Unit 1 Introduction to nursing

Introduction
• Fundamental of nursing is a basic subject designed
for freshmen students to develop basic professional
nursing knowledge and skill which is comprehensive
in scope and complete in its coverage.
• This subject will not only introduce students to the
basic concepts, process, skill and technique of
nursing practices but also provide them with a firm
foundation for more advanced areas of nursing
study.
• The fundamentals of nursing are the basic principles
on which nursing is founded. These fundamentals
include patient assessment, communication, and
intervention. It is essential for nurses to start with
these fundamentals when pursuing their education
to ensure quality and patient-centered care.
Nurse and nursing
• The word “nurse” is derived from latin word Nutricius
which means nourish, foster and protect from illness.
• The word nursing is originated from the latin “nutrire”
which means “to nourish”.
• Nurse
N:Nobility knowledge
U:usefulness and understanding
R:responsibilty
S:simplicity, sympathy
E:efficiency
Definition of nurse
• "A nurse is a person who has completed a
program of basic nursing education and is
qualified and authorized in his/her country to
provide responsible and competent
professional services for the promotion of
health, prevention of illness, care of the sick
and rehabilitation of the disabled.“-ICN
(International Council of Nursing)
Definition of nurse
• "A nurse is a person educated and licensed in the
practice of nursing; one who is concerned with the
diagnosis and treatment of human responses to
actual or potential health problems." -American
Nurses Association (ANA)
• According to Florence Nightingale, “The nurse is the
caretaker of sick and wounded person in the hospital
in a clean environment and provide comfort by a
trained nurse”
Definition of nursing

• "Nursing is an art and science based on knowledge,

skill and attitude, aimed at assisting the individual,
the family and community in health and illness, to
maintain heath, to prevent illness, to alleviate
physical, biological and psychological pain, to avoid
complication and to fulfill self-reliance in meeting
daily health needs." –WHO(World Health
Organizations)
• "Nursing is the care which puts a person in the best
possible condition for nature to restore or preserve
health, to prevent or to care disease or injury."-
Florence Nightingale
• "Nursing is the protection, promotion, and
optimization of health and abilities; prevention of
illness and injury; alleviation of suffering through the
diagnosis and treatment of human responses; and
advocacy in health care for individuals, families,
communities, and populations." -American Nurses
Association
Qualities of a good nurse

• A profession, not just a job, is nursing. It is therefore

incredibly idealistic and expected. To be a good nurse
and provide professional services to the individual,
family, and community, a person must possess a
variety of attributes. As a result, a nurse needs to
possess a few traits that set them apart as caregivers.
• These characteristics include:
• Intelligent
Intelligent refers to mental aptitude. To be a good nurse,
one must possess the capacity for perception, learning,
understanding, and knowledge. Nurses should be capable
of making difficult decisions and administering the right
medical Care to patients in the absence of doctors.
• Honest
In order to properly care for patients and maintain
positive relationships with them, their families, and other
team members, honesty is crucial. Despite the difficulty, a
nurse must learn to accept her errors. It will aid her in
developing into an honorable professional. Nurse should be
fair on what she does in order to maintain professionalism.
• Discipline
Being organized is an absolute for a nurse so it is
necessary to keep track of everything and be on time
and follows rules and regulations of the institution.
• Tactful
A great nurse can think quickly and address
problems as they arise or before they arise. for
example: administering oxygen and maintain
position to the patient complaining shortness of
breath
• Healthy
Everything a person encounters with will
be influenced by their bodily, mental, and
spiritual health. A nurse does not appear
pleasant, confident, or enthusiastic if she is
not in good physical and mental condition.
Being a nurse, have to work long days that will
sometimes have little or no breaks. So, nurse
must have outstanding physical and mental
health .
• Courageous

