Copyright 2013 by UAE Nursing and Midwifery Council. All rights reserved The UAE NMC considers this document its intellectual property and has the exclusive rights to decide to publish the work in its entirety or parts thereof as well as choose the form of publication. Reproduction of any part is limited to non-commercial purposes. Therefore, any reproduction, modification (including translation), storage in retrieval system or retransmission, in any form or by any means (electronic, mechanical or otherwise), for reasons other than the above, is not allowed without prior written permission. Written permission to reproduce the document or any part thereof (beyond this limited permission) must be obtained from the UAE NMC. If such permission is given, it will also be subject to acknowledging in relevant details the author's name and interest in the material. Inquiries to be directed to: UAE Nursing and Midwifery Council Email: info@uaenmc.gov.ae Website: www.uaenmc.gov.ae
CONTENTS PREFACE...3 ACKNOWLEDGEMENTS...4 LIST OF ABBREVIATIONS...5 INTRODUCTION...6 CODE OF CONDUCT DOMAINS...7 DOMAIN ONE : DOMAIN TWO: DOMAIN THREE: DOMAIN FOUR: Nursing and midwifery in relation to people....8 Nursing and midwifery in relation to practice...9 Nursing and midwifery in relation to profession.11 Nursing and midwifery in relation to colleagues. 12 GLOSSARY....13 REFERENCES...15 UAE Nursing and Midwifery Council 2
PREFACE The UAE Nursing and Midwifery Council (UAE NMC) was established in 2009 to regulate the nursing and midwifery professions, promote and advance nursing and midwifery services and protect and promote the health and safety of the public based on the highest standards. (UAE NMC establishment Cabinet Decree number 10, 2009). This code of conduct sets the foundation for the practice, education and regulation of nursing and midwifery in the UAE. It is a concrete example of the UAE NMC commitment to fulfill its purpose and to systematically advance the nursing and midwifery professions across the UAE. This document was developed by the Scientific Committee for Nursing and Midwifery Practice. The members of this committee represent all major healthcare stakeholders in the UAE. These Include, but are not limited to: UAE NMC, Health Authority of Abu Dhabi, Abu Dhabi Health Services Company, Ministry of Health, Dubai Healthcare City Authority, Dubai Health Authority, University of Sharjah, Higher Colleges of Technology, Medical Services Corps of the UAE Armed Forces, Dubai Police, Institutes of Nursing, the private sector and the Emirates Nursing Association. This code of conduct document was developed with input from national and international experts. In developing this document, several resources - from ICN, ICM, MOH, HAAD, DHA and DHCA were utilized including, but not limited to, professional codes of conduct and codes of ethics, scopes of practice and practice standards. UAE Nursing and Midwifery Council 3
ACKNOWLEDGEMENTS The Council sincerely appreciates the concerted efforts of all involved in making this publication possible expressing special gratitude to: HRH Princess Haya Bint Al Hussein, President of the UAE NMC, wife of His Highness Sheikh Mohammed Bin Rashid Al Maktoum, Vice-President and Prime Minister of the UAE and Ruler of Dubai; for her infinite guidance and support for the nursing and midwifery professions. H.E. UAE Minister of Health. The UAE NMC board members. All members of the Scientific Committee for Nursing and Midwifery Practice, for their excellent work in developing this document. The International Council of Nurses and the International Confederation of Midwives for the ongoing support throughout the development of this document. All nursing and midwifery colleagues and the UAE NMC staff who participated in the development, validation and revision of this document. All individuals representing different healthcare institutions for the contribution in one way or another to the development of this document. UAE Nursing and Midwifery Council 4
LIST OF ABBREVIATIONS DHA DHCA ENA HAAD HCT ICM ICN ION MOH UAE UOS UAE NMC Dubai Health Authority Dubai Healthcare City Authority Emirates Nursing Association Health Authority of Abu Dhabi Higher Colleges of Technology International Confederation of Midwives International Council of Nurses Institutes of Nursing Ministry of Health United Arab Emirates University of Sharjah United Arab Emirates Nursing and Midwifery Council UAE Nursing and Midwifery Council 5
