Legal / Ethical

Fidelity in Nursing: Nursing Code of Ethics Breakdown

  • The origin of fidelity stems from the nineteenth century.  
  • Identify the importance of fidelity in nursing and understand examples of fidelity.  
  • Observe the consequences of nursing in fidelity.  

Katy Luggar-Schmit


January 24, 2024
Simmons University

As a nurse, you must keep your promises to patients while providing high-quality nursing care. Fidelity means keeping your word, and fidelity in nursing is one of the ethical principles nurses must uphold. Let’s discuss fidelity in nursing and its importance in nursing care. 

Origin of Fidelity 

The concept of nursing ethics started in the nineteenth century. These ethics refer to character traits a nurse should demonstrate as a medical professional that helps ensure nurses provide a high quality of care to the patients they care for.

Nurses must be honest, faithful, and true to their professional promises and responsibilities by providing safe and competent care. Fidelity can often result in dilemmas due to commitments being made to patients that may not be in their best interests.  

Nursing ethics promotes fair treatment toward all individuals and denounces discrimination for any reason. Caregivers create positive and trusting relationships with patients by providing appropriate care. Life and death decisions are a part of nursing, and ethics are fundamental to the integrity of the nursing profession. Nurses should support each other to fulfill their ethical obligations to patients and the public.  

Ethics serve as the heart of professionalism and promote the considerations of values in prioritizing and justifying actions conducted by health professionals, researchers, and policymakers. These values impact the well-being of patients, families, and their communities.

Privacy and patient confidentiality are two of the most significant legal and healthcare issues and must be addressed appropriately. Fidelity is one of the seven ethics and involves “keeping one’s promise” and giving competent and professional care to all patients.

There are seven ethics of nursing, and they are as follows: 

  1. Accountability: accountability is one of the most important ethical principles in nursing. Nurses must be responsible for their own choices and actions during patient care. Nurses who hold themselves accountable often provide higher-quality patient care. 
  2. Justice: every nurse has a responsibility to make care decisions that are based only on the facts, not on other factors like the patient’s age, ethnicity, religion, socioeconomic status, or sexual orientation. To uphold these principles, nurses should act as fairly and objectively as possible, which can help patients feel more valued. Treating each patient reasonably, regardless of their circumstances, is essential for helping patients accept and participate in their health care. 
  3. Nonmaleficence: this means not to harm. Nurses have a critical responsibility to prevent further harm to all patients. Please make sure you are safe and take action to avoid damage. This is essential to provide safe, effective patient care for all individuals.  
  4. Autonomy: nurses should be able to perform their duties using their knowledge and professional judgment to provide high-quality care. They must act within their scope of practice yet continue to provide high-quality nursing care. Autonomy is essential to all aspects of nursing practice, helping nurses make appropriate decisions based on critical thinking. This principle goes hand in hand with accountability. 
  5. Beneficence: actions that are performed to benefit other people. An example is a nurse caring for a patient and putting their needs above their own in the patient’s best interests. 
  6. Fidelity: indicates keeping your word to your patients. Nurses should be honest and loyal to each patient. Without fidelity, more trusting relationships cannot be formed, leading to less positive patient outcomes and trust. 
  7. 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, making decisions for their care based on all relevant and factual information. 

Importance of Fidelity in Nursing  

Fidelity in nursing can be demonstrated by being loyal and supportive. Fidelity means nurses must be faithful to professional promises such as high-quality care. It also means promoting patient autonomy and showing respect for a patient’s decisions regarding their healthcare.

Fidelity in nursing is important due to the following: 

  • Strengthens the nurse-patient relationship 
  • Promotes patients’ autonomy 
  • Promotes favorable patient outcomes 
  • Demonstrates respect for patients 
  • Increases patient satisfaction 
  • Inspires others to demonstrate the same behaviors 


Loyalty and support are also important in demonstrating fidelity in nursing practice. In application, this refers to nurses keeping their promises and providing safe and effective patient care. If a patient is promised medication for pain, follow the plan and obtain medication promptly. If a patient is told they will receive a follow-up call after they are discharged home, ensure the phone call is completed.

The following are examples of fidelity in nursing: 

  • Fulfilling nursing commitments  
  • Protecting patient confidentiality 
  • Being faithful to the nursing profession 
  • Promoting patient autonomy 
  • Putting the patient first 

Consequences Due to Lack of Fidelity in Nursing 

  • Lack of professional credibility 
  • Loss of job or revoked nursing license 
  • Patient safety risks 
  • Patients lose confidence in their care. 
  • Harmful effects to healthcare facility’s reputation 

The Bottom Line

Fidelity is a common source of conflict in nursing. Nurses often find themselves caught in the middle between what they believe is right, what the patient wants, what the healthcare team expects, and what is policy and law. It is essential nurses talk with their team members or supervisors if they believe their feelings could compromise patient care.  

Fidelity is an essential principle in nursing that requires nurses to keep their promises. Patients must be able to depend on the fidelity of nurses. Patients also need assurance that their rights will be respected under a nurse’s care.  

Nurses must always act first in the patient’s best interests and not their own. This will facilitate a positive and trusting nurse-patient relationship and result in favorable health outcomes for the patient.  

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