A nurse is required to collaborate with diverse types

of staff in numerous challenging circumstances.
Therefore, nurses must have courage because they
are in charge of patients' lives and deaths.
• Creative
A great nurse understands the importance of
responding promptly to emergencies and sudden
incidences and is prepared for all sorts of surprises
with a composed mind and a calm attitude.
• Good personality and professionalism:
Nurses need to be professional in their approach towards
their work. While performing nursing services whether it
may be dealing with patients or responding patient’s queries,
administering medications, recording patient’s data, all need
to be done in the most skilled and ethical manner.
• Friendly and helpful:
Without making any assumptions or being judgmental
on the basis of appearance, gender, socioeconomic
background, nurses need to focus on patient’s illness, injury
and help them from overcoming their discomfort.
Additionally, providing friendly environment, quick response
helps to fulfill their expectations from care giver.
• Communication skill:
An outstanding nurse have strong communicating
and listening abilities. Interactions helps to assess patients
condition more clearly as well as understand their need.
Good communication skill helps to move forward for
following directions towards health improvement and able
to explain patient and patient’s family about the
treatment process without any problem.
• Emotional stability:
In the health sector, a nurse sees many traumatic
situations, suffering and death. A great nurse need to
allow herself/himself to be more flexible with every
situations without allowing stress to cause personal harm.
• Empathy:

Empathetic nurses better understand their

patients' needs, putting the patients at ease to discuss
their problems and concerns. Studies demonstrate how
empathy improves patient’s satisfaction, treatment
compliance, and clinical outcomes. Patients are more
likely to follow their treatment plan and practice self-
care when they feel heard and understoo d.
• Respect:
There are many ways you can promote dignity
and respect in nursing. For example, including the
patient in the decision-making about their care,
addressing the patient in the way they prefer and
respecting their personal space.
 Roles and responsibilities of nurse in
hospital and out of hospital
• Being a nurse, she or he provides comfort,
understanding and sureness at times when
patients are experiencing challenges .Nurse
have to carry out different tasks in specific
period of time effectively. There are various
roles and responsibilities of nurse in hospital
setting which need to be fulfilled in a
professional manner.
• Health caregiver :
Nurse have a goal to deliver care for the betterment of patient who
has been facing health problems. Nurse being a health caregiver,
possesses(acquire, carry) the physical, psychosocial, developmental,
cultural, and spiritual levels.
In community setting, care giver may focus on preventive and
promotive care like health teaching on communicable diseases, early
detection of possible health risk, prevention and cure of viral diseases as
well foster community people for seeking professional help at the time
of severe illness.
Health caregiver have a responsibility in curing disease of the
patient. During treatment phase, she have to assess physical health by
measuring blood pressure, respiration, oxygen level and maintain
comfortable position, administer pain medicine, solve problem of
patient’s health issues by consulting with doctors if needed, nursing
care(oral care, back care, skin care, feeding, assisting while mobilization).
• Teacher/ Educator :

As a teacher, the nurse helps clients learn about their

health and health care procedures they need to perform to
restore or maintain their health. A nurse need to teach
patient about lifestyle modifications(avoid high fat food,
junk foods, alcohol, smoking, caffeinated beverage, timely
rest and sleep), activities of daily living(exercise,
meditation, walking) in order to prevent them from severe
illness.
• Client advocate:
Patient’s advocacy is the cornerstone of nursing
practice. Being a patient’s advocate, nurse is
protecting client’s right. Nurse serve as a link
between patients and health care team, advocating
for necessary interventions, timely care and the
overall well-being of their patients. Nurses empower
patients by providing them with information,
encouraging shared decision making, promoting
autonomy in their health care journey.
• Advisor:
The nurse gives advice to client and family
members for health maintenance and other
health related information.
• Counsellor:
The nurse helps a client to recognize and cope
with stressful psychological, social problems, to
develop improved interpersonal relationships, and to
promote personal growth. It involves providing
emotional, psychological and intellectual and
psychological support.
• Facilitator:

The nurse facilitates

health promotion for clients and
families and also arrange placement in
extended care facilities as available by
health education and many more.
Change agent:

Nurse have an important role as change agent

when she finds the way of treatment or any
present clinical care is not helping a client return
to health. She needs to be updated with new
health care system and is responsible for
continually dealing with the change of health care
system. Change should be planned carefully and
implemented in a deliberate way to facilitate the
client’s progress.
• Leader:

Being a leader, nurse has a role at different levels:

individual client, family, group of clients, colleagues and
community. A leader accomplish specific goal and
influence other to work together as well. A nurse leader
should be an exemplary figure and should act as mentor
to her subordinates.
• Manager:
The nurse manages the nursing care of
individuals, families, and communities. A nurse
manager requires knowledge about organizational
structure and dynamics, authority and accountability,
leadership, delegation, supervision and evaluation.
Nursing managers work with the multidisciplinary
health care team to measure the effectiveness of the
case management plan and to monitor outcomes.
Each agency or unit specifies the role of the nurse
case manager.
• Researcher:

