Nursing contributes to the health and welfare of society through the protection, promotion and restoration of health; the prevention of illness, and the alleviation of suffering in the care of individuals, families and communities.
In carrying out the above responsibilities, the nuring profession strives to safeguard the interest of society by ensuring that its practitioners abide by a code of professional conduct.
Every registered nurse has a moral obligation to adhere to the profession's code of conduct. It offers guidelines for professional behaviour and practice and can be used as a standard against which complaints of professional misconduct are considered. It complements the Nurses' Act and Regulations, 1985 (Part V Practice and Part VI on Disciplinary Proceedings).
DEFINITION OF TERMS
A Registered Nurse is a person who has undergone a formal course of nursing education and registered with the Malaysian Nursing Board.
1. PROFESSIONAL NURSING PRACTICE
This is defined as the accepted practice of a Registered Nurse.
1.1 Respect for patient
The nurse renders care to patient regardless of ethnic origin, nature of health problems, religious beliefs and social status.
The nurse maintains confidentiality of privileged information and uses discretion in sharing information within the scope of nursing practice.
The nurse works co-operatively with the patient and his family and respects their decisions about his care.
In the event that a patient refuses treatment, the nurse continues to provide the necessary support.
The nurse maintains informed consent in the provision of nursing care to all patients.
1.2 Standards Of Care
1.2.1 The nurse is expected to provide a good standard of nursing care in the following manner:
- conscientiously assesses the physical, psychosocial and spiritual needs of each patient.
- provides compassionate and competent nursing care to meet each patient's needs.
- intervenes appropriately and promptly to prevent complications.
- maintains accurate and proper documentation of care given to each patient.
- gives correct information and education to each patient according to the needs.
- evaluates each patient's response to treatment at regular intervals.
1.2.2 Each nurse is required to keep up with advances in nursing, medical and health practices to maintain competence in nursing knowledge and skills. The minimum continuing nursing education sessions attended by the nurse per year should not be less than 10 hours.
The nurse assumes responsibility and accountability for her own nursing judgements and actions.
When delegating work to a subordinate, the nurse remains accountable for the work done and appropriate supervision, guidance and support must be given to the subordinate. In delegating her duties the nurse should give the subordinate authority and responsibility to make decisions, however she will remain accountable for the outcome of the decisions made.
The nurse acts to promote and protect the interest of the patient when he is incapable of communicating his needs and protecting himself.
In an emergency situation where consent cannot be obtained, the nurse act in the best interest of the patient within her scope of training and competency.
The nurse works collaboratively and co-operatively with other members of the health care team. She does not hesitate to consult appropriate professional colleagues when needed.
2. NEGLECT OR DISREGARD OF PROFESSIONAL RESPONSIBILITIES
The professional practice described in (1) above, constitutes the duty of care that the nurse has towards her patient.
Negligence is the failure to discharge a duty to use reasonable care. "Reasonable care" refers to that care which would be exercised by a reasonably competent nurse.
However, as nurses practice in a variety of settings, it is recognised that there may be factors beyond the nurses' control, such as management policies and resource constraints, which affect the fulfilment of their moral obligations.
3. ABUSE OF PROFESSIONAL PRIVILEGES AND SKILLS
3.1 Dangerous drugs
The nurse in expected to abide by the Dangerous Drug Ordinance and Regulations.
She must not use drugs for her own or other people's addiction.
3.2 Sale of poisons
The nurse must not participate directly or indirectly in the sale of poisons.
3.3 Induced non-therapeutic abortion
The nurse must not participate directly or indirectly in induced non-therapeutic abortion.
3.4 Acting as a witness
The nurse must not be involved as a witness for patient (such as an unconscious or mentally incapacitated patient) or his relation to personal matters.
The nurse must not disclose information which she obtained confidence from or about a patient unless it is to other professionals concerned directly with the patient's care.
3.6 Undue influence
The nurse must not exert improper influence upon a patient to lend her money or to obtain gifts or to alter the patient's will in her favour.
3.7 Personal relationship between the nurse and the patient
The nurse must not be involved emotionally or sexually with a patient currently under her care.
4. CONDUCT DEROGATORY TO THE REPUTATION OF THE PROFESSION
The nurse is expected to conduct herself in a manner in keeping with the dignity of the profession.
4.1 Respect for people
The nurse must not verbally or physically abuse the patient while caring for him.
4.2 Personal Behaviour
4.2.1 The nurse must not be involved in the selling and buying of goods while on duty.
4.2.2 She must not indulge in the consumption of drugs or alcohol which may adversely affect her professional capability and image.
4.2.3 She must not commit dishonest acts such as soliciting funds from the patient, forgery, tempering of records, fraud, theft or any other offence involving dishonesty.
4.2.4 She must not commit indecent and violent behaviour.
4.3 Commercial undertaking
The nurse must not associate herself with commercial activities that may influence her care of the patient such as promoting the use of medical supplies and facilities.
4.4 Incompetence to practice
4.4.1 The nurse is expected to report to the appropriate authority, any colleague who exhibits unethical behaviour or who is incompetent to practise due to the influence of drug, alcohol, physical or mental in capacity.
4.4.2 In the practice of the nurse's delegated and/or extended functions, such as commencing intravenous therapy, giving of intravenous drugs, venepuncture, taking blood and suturing, the nurse must have undergone an approved course or education and certified as clinically competent by a recognised educational institution before undertaking such functions.
5. ADVERTISING, CANVASSING AND RELATED PROFESSIONAL OFFENCES
5.1 The nurse may disseminate information on health care and services provided that it is done in an ethical manner.
5.2 The nurse must not allow her name and professional status to be used in the advertisement of goods and services which may cause deception and biases in order to mislead the public.
5.3 The nurse must not use calling cards for the purpose of soliciting patients. (Refer to Lembaga Iklan Kementerian Kesihatan Malaysia for details on calling cards, signboard, name plates/door plates and availability of services).
6. DISCIPLINARY PROCEEDING
Should there be any written complaint on any nurse, a preliminary investigation will be conducted by the disciplinary committee of the respective organisation and may be referred to the Nursing Board Malaysia for further action.
Nursing Board Malaysia is the regulatory body responsible for the standard of nursing and expect all registered nurses to practice and conduct themselves within the realm provided by the code.
The code in kept open for review and any suggestions for improvement would be appreciated and should any nurse need clarification, she may refer to:
LEMBAGA JURURAWAT MALAYSIA
ARAS 3, BLOK E1, PARCEL E
PUSAT PENTADBIRAN PERSEKUTUAN