Code of conduct

for nurses
Foreword
The Nursing and Midwifery Board of Australia (NMBA) undertakes functions as set by the Health Practitioner
Regulation National Law (the National Law), as in force in each state and territory. The NMBA regulates the
practice of nursing and midwifery in Australia, and one of its key roles is to protect the public. The NMBA does
this by developing standards, codes and guidelines that together establish the requirements for the professional
and safe practice of nurses and midwives in Australia.
In developing the Code of conduct for nurses, and consistent with its commitment to evidence-based structures,
systems and processes, the NMBA carried out a comprehensive review that was informed by research and by
the profession. The research included an international and national literature review of other codes and similar
publications, a comparative analysis of the predecessor code of conduct to other codes and an analysis of
notifications (complaints) made about the conduct and behaviour of nurses. Input was extensively sought in the
form of focus groups, workshops, an expert working group and other consultation strategies which included the
profession, the public and professional organisations.
The Code of conduct for nurses (the code) sets out the legal requirements, professional behaviour and conduct
expectations for nurses in all practice settings, in Australia. The code is written in recognition that nursing
practice is not restricted to the provision of direct clinical care. Nursing practice settings extend to working
in a non-clinical relationship with clients, working in management, leadership, governance, administration,
education, research, advisory, regulatory, policy development roles or other roles that impact on safe, effective
delivery of services in the profession and/or use of the nurse’s professional skills.
The code is supported by the NMBA Standards for practice and, with the other NMBA standards, codes and
guidelines, underpins the requirements and delivery of safe, kind and compassionate nursing practice.

Associate Professor Lynette Cusack RN

Chair, Nursing and Midwifery Board of Australia

1 Code of conduct for nurses Effective from 1 March 2018

Contents
Introduction 3
Domain: Practise legally
Principle 1: Legal compliance
1.1 Obligations 5
1.2 Lawful behaviour 5
1.3 Mandatory reporting 5
Domain: Practise safely, effectively and collaboratively
Principle 2: Person-centred practice
2.1 Nursing practice 6
2.2 Decision-making 6
2.3 Informed consent 7
2.4 Adverse events and open disclosure 7
Principle 3: Cultural practice and respectful relationships
3.1 Aboriginal and/or Torres Strait Islander peoples’ health 8
3.2 Culturally safe and respectful practice 8
3.3 Effective communication 8
3.4 Bullying and harassment 9
3.5 Confidentiality and privacy 9
3.6 End-of-life care 9
Domain: Act with professional integrity
Principle 4: Professional behaviour
4.1 Professional boundaries 10
4.2 Advertising and professional representation 10
4.3 Legal, insurance and other assessments 11
4.4 Conflicts of interest 11
4.5 Financial arrangements and gifts 11
Principle 5: Teaching, supervising and assessing
5.1 Teaching and supervising 12
5.2 Assessing colleagues and students 12
Principle 6: Research in health
6.1 Rights and responsibilities 13
Domain: Promote health and wellbeing
Principle 7: Health and wellbeing
7.1 Your and your colleagues’ health 14
7.2 Health advocacy 14
Glossary 15
Bibliography 17

2 Code of conduct for nurses Effective from 1 March 2018

Introduction
The Code of conduct for nurses sets out the legal requirements, professional behaviour and conduct expectations
for all nurses, in all practice settings, in Australia. It describes the principles of professional behaviour that
guide safe practice, and clearly outlines the conduct expected of nurses by their colleagues and the broader
community.
Individual nurses have their own personal beliefs and values. However, the code outlines specific standards
which all nurses are expected to adopt in their practice. The code also gives students of nursing an appreciation
of the conduct and behaviours expected of nurses. Nurses have a professional responsibility to understand and
abide by the code. In practice, nurses also have a duty to make the interests of people their first concern, and to
practise safely and effectively.
The code is consistent with the National Law. It includes seven principles of conduct, grouped into domains, each
with an explanatory value statement. Each value statement is accompanied by practical guidance to demonstrate
how to apply it in practice. Underpinning the code is the expectation that nurses will exercise their professional
judgement to deliver the best possible outcomes in practice.

This code applies to all nurses

The principles of the code apply to all types of nursing practice in all contexts. This includes any work where
a nurse uses nursing skills and knowledge, whether paid or unpaid, clinical or non-clinical. This includes
work in the areas of clinical care, clinical leadership, clinical governance responsibilities, education, research,
administration, management, advisory roles, regulation or policy development. The code also applies to all
settings where a nurse may engage in these activities, including face-to-face, publications, or via online or
electronic means.