Nurse is responsible for patient’s health so being a nurse

she/he has an important part to care and treat patient continuously.
Nurse must inspect and evaluate the improvement of client .For
this, nurse searches the problem and further expand the scope of
nursing practice that helps to solve clinical nursing problems and
issues. Therefore, nurse as researcher gives clear vision to client’s
disease condition, his progress as well as early detection regarding
signs/symptoms of patient is facing and expectation of wellness.
Therefore, research helps to follow evidence based nursing practice.
• Evaluator:
By evaluating patient’s health condition nurse knows
whether the goal has been achieved or not. If not
fulfilled completely, then new setup or plan could be
obtained with proper nursing interventions.
• Problem solver:
Nurse is the person who could solve the client’s
heath problem through various ways for e.g. nurse
assist in changing position of bedridden patient and
provide back care who is at the risk of bedsore, this
solved the problem of patient’s discomfort .
• Rehabilitator:

In order to obtain optimum level of

physical, mental and social wellbeing, nurses
play a role as being a rehabilitator.
History of nursing
History of nursing: International/National:
• Knowledge of profession’s history increases
the nurse’s awareness and promotes an
understanding of the social and intellectual
origins.

• Traditionally in the world history, diseases was

believed to be caused by evil spirits within the
body. The body had to undergo unpleasant
experiences to get rid of these evil spirits.
• People thought that diseases was caused by
theory failure to satisfy the goal or was
punishment of their sin.
• Previously, the social group who used to give
care to sick people, aged people and children
were women, holy person.
• In Nepal also, traditionally care used to be
provided by women in the family. Some social
group like Ghubaju, Jhakri, Priest, Sudeni and
janne manche have also been involved in care
of people.
• Nursing is the oldest profession in the world.
• Around 3000 BC, the Egyptian health care system was the
first to maintain medical records and was the first to
classify medication and develop plans to maintain first to
classify medication and develop plan to maintain people’s
health.
• In the ancient Rome, during the early Christian era,
deaconesses were selected by the church to provide care
for the sick. Deaconesses had some education and were
selected by church bishops to visit and care for the sick in
their home. They were considered as first visiting nurse
who provided expert home nursing care.
• During the period from 1500 AD -1700 AD, growing
interest in science and technology led to advances in
medicine and public health. At the time, the rich paid for
the sick to be cared for at home, while the poor were
cared for free.
• Modern nursing begin in the 19th century from Germany and
Britain. Two influential people in the field of nursing were
Elizabeth Fry and Florence Nightingale.

• In 1800’s care was provided to the injured victims of work. In

1853, Florence Nightingale, founder of modern nursing give
care to the injured army men.

• She developed preventive and promotive health care with the

help of epidemiological studies, monitoring of care, keeping of
data, recording and scientific analysis regarding and scientific
analysis regarding care and improvement in patients health
condition.
• In 1873 AD, the first real nursing school established called in
USA i.e. Pittsburgh Infirmary.
• In 1981 AD, Clara Barton founded the organization American
• In 1886 AD, the first regular training school in India
was established in Bombay with the fund provided by
the governor general under the rule of Britain.
• In 1897 AD, the first American Nursing Journal was
published with the effort of Nightingale.
• In 1899 AD, Australian Trained Nurses Association
was founded in New South Wales.

