Modern yet timeless Code guides decision-making wherever nursing practice occurs.

For 23 consecutive years, the American public has ranked nurses as the most honest and ethical professionals, ahead of military officers, pharmacists, and grade-school teachers. What sets nurses apart from these other highly regarded individuals?

In my view, this has to do with our ethical standards reflected in the Code of Ethics for Nurses (Code), which also defines the relational aspect of our profession—between nurses and patients, among nurses, and between nurses and other providers, the public, and society.

We hold true that every human has inherent value, even if we disagree with their beliefs or actions. We don’t judge. We spend time listening to our patients, understanding their wishes, and co-creating plans with them, based on their preferences, the evidence, and our clinical judgement. We don’t tell patients what to do without understanding who they are. This is why we’re the most trusted professionals. Patients trust us to speak on their behalf and advocate for them regardless.

That’s why the Code has been the cornerstone of ethical nursing practice for more than 60 years. This vital resource helps us reflect on challenging or unclear circumstances, advocate for our patients, advance our profession, and achieve positive changes in our work environments.

The revised Code, published on January 29, provides guidance and instruction to effectively carry out our ethical responsibilities while also contemplating the dynamic and evolving nature of the profession (Codeofethics.ana.org). Who nurses are and what we do are fundamentally the same, but much has changed since 2015 (when the Code was last revised). For example, technologies—already deeply embedded across healthcare—have proliferated and continue changing. The Code calls on nurses to contribute to the development and adoption of new technologies, keeping in mind how these advances will affect not only nursing practice and how we gain knowledge, but also the dignity of care recipients.

The Code also rightly labels racism as a public health crisis and states that for meaningful change to occur, nurses and the nursing profession must recognize racism as the “central force” at the core of health disparities, inequities, and injustice. It calls on nurses to recognize that racism impacts both direct care and institutional policies that perpetuate systemic racism.

A new 10th provision recognizes nurses’ contributions to the global community. On the surface, this may seem far removed from the challenges and concerns of a direct care nurse. However, the Code acknowledges that nursing’s role in advancing human and environmental health, well-being, and flourishing extends beyond borders. For example, the Code can be our North Star in finding ways to reduce healthcare’s environmental footprint, and in considering staffing solutions that don’t deplete nursing workforces in other countries.

The Code grounds nurses in our practice in all settings and circumstances. It guides us in our interactions with recipients of care, among colleagues, and in our daily life and work. Crucially, the Code also stresses that nurses’ well-being directly benefits those we serve.

A series of peer-reviewed online courses and Ethics InBox columns in this journal will explore how each Code provision relates to current nursing practice in all settings today.

The Code doesn’t provide specific answers to ethical dilemmas. However, all nurses can use it as an indispensable guide to reflect on our ethical obligations, make informed decisions, and take prudent actions in the complex situations that characterize nursing practice in the 21st century. This ethical standard ensures that patients and the public can count on nurses now and for decades to come.

Jennifer Mensik Kennedy PhD, MBA, RN, NEA-BC, FAAN
President, American Nurses Association

American Nurse Journal. 2025; 20(2). Doi: 10.51256/ANJ022529