Using the code of conduct

The code will be used:
• to support individual nurses in the delivery of safe practice and fulfilling their professional roles
• as a guide for the public and consumers of health services about the standard of conduct and behaviour they
should expect from nurses
• to help the NMBA protect the public, in setting and maintaining the standards set out in the code and to
ensure safe and effective nursing practice
• when evaluating the professional conduct of nurses. If professional conduct varies significantly from the
values outlined in the code, nurses should be prepared to explain and justify their decisions and actions.
Serious or repeated failure to abide by this code may have consequences for nurses’ registration and may be
considered as unsatisfactory professional performance, unprofessional conduct or professional misconduct1,
and
• as a resource for activities which aim to enhance the culture of professionalism in the Australian health
system. These include use, for example, in administration and policy development by health services and
other institutions; in nursing education, in management and for the orientation, induction and supervision of
nurses and students.
The code is not a substitute for requirements outlined in the National Law, other relevant legislation, or case
law. Where there is any actual or perceived conflict between the code and any law, the law takes precedence.
Nurses also need to understand and comply with all other NMBA standards, codes and guidelines.

As defined in the National Law, with the exception of NSW where the definitions of unsatisfactory professional conduct and
1

professional misconduct are defined in the Health Practitioner Regulation National Law (NSW)

3 Code of conduct for nurses Effective from 1 March 2018

Code of conduct for nurses: domains,
principles and values
These domains, principles and values set out legal requirements, professional behaviour and conduct
expectations for all nurses. The principles apply to all areas of practice, with an understanding that nurses will
exercise professional judgement in applying them, with the goal of delivering the best possible outcomes.
(To note: Person or people is used to refer to those individuals who have entered into a therapeutic and/or
professional relationship with a nurse. See the glossary for further detail).

Domain: Practise legally

1. Legal compliance
Nurses respect and adhere to their professional obligations under the National Law, and abide by relevant laws.

Domain: Practise safely, effectively and

collaboratively
2. Person-centred practice
Nurses provide safe, person-centred and evidence-based practice for the health and wellbeing of people and, in
partnership with the person, promote shared decision-making and care delivery between the person, nominated
partners, family, friends and health professionals.

3. Cultural practice and respectful relationships

Nurses engage with people as individuals in a culturally safe and respectful way, foster open and honest
professional relationships, and adhere to their obligations about privacy and confidentiality.

Domain: Act with professional integrity

4. Professional behaviour
Nurses embody integrity, honesty, respect and compassion.

5. Teaching, supervising and assessing

Nurses commit to teaching, supervising and assessing students and other nurses, in order to develop the
nursing workforce across all contexts of practice.

6. Research in health
Nurses recognise the vital role of research to inform quality healthcare and policy development, conduct
research ethically and support the decision-making of people who participate in research.

Domain: Promote health and wellbeing

7. Health and wellbeing
Nurses promote health and wellbeing for people and their families, colleagues, the broader community and
themselves and in a way that addresses health inequality.

4 Code of conduct for nurses Effective from 1 March 2018

Code of conduct for nurses
Domain: Practise legally

Principle 1: Legal compliance2

Value
Nurses respect and adhere to professional obligations under the National Law, and abide by relevant laws2.

1.1 Obligations
It is important that nurses are aware of their obligations under the National Law, including reporting
requirements and meeting registration standards. Nurses must:
a. abide by any reporting obligations under the National Law and other relevant legislation. Please refer to
sections 129, 130, 131 and 141 of the National Law and the NMBA Guidelines for mandatory notifications
b. inform the Australian Health Practitioner Regulation Agency (AHPRA) and their employer(s) if a legal or
regulatory entity has imposed restrictions on their practice, including limitations, conditions, undertakings,
suspension, cautions or reprimands, and recognise that a breach of any restriction would place the public at
risk and may constitute unprofessional conduct or professional misconduct
c. complete the required amount of CPD relevant to their context of practice. See the NMBA Registration
standard: Continuing professional development, Policy: Exemptions from continuing professional
development for nurses and midwives and Fact sheet: Continuing professional development for these
requirements
d. ensure their practice is appropriately covered by professional indemnity insurance (see the NMBA
Registration standard: Professional indemnity insurance arrangements and Fact sheet: Professional
indemnity insurance arrangements), and
e. inform AHPRA of charges, pleas and convictions relating to criminal offences (see the NMBA Registration
standard: Criminal history).