• World war I (1914 AD-1918 AD) marked the first

emergency training for nurses.
• In 1876 AD- 1955 AD, The army School of Nursing
was established and Annie W. Goodrich wrote the
curriculum.
• Florence Nightingale’s birthday (May12) was declared as the
official nursing day in Japan.
• World War II (1939AD- 1945 AD), marked for the second time
that men as well as women were recruited into nursing.
• In 1985 AD, the first nurse training institute was established in
Japan, a pioneering work of Linda Richards. n late 19th century,
nursing professionalized rapidly. Women who had served as
nurse during the civil war realized the importance of formal
education and played crucial role in establishing the first nurse
training school.
• In 20th century, there was huge fluctuation in the supply and
demand of nurses. Nursing school opened up in Europe,
Australia, Canada and united state. Having trained nurses to care
for the sick, hospital became a necessity and many women
entered schools and became nurse with the intent of acquiring
and holding skills for survival.
• The founder of
Modern Nursing:
• Florence Nightingale (May 12,
1820 – August 13, 1910)
• She was English reformer,
statistician and the founder of
modern nursing.
• Nightingale came to prominence
while serving as a manager and
trainer of nurses during the
Crimean War , in which she
organized care for wounded
soldiers at Constantinople.
• She became Icon of Victorian
culture by giving nursing
favorable reputation.
• The Lady with the Lamp:
• She is also known as “The
Lady with the Lamp”
• In 1860, she laid the
foundation of professional
nursing with the
establishment of her
nursing school at St.
Thomas’ Hospital London.
It was the first secular
nursing school in the world.
• Annual International
Nurses Day is celebrated on
her birthday (May 12)
 History of nursing in Nepal before 1972 AD
(2029B.S.)
• In the beginning , girls were not sent to nursing school
due to socio-economic factors. Until 1960’s AD
teachers had to contact with parents for their girls to
allow nursing training. Widow, unmarried were the
criteria at that time and need to remain unmarried
until the training period.
• With the change of time, care was extended from the
home to institution with establishment of Bir hospital
in 1947 BS (1890 AD), but nursing practice was non-
existent till 1987B.S .Medicines and dressings were
done by doctors or compounders.
• On 1985 B.S, four Nepalese girls(Ms Vidyabati Kansakar,
Ms Radha Devi Malakar, Ms Dharma Devi Kansakar,Ms
Bishnu Devi Mali) were sent to India for training then
posted at Bir hospital for their service.
• As a result, the country's focus for maternity care and
child care while nursing was established.
• The civil medical school was created in 1998 BS (1941
AD) to teach compounders and dressers at Bir Hospital.
Nine Nepali ladies, Ms. Sabitri, Ms. Kamali, Ms. Asta
Kumari, Ms. Shree Prabha, Ms. Prabha Laxmi, Ms. Ratna
Devi, Ms. Dhana Laxmi, Ms. Purna Laxmi, and Miss
Chanchala Devi, participated in this program. These
women were transferred to India for a midwifery course
once their training was complete. They were assigned to
Bir Hospital in 2002 B.S.
• In 2009 BS, Miss Rukmani Charan Shrestha and Ms.
Uma Devi Das were sent to India to learn registered
nursing.
• The first nursing school opened its doors in
Surendrabhawan, Lalitpur, Nepal in 2013 BS. Later, it
was moved to the Mahabauddha Chhetrapati and Bir
Hospital complex. It has been known as the "Mother
Institute of Nursing Education of the Country" since
2042 and is located in Maharajgunj, Kathmandu. WHO
oversaw and operated the school.
• There were fifteen students in the nursing school's
inaugural intake; eleven of them graduated
successfully, and four dropped out before 1960 A.D.
(2018 BS), at which point they were still under SLC until
2018 BS.
• In 1969,entry after SLC is made eligible to maintain
standard of nursing education which was under Nepal
Government and it was of 3 and half year course.
• The "United Mission to Nepal" created a second
nursing school in 1959AD, independent from the HMG
school of Nursing in Mahabaudha, in Nirbhawan.
• In 1972 all medical education came under TU,IOM.The
UMN Nir Bhawan nursing campus split apart from the
Maharajgunj nursing campus in 1991, however it
remains directly under the control of the IOM Dean's
office. Lalitpur Nursing Campus is now the official
name of the new campus. Academically, it adheres to
TU and IOM laws and regulations, although United
Mission to Nepal provided financial support. on came
under TU, IOM.
The following different nursing schools and ANM
training facilities were founded and later
upgraded to PCL nursing.
• At 2013 BS Surendrabhawan School of Nursing.
• At 2016 BS School of nursing in Nirbhawan
Sanepa.
• ANM Training Center Bharatpur with assistance
from USAID in 2019 BS (1962).
• The ANM Training Center Biratnagar opened in
2023 BS (1966), and in 2038 BS
• ANM Training Center Nepalgunj in 2026 BS
upgraded in PCL nursing in 2041 B.S..
• PCL nursing in Pokhara in 2041 (1986)
 History of nursing after 1972 AD (2029BS)