INTRODUCTION The code of conduct for nurses and midwives serves as the foundation for nurses/midwives ethical practice. It defines the ethical responsibility inherent in the nurse and midwife s role and supports the need to protect and promote the interest of the client, family, community and society in the UAE. A Code of Conduct outlines standards of professional and personal behavior as based on ethical principles. A code of conduct is the nursing and midwifery profession s non-negotiable ethical standard. It is a statement of the ethical obligations and duties of every person in the profession in all roles and settings. It is an expression of the profession s interpretation of its commitment to society and thus it informs the public what they can expect from nurses and midwives. It will inform employers, other health care professionals and the public about the ethical commitments and responsibilities of nurses and midwives. The primary goal of this code of conduct is to protect the public. This code intends to: Establish the ethical standard of the nursing and midwifery professions. Establish a framework for professional behavior and responsibilities. Guide and strengthen nurses and midwives ethical behavior in practice. Provide a benchmark for nurses and midwives to use for self-evaluation. Promote high standard of practice. Provide a benchmark for the regulator to evaluate if ethical commitments and standards of practice are not being met. The code of conduct standards can be used by nurses and midwives, employers, regulators, educators and researchers. Regulatory bodies shall use the code to align licensing and relicensing requirements accordingly; educational institutions shall include the ethical content in curricula to guide students in their practice and character formation; and, nurses and midwives shall use it as a guide for carrying out nursing and midwifery responsibilities in a manner consistent with quality nursing and midwifery care and the ethical obligations of the professions. UAE Nursing and Midwifery Council 6
CODE OF CONDUCT DOMAINS The code of conduct for nurses and midwives is written as a framework consisting of four major domains (see Figure 1): Domain one: Domain two: Domain three: Domain four: Relation to People Relation to Practice Relation to Profession Relation to Colleagues UAE Nursing and Midwifery Council 7
A breach of the code of conduct may constitute either professional misconduct or unprofessional conduct that may result in disciplinary consequences. The exact process by which reports of nurses and midwives unethical, illegal or deficient practices are dealt with is beyond the scope of this document. Failure to comply with this code may jeopardize the eligibility to practice into question and endanger the nurse and midwife s registration. This document should be read in conjunction with: The professional code of conduct for nurses and midwives (in own institution) The client's bill of rights (or equivalent document in own institution) The UAE NMC Scope of Practice Laws and regulations that guide practice DOMAIN ONE: NURSING AND MIDWIFERY IN RELATION TO PEOPLE The nurses and midwives primary responsibility is to demonstrate professional values and conduct themselves ethically in how they interact with individuals/groups receiving care. This domain addresses the nurses and midwives role with regards to respect, integrity and partnership. 1.1 Respect Promote an environment where the human rights, values, culture, customs and spiritual beliefs of the individuals/groups are respected. Respect and maintain the individual rights for dignity and privacy. Intervene and if needed, report when others do not respect the dignity and privacy of those receiving care. Not discriminate individuals/groups on the basis of race, nationality, religion, gender, socio-economic level, health status or any other attribute. Respect the individual rights for self-determination and decision making including the right to seek a second opinion. Prohibit disclosure of information gained without the consent of the original source of information. UAE Nursing and Midwifery Council 8
1.2 Integrity Provide impartial, honest, timely and accurate information in a culturally appropriate manner on which to base consent for care and related treatment. Refrain from taking advantage of a privileged position for personal gain. Maintain professional boundaries and not enter into inappropriate relationships with clients. Act as an advocate for individuals/groups particularly when the health and wellbeing of those in their care is being compromised by the decision making or actions of others. Respect the client s right for self-determination and informed consent to nursing and/or medical care. 1.3 Partnership The nurse and midwife shall, in partnership with other healthcare professionals: Support the rights of client/family/community/society to accurate, current and meaningful information about healthcare. Encourage the contributions of client/family/community/society in decision making concerning healthcare and wellbeing. Share with client/family/community/society pertinent knowledge, skills and resources to self-care. DOMAIN TWO: NURSING AND MIDWIFERY IN RELATION TO PRACTICE The nurse and midwife carry personal responsibility and accountability for professional practice and for maintaining competence thereby using rational judgment in delivering evidence-based care. 2.1 Responsibility and Accountability Assume responsibility for identifying own developmental needs and engage in continuing education through lifelong learning to ensure continued competence in professional practice. UAE Nursing and Midwifery Council 9