1.2 Lawful behaviour

Nurses practise honestly and ethically and should not engage in unlawful behaviour as it may affect their
practice and/or damage the reputation of the profession. Nurses must:
a. respect the nurse-person professional relationship by not taking possessions and/or property that belong to
the person and/or their family
b. comply with relevant poisons legislation, authorisation, local policy and own scope of practice, including to
safely use, administer, obtain, possess, prescribe, sell, supply and store medications and other therapeutic
products
c. not participate in unlawful behaviour and understand that unlawful behaviour may be viewed as
unprofessional conduct or professional misconduct and have implications for their registration, and
d. understand that making frivolous or vexatious complaints may be viewed as unprofessional conduct or
professional misconduct and have implications for their registration.

1.3 Mandatory reporting

Caring for those who are vulnerable brings legislative responsibilities for nurses, including the need to abide by
relevant mandatory reporting requirements, as they apply across individual states and territories. Nurses must:
a. abide by the relevant mandatory reporting legislation that is imposed to protect groups that are particularly
at risk, including reporting obligations about the aged, child abuse and neglect and remaining alert to the
newborn and infants who may be at risk, and
b. remain alert to other groups who may be vulnerable and at risk of physical harm and sexual exploitation and
act on welfare concerns where appropriate.

The code does not address in detail the full range of legal and ethical obligations that apply to nurses. Examples of legal
2

obligations include, but are not limited to, obligations arising in Acts and Regulations relating to privacy, the aged and
disabled, child protection, bullying, anti-discrimination and workplace health and safety issues. Nurses should ensure they
know all of their legal obligations relating to professional practice, and abide by them.

5 Code of conduct for nurses Effective from 1 March 2018

Domain: Practise safely, effectively and collaboratively

Principle 2: Person-centred practice

Value
Nurses provide safe, person-centred, evidence-based practice for the health and wellbeing of people and,
in partnership with the person, promote shared decision-making and care delivery between the person,
nominated partners, family, friends and health professionals.

2.1 Nursing practice

Nurses apply person-centred and evidence-based decision-making, and have a responsibility to ensure the
delivery of safe and quality care. Nurses must:
a. practise in accordance with the standards of the profession and broader health system (including the
NMBA standards, codes and guidelines, the Australian Commission on Safety and Quality in Health Care and
The Australian Aged Care Quality Agency Standards for residential aged care)
b. provide leadership to ensure the delivery of safe and quality care and understand their professional
responsibility to protect people, ensuring employees comply with their obligations, and
c. d
ocument and report concerns if they believe the practice environment is compromising the health and
safety of people receiving care.

2.2 Decision-making
Making decisions about healthcare is the shared responsibility of the person (who may wish to involve their
nominated partners, family and friends) the nurse and other health professionals. Nurses should create and
foster conditions that promote shared decision-making and collaborative practice. To support shared decision-
making, nurses must:
a. take a person-centred approach to managing a person’s care and concerns, supporting the person in a
manner consistent with that person’s values and preferences
b. advocate on behalf of the person where necessary, and recognise when substitute decision-makers are
needed (including legal guardians or holders of power of attorney)
c. support the right of people to seek second and/or subsequent opinions or the right to refuse treatment/care
d. recognise that care may be provided to the same person by different nurses, and by other members of the
healthcare team, at various times
e. recognise and work within their scope of practice which is determined by their education, training,
authorisation, competence, qualifications and experience, in accordance with local policy (see also the NMBA
Decision-making framework)
f. recognise when an activity is not within their scope of practice and refer people to another health practitioner
when this is in the best interests of the person receiving care
g. take reasonable steps to ensure any person to whom a nurse delegates, refers, or hands over care has the
qualifications, experience, knowledge, skills and scope of practice to provide the care needed (see also the
NMBA Decision-making framework), and
h. recognise that their context of practice can influence decision-making. This includes the type and location of
practice setting, the characteristics of the person receiving care, the focus of nursing activities, the degree to
which practice is autonomous and the resources available.

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2.3 Informed consent
Informed consent is a person’s voluntary agreement to healthcare, which is made with knowledge and
understanding of the potential benefits and risks involved. In supporting the right to informed consent, nurses
must:
a. support the provision of information to the person about their care in a way and/or in a language/dialect
they can understand, through the utilisation of translating and interpreting services, when necessary. This
includes information on examinations and investigations, as well as treatments
b. give the person adequate time to ask questions, make decisions and to refuse care, interventions,
investigations and treatments, and proceed in accordance with the person’s choice, considering local policy
c. act according to the person’s capacity for decision-making and consent, including when caring for children
and young people, based on their maturity and capacity to understand, and the nature of the proposed care
d. obtain informed consent or other valid authority before carrying out an examination or investigation, provide
treatment (this may not be possible in an emergency), or involving people in teaching or research, and
e. inform people of the benefit, as well as associated costs or risks, if referring the person for further
assessment, investigations or treatments, which they may want to clarify before proceeding.