in Nepal
• 1973: Princess Prekshya Rajya Laxmi Devi Shah entered in Nursing
• 1977 AD:BN (Bachelor in Nursing) started in nursing
• 1986 March 14(2042 B.S, Chaitra 1): Nursing campus moved to
Maharajgunj named as Maharajgunj Nursing Campus)
• 1986 as all certificate nursing programme enrolled 10% male
students , in1990 AD Male students was stopped, last group of
male students graduated in 1992 AD
• 1988 (2045), all Bachelor Nursing curricula were reorganized
and a two track B.N programme was initiated with
specialization in Community Nursing and hospital nursing.
• 1989 AD: Bir Nursing Campus established 2046 B.S
• 1993 AD : Entrance exam started
• 1995 AD: MN (Master in Nursing ) started at
Maharajgunj Nursing Campus with specialization
women health and development. Then adult nursing
was established in 2000 and pediatric in 2001 and
from 2017 Psychiatric was initiated.
• 1996 AD: Basic Bachelor of Science in
Nursing(Bsc.Nursing) was initiated by BP Koirala
Institute of Health Science (BPKIHS)
• 2012 AD: PHD programme started in TU/IOM
• 2012 AD: Nursing License exam started.
• 2013 AD : PHD in Nursing programme started
• 2015 (2072 B.S): PCL Programme was phased out
Ethical and legal aspect of nursing
ETHICS
• A theory or system of moral values based on the ideas
of right and wrong
 It governs our relationship with others
 A code of ethics provides standard and values for a
profession; individuals must integrate the values of the
profession with their own values.
 Ethics is the study of good conduct, character and
motives. It is concerned with determining what is good
or valuable for all people.
• Johnstone (2008) defined nursing ethics as “ the
examination of all kinds of ethical and bioethical
issues fro the perspective of nursing theory and
practice, which in turn rest on the agreed core
concept of nursing, namely: person, culture, care,
health, healing, environment and nursing itself.”
Goals of Ethics:
• Ethics seeks to uphold what is morally correct and
appropriate.
• Care for the person, family, community, and
society is the aim of ethics.
• Respecting the client's right to self-determination
and treating them with respect.
Ethical Principles
• Ethical principles are defined as basis for
nurse’s decisions on consideration of
consequences and of universal moral
principles when making clinical judgments.
• Ethical principles :two major classifications
are
 Dentology-focus on certain duties, responsibilities
 Utilitarian-focus on consequences
Purposes of Ethical Principles:
Establish common ground between nurse,
patient , family, other health care
professionals and society to discuss ethical
questions and take ethical decisions.
Provide a scenario so that moral problems can
be evaluated
Permit people to take a consistent position on
specific or related issues.
• Primary and Basic ethical principles are:
 Autonomy: Respect for an individual's right to self-
determination
 Nonmaleficence: The obligation to do or cause no
harm to another
 Beneficence: The duty to do good to others and to
maintain a balance between benefits and harms
 Justice: the equitable distribution of potential
benefits and tasks determining the order in which
client should be care for
Autonomy
• It refers to the right to make one’s own decision.
• Nurses are required to follow the principles of
autonomy by respecting a client’s right to make
decision even those choices seem not to be in the
client’s best interest.
• Respect for people means treating with consideration.
• Clients must provide an informed consent before tests
and procedures are carry out. The nurse will support
freedom of choices, independences and self
determination.
• Clients are given opportunities to make decision and
informed consent is the basic for health care decision
 Non-malificence
• The duty to do no harm
• Harm can mean deliberate harm, risk of harm
and unintentional harm.
• In nursing, intentional is always unacceptable
at risk of harm during nursing intervention
that is intended to be helpful.
• Client may react adversely to a medication
sometimes; the degree to which a risk is
morally permissible can be a conflict
 Beneficience
• Nurses should always do for goodness and
work to prevent harm.
• All health care providers should keep this
principles in mind when making health care
decision.
• Nurses are obligated to do for goodness that is
to implement.
• Health care professionals aspire to help
people achieve a better life through an
improved state of health
Justice
• Justice or fairness relates to the distribution of
services and resources.
• As the health care becomes increasingly
scarcer, justices seeks to allocate resources
fairly and treat equals equally.
• Dilemmas arise when resources are scarce and
insufficient to meet the needs of everyone.
How do we decide fairly who gets what is
situation.
• Secondary ethical principles:
 Veracity: The obligation to tell the truth
 Fidelity: The duty to do what one has promised.
 Confidentiality : It refers to the duty to protect privileged
information and to share entrusted information responsibly.