Be accountable for the provision of evidence-based care. Be responsible for ensuring own practice conforms to the standards developed and agreed by the profession. Demonstrate accountability, responsibility for own professional judgment, actions, outcomes of care and continued competence in accordance with the UAE NMC Scope of Practice and the UAE laws and regulations. Use judgment regarding individual competence when accepting and delegating responsibility. Maintain own fitness to practice (e.g. valid license) and withdraw from practice, after consulting with employer, if not fit to provide safe competent care. Maintain a standard of personal health such that the ability to provide care is not compromised. Identify and disclose situations where there may be conflict of interest in professional role and resolve them in the best interest of the client. 2.2 Competence Be responsible to maintain competence required for current practice. Seek appropriate guidance when encountering situations beyond the Scope of Practice and the limits of one s own competence. 2.3 Safety and Quality Ensure a safe environment by identifying actual and potential risks and take timely action to meet national legislation and workplace health and safety principles. Practice in accordance with standards that promote a culture of safety and quality services. Report unethical, illegal or impaired practices. Acknowledge and protect the health of the community against threats to health and safety. UAE Nursing and Midwifery Council 10
2.4 Confidentiality Refrain from accessing information that is not necessary for the provision of health care or that is not directly related to their role. Hold in confidence client information, and disclose only pertinent information to healthcare professionals involved in providing care. Inform the client that medical information might, under certain circumstances, be shared with other members of the healthcare team. Not abuse access to information for purposes inconsistent to their professional obligations. DOMAIN THREE: NURSING AND MIDWIFERY IN RELATION TO THE PROFESSION The nurse and midwife assume the major role in determining and applying acceptable standards of clinical practice, management, research and education thereby upholding the image of nursing and midwifery professions. 3.1 Continuous Professional Development Be responsible for upholding own professional knowledge and skills to ensure licensure to practice. Engage in life-long learning to maintain and improve professional knowledge, skills and attitudes. 3.2 Image of Nursing and Midwifery Uphold and promote the positive image of the nursing and midwifery professions to maintain and enhance public confidence. This applies to conduct in the real world and online social networking. Identify and report situations that harm the image of nursing and midwifery professions. Participate in creating a positive practice environment. UAE Nursing and Midwifery Council 11
DOMAIN FOUR: NURSING AND MIDWIFERY IN RELATION TO COLLEAGUES The nurse and midwife sustain a collaborative and respectful relationship with colleagues and other healthcare professionals. 4.1 Teamwork/Collaboration Work collaboratively within multidisciplinary teams. Respect the skills, expertise and contribution of nursing and midwifery colleagues and other health care providers to maximize benefits to those receiving care. Take appropriate action to support and guide colleagues to advance ethical conduct. UAE Nursing and Midwifery Council 12
GLOSSARY Client A person or persons who engage(s) or is/are served by the nurse or midwife with advice and/or care; client may refer to an individual, family, community or society; its use acknowledges that a significant part of nursing and midwifery services are delivered to people who are well or ill and proactively engaging in healthcare. In this document, the terms client and patient are used interchangeably. Conduct The way a person acts, especially from the standpoint of morality and ethics. Confidentiality According to The American Heritage Stedman's Medical Dictionary (2002), confidentiality is defined as the ethical principle or legal right that a physician or other health professional will hold secret all information relating to a patient, unless the patient gives consent permitting disclosure. Ethics A set of principles that people use to decide what is right and what is wrong (Macmillan Dictionary, 2012). Fitness to practice All the qualities and capabilities of an individual relevant to his or her capacity to practice as a nurse or midwife, including but not limited to, freedom from any cognitive, physical, psychological or emotional condition and dependence on alcohol or drugs that impairs his or her ability to practice nursing or midwifery (CNA, 2008, p. 25). Image An opinion that people have about someone or something which may not be true one (Macmillan Dictionary, 2012). People Refers in this document to the patients/clients, their families and the community UAE Nursing and Midwifery Council 13