2.4 Adverse events and open disclosure

When a person is harmed by healthcare (adverse events), nurses have responsibilities to be open and honest
in communicating with the person, to review what happened, and to report the event in a timely manner, and in
accordance with local policy. When something goes wrong, nurses must:
a. recognise and reflect on what happened and report the incident
b. act immediately to rectify the problem if possible, and intervene directly if it is needed to protect the person’s
safety. This responsibility includes escalating concerns if needed
c. abide by the principles of open disclosure and non-punitive approaches to incident management
d. identify the most appropriate healthcare team member to provide an apology and an explanation to the
person, as promptly and completely as possible, that supports open disclosure principles
e. listen to the person, acknowledge any distress they experienced and provide support. In some cases it may
be advisable to refer the person to another nurse or health professional
f. ensure people have access to information about how to make a complaint, and that in doing so, not allow a
complaint or notification to negatively affect the care they provide, and
g. seek advice from their employer, AHPRA, their professional indemnity insurer, or other relevant bodies, if
they are unsure about their obligations.
See also the Australian Commission on Safety and Quality in Health Care’s publication:
Australian Open Disclosure Framework.

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Principle 3: Cultural practice and respectful
relationships
Value
Nurses engage with people as individuals in a culturally safe and respectful way, foster open and honest
professional relationships, and adhere to their obligations about privacy and confidentiality.

3.1 Aboriginal and/or Torres Strait Islander peoples’ health

Australia has always been a culturally and linguistically diverse nation. Aboriginal and/or Torres Strait Islander
peoples have inhabited and cared for the land as the first peoples of Australia for millennia, and their histories
and cultures have uniquely shaped our nation. Understanding and acknowledging historic factors such as
colonisation and its impact on Aboriginal and/or Torres Strait Islander peoples’ health helps inform care. In
particular, Aboriginal and/or Torres Strait Islander peoples bear the burden of gross social, cultural and health
inequality. In supporting the health of Aboriginal and/or Torres Strait Islander peoples, nurses must:
a. provide care that is holistic, free of bias and racism, challenges belief based upon assumption and is
culturally safe and respectful for Aboriginal and/or Torres Strait Islander peoples
b. advocate for and act to facilitate access to quality and culturally safe health services for Aboriginal and/or
Torres Strait Islander peoples, and
c. recognise the importance of family, community, partnership and collaboration in the healthcare decision-
making of Aboriginal and/or Torres Strait Islander peoples, for both prevention strategies and care delivery.
See the National Aboriginal and Torres Strait Islander Health Plan 2013-2023.
See also Congress of Aboriginal and Torres Strait Islander Nurses and Midwives.

3.2 Culturally safe and respectful practice

Culturally safe and respectful practice requires having knowledge of how a nurse’s own culture, values,
attitudes, assumptions and beliefs influence their interactions with people and families, the community and
colleagues. To ensure culturally safe and respectful practice, nurses must:
a. understand that only the person and/or their family can determine whether or not care is culturally safe and
respectful
b. respect diverse cultures, beliefs, gender identities, sexualities and experiences of people, including among
team members
c. acknowledge the social, economic, cultural, historic and behavioural factors influencing health, both at the
individual, community and population levels
d. adopt practices that respect diversity, avoid bias, discrimination and racism, and challenge belief based
upon assumption (for example, based on gender, disability, race, ethnicity, religion, sexuality, age or political
beliefs)
e. support an inclusive environment for the safety and security of the individual person and their family and/or
significant others, and
f. create a positive, culturally safe work environment through role modelling, and supporting the rights, dignity
and safety of others, including people and colleagues.

3.3 Effective communication

Positive professional relationships are built on effective communication that is respectful, kind, compassionate
and honest. To communicate effectively, nurses must:
a. be aware of health literacy issues, and take health literacy into account when communicating with people
b. make arrangements, whenever possible, to meet the specific language, cultural, and communication needs
of people and their families, through the utilisation of translating and interpreting services where necessary,
and be aware of how these needs affect understanding
c. endeavour to confirm a person understands any information communicated to them
d. clearly and accurately communicate relevant and timely information about the person to colleagues, within
the bounds of relevant privacy requirements, and
e. be non-judgemental and not refer to people in a non-professional manner verbally or in correspondence/
records, including refraining from behaviour that may be interpreted as bullying or harassment and/or
culturally unsafe.

