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Provision 1

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The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person.

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Interpretive Statement 1.1

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"respect for human dignity." - Nurses consider the needs and respect the values of each person in every professional relationship and setting.

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Interpretive Statement 1.2

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"relationships with patients." - Nurses establish relationships of trust and provide nursing services according to need, setting aside any bias or prejudice.

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Interpretive Statement 1.3

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"nature of health." - Nurses respect the dignity and rights of all human beings regardless of the factors contributing to the health status.

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Interpretive Statement 1.4

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"the right to self-determination." - Patients have the moral and legal right to determine what will be done with their own person.

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Interpretive Statement 1.5

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"relationships with colleagues and others." - Nurses maintain professional, respectful and caring relationships with colleagues and are committed to fair treatment, integrity-preserving compromise, and the resolution of conflicts.

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Provision 2

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The nurse's primary commitment is to the patient, whether an individual, family, group, community, or population.

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Interpretive Statement 2.1

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"primacy of the patient's interests." - The nurse's primary commitment is to the recipients of nursing and healthcare services—the patient— whether individuals, families, groups, communities, or populations.

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Interpretive Statement 2.2

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"conflict of interest for nurses." - Nurses must examine the conflicts arising between their own personal and professional values and the values and interests of others including those who are also responsible for patient care and healthcare decisions, and perhaps patients themselves.

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Interpretive Statement 2.3

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"collaboration." - Nurses should actively foster collaborative planning to provide high quality, patient-specific health care.

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Interpretive Statement 2.4

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"professional boundaries." - Nurse-patient relationships and collegial relationships have as their foundation the protection, promotion, and restoration of health and the alleviation of suffering.

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Provision 3

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The nurse promotes, advocates for, and protects the rights, health, and safety of the patient.

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Interpretive Statement 3.1

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"protection of the rights of privacy and confidentiality." - The nurse advocates for an environment that provides sufficient physical privacy, including privacy for discussions of a personal nature. The nurse has a duty to maintain confidentiality of all patient information, both personal and clinical in the work setting and off duty in all venues.

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Interpretive Statement 3.2

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"protection of human participants in research." - Individuals have the right to choose whether or not to participate in research as a human subject.

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Interpretive Statement 3.3

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"performance standards and review mechanisms." - Nurse educators must ensure that basic competence and commitment to professional practice exist prior to entry into practice. Nurse managers and executives similarly ensure that nurses have the required knowledge, skills, and dispositions to perform clinical responsibilities.

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Interpretive Statement 3.4

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"professional responsibility in promoting a culture of safety." - Nurses must establish processes where mistakes or errors are revealed and nurses are personally accountable, and any system factors that led to error are rectified.

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Interpretive Statement 3.5

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"protection of patient health and safety by acting on questionable practice." - Nurses must be alert to and take appropriate action in instances of incompetent, unethical, illegal, or impaired practice or any actions that place the rights or best interests of the patient in jeopardy.

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Interpretive Statement 3.6

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"patient protection and impaired practice." - Nurses must protect the patient, the public, and the profession from potential harm when a colleague's practice appears to be impaired.

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Provision 4

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The nurse has authority, accountability, and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to promote health and to provide optimal care.

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Interpretive Statement 4.1

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"authority, accountability, and responsibility." - Nurses bear primary responsibility for the nursing care that their patients and clients receive and are accountable for their own practice.

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Interpretive Statement 4.2

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"accountability for nursing judgments, decisions, and actions." - Nurses are accountable for judgments made and actions taken in the course of nursing practice, irrespective of other providers' directives or institutional policies.

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Interpretive Statement 4.3

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"responsibility for nursing judgments, decisions, and actions." - Nurses accept or reject specific role demands and assignments based on their education, knowledge, competence, experience, and assessment of patient safety.

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Interpretive Statement 4.4

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"assignment and delegation of nursing activities or tasks." - Nurses must make reasonable effort to assess individual competence when delegating selected nursing activities.

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Provision 5

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The nurse owes the same duties to self as to others, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence, and continue personal and professional growth.

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Interpretive Statement 5.1

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"duty to self and others." - Moral respect accords moral worth and dignity to all human beings regardless of their personal attributes or life situation. Such respect extends to oneself as well: the same duties that we owe to others we owe to ourselves.

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Interpretive Statement 5.2

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"promotion of personal health, safety, and well-being." - Nurses should model the same health maintenance and health promotion measures that they teach and research, seek health care when needed, and avoid taking unnecessary risks to health or safety in the course of their customary professional and personal activities.

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Interpretive Statement 5.3

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"preservation of wholeness of character." - Nurses have both personal and professional identities that are integrated and embrace the values of the profession, merging them with personal values.

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Interpretive Statement 5.4

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"preservation of integrity." - When a particular decision or action is morally objectionable to the nurse, whether intrinsically so or because it may jeopardize a specific patient, family, community or population, or when it may jeopardize nursing practice, the nurse is justified in refusing to participate on moral grounds.