Veracity:
 It refers to telling the truth.
 It is based on mutual trust and respect for human dignity.
 Professionals have a duty to be honest and trustworthy in
dealings with people.
 There are 3 levels of veracity
 fully disclosing information
 With-holding information
 Giving false information
Fidelity:
 It means to be faithful to agreement and
responsibility one has undertaken. A nurse has
responsibility to clients, employers,
government and society and to themselves.
 Circumstances often affects which
responsibility take precedence at a particular
time
Confidentiality:
 Confidentiality means that information entrusted to
professionals in line of duty should not be reveled to
others.
 The patient must feel that he or she and the nurse
are in a relationship of trust and confidence for such
information to be share.
 For example, with a child, it’s acceptable and
necessary to share information with the child’s
parents ,but an adult patient must request that even
family members not know all of the details of his or
her case
Code of ethics
• INTRODUCTION
The international council of nurses (ICN) is
a federation of more than 130 National Nurses
Associations (NNAs), representing the more
than 16 million nurses worldwide.
 Founded in 1899, ICN is the world's first and
widest reaching international organization for
the health professionals.
Nepal became a member of ICN in 1969.
• It works with the specialized agencies of the United
nations system, particularly with the world health
organization and the World Bank, are important for
nurses everywhere.

• Operated by nurses and leading nurses

internationally ,
• ICN works to ensure quality nursing care for all, and
a competent and satisfied nursing workforce.

• As a member of ICN, nurses can attend

international conference, take part in the ICN
exchange programs.
Vision

• ICN represents the voice of nurses around the world.

Advancement and sustain the nursing profession and
its contribution to peoples health and public policy.
Mission
• To represent nursing worldwide, advancing
the profession and influencing health policy to
enhance the health of individuals, population,
and societies by advocating the contribution
and image of nurses worldwide at all levels,
advancing the nursing profession and
influencing health, social, economic and
education policy.
Goal
• To advance the socio-economic status of
nurses and the profession of nursing
worldwide.

• To bring nursing together world-wide.

• To influence global and domestic health

policy.
Objectives
• To influence nursing, health and social policy,
professional and socio-economic standards world-wide.
• To assist National Nurses' Associations (NNAs) to
improve the standards of nursing and the competence
of nurses.
• To promote the development of strong National Nurses
Associations.
• To represent nurses and nursing internationally.
• To establish, receive and manage funds and trusts
which contribute to the advancement of nursing and of
ICN.
Function
• To establish categories of membership and
determine their rights and obligations and dues.
• To provide policy direction to fulfill the
objectives of ICN
• To act upon recommendations of the board of
directors relating to admission and readmission
of members associations into ICN.
• To receive and consider information from the
board regarding ICN activities since the last CNR.
• To receive nominees for the board and to elect the
board.
• To act upon proposed amendments to the ICN
constitution.
• To act upon recommendations of the board of
directors for the amount of NNA dues.
• To act through mail or any written communication
on ICN business that requires immediate attention
by the CNR between meetings.
• To act upon recommendations for the dissolution
of the ICN.
Preamble

✓ There are four fundamental responsibilities of nurses

• To prevent illness,
• To restore health,
• To alleviate suffering.
• To promote health,

✓ The need for nursing is universal.