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3.4 Bullying and harassment
When people repeatedly and intentionally use words or actions against
someone or a group of people, it causes distress and risks their wellbeing.
Nurses understand that bullying and harassment relating to their practice
or workplace is not acceptable or tolerated and that where it is affecting
public safety it may have implications for their registration. Nurses must:
a. never engage in, ignore or excuse such behaviour
b. recognise that bullying and harassment takes many forms, including
behaviours such as physical and verbal abuse, racism, discrimination,
violence, aggression, humiliation, pressure in decision-making,
exclusion and intimidation directed towards people or colleagues
c. understand social media is sometimes used as a mechanism to bully
or harass, and that nurses should not engage in, ignore or excuse such
behaviour
d. act to eliminate bullying and harassment, in all its forms, in the workplace, and
e. escalate their concerns if an appropriate response does not occur.
For additional guidance see the Australian Human Rights Commission’s Fact sheet on
workplace bullying
See also Nurse & Midwife Support, the national health support service for nurses, midwives and students.

3.5 Confidentiality and privacy

Nurses have ethical and legal obligations to protect the privacy of people. People have a right to expect that
nurses will hold information about them in confidence, unless the release of information is needed by law,
legally justifiable under public interest considerations or is required to facilitate emergency care. To protect
privacy and confidentiality, nurses must:
a. respect the confidentiality and privacy of people by seeking informed consent before disclosing information,
including formally documenting such consent where possible
b. provide surroundings to enable private and confidential consultations and discussions, particularly when
working with multiple people at the same time, or in a shared space
c. abide by the NMBA Social media policy and relevant Standards for practice, to ensure use of social media is
consistent with the nurse’s ethical and legal obligations to protect privacy
d. access records only when professionally involved in the care of the person and authorised to do so
e. not transmit, share, reproduce or post any person’s information or images, even if the person is not directly
named or identified, without having first gained written and informed consent. See also the NMBA Social
media policy and Guidelines for advertising regulated health services
f. recognise people’s right to access information contained in their health records, facilitate that access and
promptly facilitate the transfer of health information when requested by people, in accordance with local
policy, and
g. when closing or relocating a practice, facilitating arrangements for the transfer or management of all health
records in accordance with the legislation governing privacy and health records.

3.6 End-of-life care

Nurses have a vital role in helping the community to deal with the reality of death and its consequences. In
providing culturally appropriate end-of-life care, nurses must:
a. understand the limits of healthcare in prolonging life, and recognise when efforts to prolong life may not be
in the best interest of the person
b. accept that the person has the right to refuse treatment, or to request withdrawal of treatment, while
ensuring the person receives relief from distress
c. respect diverse cultural practices and beliefs related to death and dying
d. facilitate advance care planning and provision of end-of-life care where relevant and in accordance with local
policy and legislation, and
e. take reasonable steps to ensure support is provided to people, and their families, even when it is not possible
to deliver the outcome they desire.
See also the Australian Commission on Safety and Quality in Health Care - End-of-Life Care.

9 Code of conduct for nurses Effective from 1 March 2018

Domain: Act with professional integrity

Principle 4: Professional behaviour

Value
Nurses embody integrity, honesty, respect and compassion.

4.1 Professional boundaries

Professional boundaries allow nurses, the person and the person’s nominated partners, family and friends,
to engage safely and effectively in professional relationships, including where care involves personal and/or
intimate contact. In order to maintain professional boundaries, there is a start and end point to the professional
relationship and it is integral to the nurse-person professional relationship. Adhering to professional boundaries
promotes person-centred practice and protects both parties. To maintain professional boundaries, nurses must:
a. recognise the inherent power imbalance that exists between nurses, people in their care and significant
others and establish and maintain professional boundaries
b. actively manage the person’s expectations, and be clear about professional boundaries that must exist in
professional relationships for objectivity in care and prepare the person for when the episode of care ends
c. avoid the potential conflicts, risks, and complexities of providing care to those with whom they have a pre-
existing non-professional relationship and ensure that such relationships do not impair their judgement. This
is especially relevant for those living and working in small, regional or cultural communities and/or where
there is long-term professional, social and/or family engagement
d. avoid sexual relationships with persons with whom they have currently or had previously entered into
a professional relationship. These relationships are inappropriate in most circumstances and could be
considered unprofessional conduct or professional misconduct
e. recognise when over-involvement has occurred, and disclose this concern to an appropriate person, whether
this is the person involved or a colleague
f. reflect on the circumstances surrounding any occurrence of over-involvement, document and report it, and
engage in management to rectify or manage the situation
g. in cases where the professional relationship has become compromised or ineffective and ongoing care
is needed, facilitate arrangements for the continuing care of the person to another health practitioner,
including passing on relevant clinical information (see also 3.3 Effective communication)
h. actively address indifference, omission, disengagement/lack of care and disrespect to people that may reflect
under-involvement, including escalating the issue to ensure the safety of the person if necessary
i. avoid expressing personal beliefs to people in ways that exploit the person’s vulnerability, are likely to cause
them unnecessary distress, or may negatively influence their autonomy in decision-making (see the NMBA
Standards for practice), and
j. not participate in physical assault such as striking, unauthorised restraining and/or applying unnecessary
force.

