Provision 2
A nurse’s primary commitment is to the recipient(s) of nursing care, whether an individual, family, group, community, or population.
2.2 Conflicts of Interest and Conflicts of Commitment in Nursing
Nurses may experience conflicts of interest and/or conflicts in their commitments during the practice of nursing in any setting. Nurses examine and identify their actual or perceived conflicts of interest and follow professional guidance and other policies in the workplace.
Conflicts of interest and commitment are closely related and require careful examination. Both may exist whether a nurse is actually influenced by the competing interest, or there is only the appearance of a conflict. Conflicts of interest occur when a nurse’s personal, business, entrepreneurial, commercial, political, academic, research, or financial interests interfere with the nurse’s professional responsibilities or a patient’s interests. Nurses who bill for services, have budgetary responsibilities, or receive bonuses, sanctions, endorsements, or other incentives tied to financial targets should be especially aware of the potential for conflicts of interest. Dual agency in nursing occurs when nurses are required to fulfill their professional healthcare duties while also adhering to the mandates of another authority, such as a correctional facility or military organization. This dual responsibility can create a conflict when nurses have to balance their commitment to patient care with the directives of the governing institution.
Conflicts of commitment occur when the focus of the nurse’s time and attention is not on the recipients of care. This inattention interferes with the nurse’s ability or willingness to perform the full range of responsibilities associated with their position. Potential or perceived conflicts, regardless of type, should be managed in ways that protect both the nurse and the recipient of care.
Nurses disclose when a conflict interferes with their ability to provide nursing care, to prioritize the patient’s values, or to meet the standard of care. When there is a conflict, nurses can request a second opinion from a qualified or expert nurse, refer care to a nurse colleague, escalate to those in leadership roles, consult with professional organizations, or seek a safe transfer of care.