  

Fidelity 

Fidelity involves keeping one’s word to the patients. Nurses should be honest and loyal to each patient. Without fidelity, trusting relationships cannot be formed, which ultimately leads to less positive patient outcomes and trust. 

Veracity 

Working in healthcare is challenging for many reasons, and in some cases, nurses must communicate unpleasant information to a patient. Veracity in nursing is the ethical principle of being completely open and honest with patients, even if the truth causes distress. Veracity helps patients become more autonomous in making decisions for their care based on all information. 

Autonomy of Nursing

Nursing autonomy involves the authority to make decisions and the freedom to act in accordance with one’s knowledge. This means having the competence, knowledge, and trust of other medical professionals to make decisions. It involves having the freedom to make judgments and choices and take actions appropriate for the care of the patient. 

While patients and the public value nurses, they are undervalued and underappreciated in healthcare. Nurses are not always regarded as authoritative individuals who can make critical decisions independently regarding patient care and safety. The value placed on nurses is an important aspect of autonomy. By encouraging collaboration with nursing staff, nursing autonomy can be increased. To develop the nursing profession within changing healthcare environments, an adequate understanding of nursing autonomy is needed to develop the nursing profession within changing healthcare environments. The main aspects of nursing should be considered when focusing on nursing roles. Autonomy and nursing generally have four key themes: 

• Having a holistic view 
• Knowing the patient 
• Confidence in your knowledge and expertise 
• Competency and courage to take charge in situations where you can be responsible 

Examples of Autonomy in Nursing 

There are many areas in which a nurse can demonstrate autonomy within healthcare. Whether within a hospital, specialty care services, or a doctor’s practice, you are an important part of the medical profession. Examples of autonomy in nursing include: 

• Administering pain medications  
• Giving vaccinations and taking blood for lab work 
• Monitoring vitals 
• Providing non-critical care 
• Referring patients to a more critical care facility when needed 
• Providing in-home care and on-site support to the elderly 
• Delegating CNAs to assist with ambulation 
• Assessing and dressing wounds 
• Knowing when to seek advice and assistance from other health professionals, such as a dietitian, provider, or fellow nurse 

Benefits of Autonomy in Nursing 

There are several benefits of autonomy in nursing. Autonomy provides improved patient outcomes and reduced stress on staff. Other benefits of autonomy in nursing include the following: 

Improvements in Patient Welfare 

The care of the patient is especially important. Hospitals and healthcare providers are expected to deliver high-quality patient care. Autonomy in nursing can improve patient welfare because it allows you to administer appropriate medical treatment without waiting for approval to do so. 

Enhances Job Satisfaction and Performance 

Autonomy in the workplace can increase your job satisfaction performance and reduce stress. It provides you with empowerment to take on the roles and responsibilities for which you have been trained. It also provides other medical professionals with the time to address other patients for which you may not have the experience. You can provide the necessary day-to-day support without the need for approval. Providing autonomy can lead to greater satisfaction in your career and ultimately greater performance in your role. 

Encourages Effective Communication  

Effective communication between medical professionals can lead to greater autonomy. With greater nurse-physician communication, your patients can receive the care they need in a quicker manner. The patient’s physician can be assured that they will be contacted by you if a critical issue arises, and they can place trust in you that the best judgment and treatment will be provided. Autonomy can often help you facilitate relationships with your patients, which leads you to a better understanding of their situation. In turn, you can better advocate for your patients’ needs and provide better care. 

Improving Autonomy in Nursing 

The goal of each nurse should be to strive to improve autonomy in an effort to provide the most effective care to each patient. Without autonomy in nursing, the professional growth of the nurse and care for the patients can be vastly affected. The following are some ways to improve your autonomy in nursing: 

Grow your knowledge 

As a nurse, you are expected to learn and apply your knowledge by demonstrating your abilities to perform new practices. Advances in the medical field and technology are ongoing, so it is especially important to keep up with improvements and continue to grow your skills and knowledge. You can also seek a mentor to help you develop knowledge that you do not yet have. 

Communicate  

An effective workplace is often created when there is clear communication and collaboration of roles, responsibilities, and general expectations. Include yourself in groups that establish patient care policies and procedures. By including yourself in the decision-making processes and actively working with your team to collaborate on the best practices, a smooth work environment can be established for the benefit of all involved.  

Work independently 

Obtain courage in your knowledge and be proactive by asking for responsibility for patient care when able to do so. Start small and demonstrate your skills over time. By demonstrating that you are capable of working independently, you may be provided with greater job satisfaction and a happier work environment that is built on trust. Offer possible solutions to problems, build your nurse-patient relationships, and ensure that you can advocate for patients when needed. 

Consider the Impact of Autonomy on Your Career 

Autonomy plays an important role in each one’s career as a nurse. Many experiences, such as working in long-term care or serving in the role of a charge nurse help to shape these experiences.  

Delegation of other staff, monitoring resident’s health status, being familiar with what changes are critical, alerting providers of those changes, and administering medications in urgent circumstances are just a few of the responsibilities that can be provided to a long-term care nurse. Working as a charge nurse in long-term care can also contribute to one’s confidence in critical thinking skills and the ability to act quickly in an emergency.  

These can provide the nurse with increased job satisfaction and the feeling of being a valued and trusted part of the healthcare team. Every nurse should have the chance to experience that feeling and have autonomy in their nursing position.  

The Bottom Line

Nurses are medical professionals with vast amounts of knowledge and capacity who are capable of independently making important decisions regarding their patients and the care they receive. Instilling trust in nurses and allowing them to demonstrate competency is important and will allow nurses to feel more valued, providing greater job satisfaction and nurse retention.  

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