4.2 Advertising and professional representation

Nurses must be honest and transparent when describing their education, qualifications, previous occupations
and registration status. This includes, but is not limited to, when nurses are involved in job applications, self-
promotion, publishing of documents or web content, public appearances, or advertising or promoting goods or
services. To honestly represent products and regulated health services, and themselves, nurses must:
a. comply with legal requirements about advertising outlined in the National Law (explained in the NMBA
Guidelines for advertising regulated health services), as well as other relevant Australian state and territory
legislation
b. provide only accurate, honest and verifiable information about their registration, experience and
qualifications, including any conditions that apply to their registration (see also Principle 1: Legal
compliance)
c. only use the title of nurse if they hold valid registration and/or endorsement (see also the NMBA Fact sheet:
The use of health practitioner protected titles), and
d. never misrepresent, by either a false statement or an omission, their registration, experience, qualifications
or position.

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4.3 Legal, insurance and other assessments
Nurses may be contracted by a third party to provide an assessment of a person who is not in their care, such
as for legal, insurance or other administrative purposes. When this occurs the usual nurse-person professional
relationship does not exist. In this situation, nurses must:
a. explain to the person their professional area of practice, role, and the purpose, nature and extent of the
assessment to be performed
b. anticipate and seek to correct any misunderstandings the person may have about the nature and purpose of
the assessment and report, and
c. inform the person and/or their referring health professional of any unrecognised, serious problems that are
discovered during the assessment, as a matter of duty-of-care.

4.4 Conflicts of interest

People rely on the independence and trustworthiness of nurses who provide them with advice or treatment. In
nursing practice, a conflict of interest arises when a nurse has financial, professional or personal interests or
relationships and/or personal beliefs that may affect the care they provide or result in personal gain.
Such conflicts may mean the nurse does not prioritise the interests of a person as they should, and may be
viewed as unprofessional conduct. To prevent conflicts of interest from compromising care, nurses must:
a. act with integrity and in the best interests of people when making referrals, and when providing or arranging
treatment or care
b. responsibly use their right to not provide, or participate directly in, treatments to which they have a
conscientious objection. In such a situation, nurses must respectfully inform the person, their employer and
other relevant colleagues, of their objection and ensure the person has alternative care options
c. proactively and openly inform the person if a nurse, or their immediate family, has a financial or commercial
interest that could be perceived as influencing the care they provide
d. not offer financial, material or other rewards (inducements) to encourage others to act in ways that
personally benefit the nurse, nor do anything that could be perceived as providing inducements, and
e. not allow any financial or commercial interest in any entity providing healthcare services or products to
negatively affect the way people are treated.

4.5 Financial arrangements and gifts

It is necessary to be honest and transparent with people. To ensure there is no perception of actual or personal
gain for the nurse, nurses must:
a. when providing or recommending services, discuss with the person all fees and charges expected to result
from a course of treatment in a manner appropriate to the professional relationship, and not exploit people’s
vulnerability or lack of knowledge
b. only accept token gifts of minimal value that are freely offered and report the gifts in accordance with local
policy
c. not accept, encourage or manipulate people to give, lend, or bequeath money or gifts that will benefit a nurse
directly or indirectly
d. not become financially involved with a person who has or who will be in receipt of their care, for example
through bequests, powers of attorney, loans and investment schemes, and
e. not influence people or their families to make donations, and where people seek to make a donation refer to
the local policy.

11 Code of conduct for nurses Effective from 1 March 2018

Principle 5: Teaching, supervising and assessing
Value
Nurses commit to teaching, supervising and assessing students and other nurses in order to develop the
nursing workforce across all contexts of practice.

5.1 Teaching and supervising

It is the responsibility of all nurses to create opportunities for nursing students and nurses under supervision to
learn, as well as benefit from oversight and feedback. In their teaching and supervisor roles, nurses must:
a. seek to develop the skills, attitudes and practices of an effective teacher and/or supervisor
b. reflect on the ability, competence and learning needs of each student or nurse who they teach or supervise
and plan teaching and supervision activities accordingly, and
c. avoid, where possible, any potential conflicts of interest in teaching or supervision relationships that may
impair objectivity or interfere with the supervised person’s learning outcomes or experience. This includes,
for example, not supervising somebody with whom they have a pre-existing non-professional relationship.

