Provision 2
A nurse’s primary commitment is to the recipient(s) of nursing care, whether an individual, family, group, community, or population.
2.1 Primary Commitment to Recipients of Nursing Care
Within the context of nursing practice, the nurse prioritizes recipients of nursing care, placing them over institutions. Every clinical encounter and plan of care reflects the fundamental commitment of nursing to the inherent dignity, worth, unique attributes, and human rights of the patient. Nurses provide patients with opportunities to participate in assessing their capacity for, planning and implementing their plan of care, and deciding what supportive services are acceptable to them.
Nurses facilitate informed decision-making as members of the healthcare team. Informed decision-making involves attending to language needs, other accommodations, and the disclosure of all options, including interventions not available at an institution or organization. Nurses have honest discussions providing information within their scope of practice in a nondirective manner about treatment options. Addressing patient interests requires recognition of the patient’s values, preferences, and commitments within their family and other important relationships. When the patient’s wishes are in conflict with those of others, nurses help to resolve the conflict and advocate for additional resources as needed. Where conflict persists, the nurse’s commitment remains to the patient. There are instances when patients seek treatment that is within the standard of care, but institutions or organizations have limited treatment options. Nurses act to preserve life and promote health as determined by the patient’s values. Nurses appropriately escalate concerns when needed, such as in states where laws prohibit treatment for persons who are pregnant, undocumented, uninsured, gender diverse, or otherwise disenfranchised, marginalized, or socially stigmatized.