✓ Inherent in nursing is respect for human rights, including cultural rights, the right to
life and choices, dignity and to be treated with respect.
✓ Nursing care is respectful of and unrestricted by consideration of age, color, and
Creed, culture, disability, or illness, gender, sexual orientation, race or social status.
Funding of icn
• ICN derives around 80% of its funding from
membership dues, which is used to cover core
responsibilities along with administrative and
governance functions.
• It also relies on grants or donations from
other foundations, corporates and
governments to cover programming, special
projects, conferences and congresses, awards
and fellowships.
• Foundations
• The International Council of Nurses
Foundation (ICNF).
• Florence Nightingale International Foundation
(FNIF)
Elements of code
• Nurses and people
• Nurses and practice
• Nurses and the profession
• Nurses and co-workers
• Nurses and society
 Nurses and people
• They must respect the values, customs and
spiritual belief of an individual.
• They hold in personal information and use
judgment in sharing information.
• The basic responsibility of a nurse is to provide
required nursing care.
• They share the responsibility with the society
for initiating and supporting action to meet the
health need of the people.
 Nurses and practice
• The nurse carries personal responsibility and
accountability for nursing practice and for
competence by continual learning.
• The nurse at all times maintains standards of
personal conduct which reflect well on the
profession and enhance its image and public
confidence.
 Nurses and the profession
• A nurse has a major role in determining and
implementing acceptable standards of clinical
nursing practice, management, research and
education.
• She also participates and organizes in creating
and maintaining safe, equitable social and
economic working conditions in nursing.
 Nurses and coworkers
• A nurse sustains a cooperative relationship
with co-workers in nursing and other fields.
• Also nurse takes appropriate action to
safeguard the individual when one's care is
endangered by a co-worker or any other
person.
 Nurses and society
• Participate and share responsibily with other
citizens and other health professionals.
• Recognize and perform duties of citizens.
GOVERNENCE
• BOARD OF DIRECTORS:
The ICN Board of Directors consists of 12 members.

• 1 President :
✓ Dr. Pamela Cipriano
3 Vice Presidents :
✓ Lisa Little (1st Vice-President - Canadian
Nurses Association)
✓ Dr.Karen Bjøro (2nd Vice-President-
Norwegian Nurses Organization)

✓ Dr.Lian-Hua Huang (3rd Vice-President -

Taiwan Nurses Association)
• 8 members elected on the basis of ICN voting areas.

✓ Fatima Al Rifai (Emirates Nursing Association)

✓ Nora Eloisa Barahona De Peňate (National Nurses
Association of El Salvador)
✓ Nanthaphan Chinlumprasert (Nurses Association of
Thailand)
✓ José Luis Cobos Serrano (General Council of Nursing of
Spain)
✓ Andre Gitembagara (Rwanda Nurses and Midwives Union)
✓ Yves Mengal (National Federation of Nurses of Belgium)
✓ Megumi Teshima (Japanese Nursing Association)
✓ Alisi Talatoka Vudiniabola (Fiji Nursing Association)
 MAJOR ETHCAL ISSUES IN NURSING PRACTICE

Workplaces Violence:
Major challenges nurses face is violent
behavior while on the duty from patients, visitors,
coworkes.
 Death and related issues:
It creates a great legal issues with death
include advance directives, euthanasia, do not
resuscitate(DNR) orders, certificate of death and
more.
Patient privacy and confidentiality:
The protection of private patient information is
one of the most important ethical and legal issues in
the field of healthcare because sometimes it is
necessary to share with others for the benefits of
patient which put nurses in dilemma.
 Transmission of diseases :
The right of healthcare providers to protect
themselves from communicable diseases, whether
by direct or indirect contact with an infected patient.
Ethical and legal question arise when a patient’s
health history is not provided to the medical staff.
 Relationships:
Sexual relationship between medical
practitioners and patient or between medical
staffs are strictly forbidden at a healthcare facility.
Only professional relationship should be
maintained.
 Police case:
It is an ethical dilemma to deal with police
cases like whether to start care first or to waits for
the police to come. It occurs specially in
emergency ward mainly road traffic accidents.
 Ethical and legal responsibilities of nurse

 Need to be aware of legal law

❖Needs to fulfill all written formats of the patients.
❖Ethics needs to be maintained or adopted.
❖Polices cases is to be handled carefully, by informing
police and concerning doctors.
❖Written consent is to be taken for admission,
operation, discharge and special procedures.
❖Written reports and records need to be
maintained clearly and safely, accurately,
timely.
❖Drug and medicines should not be given with
out physician orders.
❖Registration and license should be taken before
starting job/ practices.
❖Never venture for malpractices.
❖Patient’s confidentiality should be maintained.
❖Vulnerable goods of the patient should be kept
safely and give handover in written form.