5.2 Assessing colleagues and students

Assessing colleagues and students is an important part of making
sure that the highest standard of practice is achieved across the
profession. In assessing the competence and performance of
colleagues or students, nurses must:
a. be honest, objective, fair, without bias and
constructive, and not put people at risk of harm by
inaccurate and inadequate assessment, and
b. provide accurate and justifiable information
promptly, and include all relevant information
when giving references or writing reports
about colleagues.
See also the NMBA Supervision guidelines for
nursing and midwifery.

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Principle 6: Research in health
Value
Nurses recognise the vital role of research to inform quality healthcare and policy development, conduct
research ethically and support the decision-making of people who participate in research.

6.1 Rights and responsibilities

Nurses involved in design, organisation, conduct or reporting of health research have additional responsibilities.
Nurses involved in research must:
a. recognise and carry out the responsibilities associated with involvement in health research
b. in research that involves human participants, respect the decision-making of people to not participate and/
or to withdraw from a study, ensuring their decision does not compromise their care or any nurse-person
professional relationship(s), and
c. be aware of the values and ethical considerations for Aboriginal and/or Torres Strait Islander communities
when undertaking research.
See also the National Health and Medical Research Council publication: Values and Ethics - Guidelines for
Ethical Conduct in Aboriginal and Torres Strait Islander Health Research.
See also Principle 2 on the application of evidence-based decision-making for delivery of safe and quality care.

13 Code of conduct for nurses Effective from 1 March 2018

Domain: Promote health and wellbeing

Principle 7: Health and wellbeing

Value
Nurses promote health and wellbeing for people and their families, colleagues, the broader community and
themselves and in a way that addresses health inequality.

7.1 Your and your colleagues’ health

Nurses have a responsibility to maintain their physical and mental health to practise safely and effectively. To
promote health for nursing practice, nurses must:
a. understand and promote the principles of public health, such as health promotion activities and vaccination
b. act to reduce the effect of fatigue and stress on their health, and on their ability to provide safe care
c. encourage and support colleagues to seek help if they are concerned that their colleague’s health may be
affecting their ability to practise safely, utilising services such as Nurse & Midwife Support, the national
health support service for nurses, midwives and students
d. seek expert, independent and objective help and advice, if they are ill or impaired in their ability to
practise safely. Nurses must remain aware of the risks of self-diagnosis and self-treatment, and act to
reduce these, and
e. take action, including a mandatory or voluntary notification to AHPRA, if a nurse knows or reasonably
suspects that they or a colleague have a health condition or impairment that could adversely affect their
ability to practise safely, or put people at risk (see Principle 1: Legal compliance).

7.2 Health advocacy

There are significant disparities in the health status of various groups in the Australian community. These
disparities result from social, historic, geographic, environmental, legal, physiological and other factors. Some
groups who experience health disparities include Aboriginal and/or Torres Strait Islander peoples, those with
disabilities, those who are gender or sexuality diverse, and those from social, culturally and linguistically diverse
backgrounds, including asylum seekers and refugees. In advocating for community and population health,
nurses must:
a. use their expertise and influence to protect and advance the health and wellbeing of individuals as well as
communities and populations
b. understand and apply the principles of primary and public health, including health education, health
promotion, disease prevention, control and health screening using the best available evidence in making
practice decisions, and
c. participate in efforts to promote the health of communities and meet their obligations with respect to disease
prevention including vaccination, health screening and reporting notifiable diseases.
See also the NMBA Position statement on nurses, midwives and vaccination.