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Interpretive Statement 5.5

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"maintenance of competence and continuation of personal growth." - Nurses must maintain competence and strive for excellence in their nursing practice, whatever the role or setting. Continual professional growth, particularly in knowledge and skill, requires a commitment to lifelong learning. Such learning includes continuing education.

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Interpretive Statement 5.6

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"the continuation of personal growth." - Nurses are encouraged to read broadly, continue life-long learning, engage in personal study, seek financial security, participate in a wide range of social advocacy and civic activities, and to pursue leisure and recreational activities that are enriching.

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Provision 6

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The nurse, through individual and collective effort, establishes, maintains, and improves the ethical environment of the work setting and conditions of employment that are conductive to safe, quality health care.

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Interpretive Statement 6.1

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"the environment and moral virtue and value." - Nurses must create, maintain, and contribute to morally good environments that enable nurses to be virtuous. Such a moral milieu fosters mutual respect, communication, transparency, moral equality, kindness, prudence, generosity, dignity, and caring.

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Interpretive Statement 6.2

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"the environment and ethical obligation." - Nurses, in all roles, must create, maintain, and contribute to practice environments that support nurses and others in the fulfillment of their ethical obligations. Environmental factors include all that contribute to working conditions.

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Interpretive Statement 6.3

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"responsibility for the healthcare environment." - The workplace must be a morally good environment to ensure ongoing quality patient care and professional satisfaction for nurses and to minimize and address moral distress, strain, and dissonance.

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Provision 7

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The nurse, in all roles and settings, advances the profession through research and scholarly inquiry, professional standards development, and the generation of both nursing and health policy.

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Interpretive Statement 7.1

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"contributions through research and scholarly inquiry." - All nurses must participate in the advancement of the profession through knowledge development, evaluation, dissemination, and application to practice. Knowledge development relies chiefly, though not exclusively, upon research and scholarly inquiry.

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Interpretive Statement 7.2

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"contributions through developing, maintaining, and implementing professional practice standards." - Nurse executives establish, maintain, and promote conditions of employment that enable nurses to practice according to accepted standards. Nurse educators promote and maintain optimal standards of education and practice in every setting where learning activities occur. These standards must also reflect nursing's responsibility to society.

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Interpretive Statement 7.3

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"contributions though nursing and health policy development." - Nurses ought to participate in civic activities related to healthcare through local, regional, state, national, or global initiatives.

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Provision 8

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The nurse collaborates with other health professionals and the public to protect human rights, promote health diplomacy, and reduce health disparities.

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Interpretive Statement 8.1

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"health is a universal right." - The nursing profession holds that health is a universal human right and that the need for nursing is universal. The right to health is a fundamental right to a universal minimum standard of health to which all individuals are entitled.

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Interpretive Statement 8.2

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"collaboration for health, human rights, and health diplomacy." - Nurses must lead collaborative partnerships to develop effective public health policies, legislation, projects, and programs that promote health, prevent illness, restore health, and alleviate suffering.

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Interpretive Statement 8.3

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"obligation to advance health and human rights and reduce disparities." - Nurses collaborate to address barriers to health, such as poverty, homelessness, unsafe living conditions, abuse and violence, and lack of access by engaging in open discussion, education, public debate and legislative action. - Nurses must recognize that health care is provided to culturally diverse populations in this country and across the globe. Nurses collaborate to create a moral milieu that is culturally sensitive to diverse cultural values and practices.

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Interpretive Statement 8.4

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"collaboration for human rights in complex, extreme, or extraordinary practice settings." - Nurses must be mindful of competing moral claims (that is, conflicting values or obligations) and bring attention to human rights violations in all settings and contexts. - Human trafficking; the global feminization of poverty, rape, and abuse as an instrument of war; the oppression or exploitation of migrant workers; and all such human rights violations are of grave concern to nurses.

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Provision 9

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The profession of nursing, collectively through its professional organizations, must articulate nursing values, maintain integrity of the profession, and integrate principles of social injustice into nursing and health policy.

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Interpretive Statement 9.1

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"articulation and assertion of values." - The profession's organizations communicate to the public the values that nursing considers central to the promotion or restoration of health, prevention of illness, and alleviation of suffering.

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Interpretive Statement 9.2

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"integrity of the profession." - Nursing must continually emphasize the values of justice, fairness, and caring within the national and global nursing communities, in order to promote health in all sectors of the population. A fundamental responsibility is to promote awareness of and adherence to the codes of ethics for nurses.

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Interpretive Statement 9.3

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"integrating social justice." - Nurses must be vigilant and take action to influence legislators, governmental agencies, non-governmental organizations, and international bodies in all related health affairs for addressing the social determinants of health.

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Interpretive Statement 9.4

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"social justice in nursing and health policy." - The nursing profession must actively participate in solidarity with the global nursing community and health organizations to represent the collective voice of U.S. nurses around the globe.

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