Positive practice environment It is a work environment that supports performance excellence and optimal social and psychological well-being of staff through: sustaining absence of work pressure, job security and workplace safety; encouraging team work, leadership and autonomy; supporting a motivated, empowered and autonomous staff while recognizing and rewarding their achievements. Healthy work environment has an evident positive impact on nurse satisfaction and retention; in addition to the strong influence it has on patient safety, patient satisfaction and quality care. Privacy According to Mosby's Medical Dictionary (2009), privacy is defined as a culturally specific concept defining the degree of one's personal responsibility to others in regulating behavior that is regarded as intrusive. Some privacy-regulating mechanisms are physical barriers (closed doors or drawn curtains, such as around a hospital bed) and interpersonal types (lowered voices or cessation of smoking). Professional boundaries Professional boundaries are the borders that mark the edges between a professional, therapeutic relationship and a non-professional or personal relationship between a nurse or midwife and a person in their care. When nurses or midwives cross a boundary, they are generally behaving in an unprofessional manner and misusing the power in the relationship. Professional misconduct Refers to the wrong, bad or erroneous conduct of a nurse and midwife outside of the framework of practice (Australian Nursing and Midwifery Council, 2008). Regulatory bodies Regulatory bodies at the time of printing this document include MOH, HAAD, DHA and DHCA. Unprofessional conduct Refers to conduct that is contrary to the accepted standards of the profession (e.g. breaching the principles of asepsis, violating confidentiality) (Australian Nursing & Midwifery Council, 2008, p.2). UAE Nursing and Midwifery Council 14
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Image. (2012). In Macmillan Dictionary. Retrieved from http://www.macmillandictionary.com/dictionary/british/image International Confederation of Midwives. (2011). Midwives code of ethics. Retrieved from http://www.internationalmidwives.org/portals/5/2011/international%20code%20of%20 Ethics%20for%20Midwives%20jt%202011rev.pdf International Council of Nurses. (2012). The ICN code of ethics for nurses. Retrieved from http://www.icn.ch/images/stories/documents/about/icncode_english.pdf Lachman, V.D. (2009). Practical use of the nursing code of ethics: Part I. MEDSURG Nursing. Vol. 18/No.1, 55-57. Retrieved from http://nursingworld.org/documentvault/ethics/practical-use-of-the-nursing-code-of- Ethics-Part-I.aspx Ministry of Health, UAE. (2001). Professional code of conduct for nurses. Abu Dhabi: Author. New Zealand College of Midwives. (2011). Code of conduct. Retrieved from http://www.midwife.org.nz/index.cfm/1,179,530,0,html/code-of-ethics Nursing Council of New Zealand. (2009). Code of conduct for nurses. Retrieved from http://www.nursingcouncil.org.nz/download/48/code-of-conduct-nov09.pdf Privacy. (2009). In Mosby's Medical Dictionary. Retrieved from http://medicaldictionary.thefreedictionary.com/privacy The Scottish Government. (2005). Framework for nursing in general practice. Retrieved from http://www.scotland.gov.uk/publications/2004/09/19966/43293 UK Nursing and Midwifery Council. (2012). Regulation in practice topics. Retrieved from http://www.nmc-uk.org/nurses-and-midwives/advice-bytopic/a/advice/confidentiality/ UK Nursing and Midwifery Council. (2010). Social networking sites. Retrieved from http://www.nmc-uk.org/nurses-and-midwives/advice-by-topic/a/advice/socialnetworking-sites/ UK Nursing and Midwifery Council. (2008). The code: Standards of conduct, performance and ethics for nurses and midwives. Retrieved from http://www.nmck.org/publications/standards/the-code/introduction/ UK Nursing and Midwifery Council. (2012). The code: Standards of conduct, performance and ethics for nurses and midwives. Retrieved from http://www.nmc-uk.org/nurses-andmidwives/standards-and-guidance1/the-code/the-code-in-full/ Yeo, M. & Moorhouse, A. (Eds). (1998). Concepts and cases in nursing ethics (2 nd ed.). Canada: Broadview Press Ltd. UAE Nursing and Midwifery Council 16