14 Code of conduct for nurses Effective from 1 March 2018

Glossary health professional, cultural safety calls for a genuine
partnership where power is shared between the
individuals and cultural groups involved in healthcare.
These meanings relate to the use of terms in the Code
Cultural safety is also relevant to Aboriginal and
of conduct for nurses.
Torres Strait Islander health professionals. Non-
Advance care planning is an on-going process of Indigenous nurses and midwives must address how
shared planning for current and future healthcare. they create a culturally safe work environment that
It allows an individual to make known their values, is free of racism for their Aboriginal and Torres Strait
beliefs and preferences to guide decision-making, Islander colleagues (CATSINaM, 2017a6).
even after when the individual cannot make or
Delegation is the relationship that exists when
communicate their preferences and decisions (See
a nurse devolves aspects of nursing practice to
Advance Care Planning Australia).
another person. Delegations are made to meet the
Bullying and harassment is ‘when people repeatedly person’s health needs. The nurse who is delegating
and intentionally use words or actions against retains accountability for the decision to delegate.
someone or a group of people to cause distress and The nurse is also accountable for monitoring
risk to their wellbeing. These actions are usually done of the communication of the delegation to the
by people who have more influence or power over relevant persons and for the practice outcomes.
someone else, or who want to make someone else Both parties share the responsibility of making the
feel less powerful or helpless’.3 delegation decision, which includes assessment of
the competence and risks. For further details see
Competence is the possession of required skills, the NMBA National framework for the development
knowledge, education and capacity. of decision-making tools for nursing and midwifery
Cultural safety concept was developed in a First practice.
Nations’ context and is the preferred term for nursing Discrimination is the unjust treatment of one or more
and midwifery. Cultural safety is endorsed by the person/s based on factors such as race, religion,
Congress of Aboriginal and Torres Strait Islander sex, disability or other grounds specified in anti-
Nurses and Midwives (CATSINaM), who emphasise discrimination legislation7.
that cultural safety is as important to quality care as
clinical safety. However, the “presence or absence of Handover is the process of transferring all
cultural safety is determined by the recipient of care; responsibility for the care of one or more people to
it is not defined by the caregiver” (CATSINaM, 2014, another health practitioner or person.
p. 94). Cultural safety is a philosophy of practice that
Health literacy ‘is about how people understand
is about how a health professional does something,
information about health and healthcare, how they
not [just] what they do. It is about how people are
apply that information to their lives, use it to make
treated in society, not about their diversity as such,
decisions and act on it’.8
so its focus is on systemic and structural issues and
on the social determinants of health. Cultural safety Local policy refers to the policies that apply to
represents a key philosophical shift from providing decision-making, relevant to the specific location and/
care regardless of difference, to care that takes or organisation where practice is being undertaken.
account of peoples’ unique needs. It requires nurses
Mandatory notification is the requirement under
and midwives to undertake an ongoing process of
the National Law for registered health practitioners,
self-reflection and cultural self-awareness, and
employers and education providers to report certain
an acknowledgement of how a nurse’s/midwife’s
conduct (see Guidelines for mandatory notifications).
personal culture impacts on care. In relation to
Aboriginal and Torres Strait Islander health, cultural Mandatory reporting is a state and territory
safety provides a de-colonising model of practice legislative requirement imposed to protect at risk
based on dialogue, communication, power sharing groups such as the aged, children and young people.
and negotiation, and the acknowledgment of white
National law means the Health Practitioner
privilege. These actions are a means to challenge
Regulation National Law that is in force in each
racism at personal and institutional levels, and to
state and territory in Australia and applies to those
establish trust in healthcare encounters (CATSINaM,
professions regulated under that law (see Australian
2017b, p. 115). In focusing on clinical interactions,
Health Practitioner Regulation Agency).
particularly power inequity between patient and

3 Australian Human Rights Commission, ‘What is bullying?’ www.humanrights.gov.au/what-bullying-violence-harassment-

and-bullying-fact-sheet
4 CATSINaM, 2014, Towards a shared understanding of terms and concepts: strengthening nursing and midwifery care of Aboriginal
and Torres Strait Islander peoples, CATSINaM, Canberra.
5 CATSINaM, 2017b, The Nursing and Midwifery Aboriginal and Torres Strait Islander Health Curriculum Framework (Version 1.0),
CATSINaM, Canberra.
6 CATSINaM, 2017a, Position statement: Embedding cultural safety across Australian nursing and midwifery, CATSINaM,
Canberra.
7 Australian Human Rights Commission, ‘Discrimination’ www.humanrights.gov.au/quick-guide/12030
8 Australian Commission on Safety and Quality in Health Care, Health literacy: www.safetyandquality.gov.au/our-work/patient-
and-consumer-centred-care/health-literacy

15 Code of conduct for nurses Effective from 1 March 2018

Nominated partners, family and friends include serves a nurse’s own personal views, feelings and
people in consensual relationships with the person, relationships that are not relevant to the professional
as identified by the person receiving care. relationship.
Nurse refers to a registered nurse, enrolled nurse or Professional misconduct includes conduct by a health
nurse practitioner. The term is reserved in Australia, practitioner that is substantially below the expected
under law, for a person who has completed the standard and which, whether connected to practice or
prescribed training, demonstrates competence to not, is inconsistent with being a fit and proper person
practise, and is registered as a nurse under the to be registered in the profession.
National Law.
Professional relationship is an ongoing interaction
Open disclosure ‘is an open and honest discussion that observes a set of established boundaries or limits
with a person about any incident(s) that caused them deemed appropriate under governing standards.
harm while they were receiving healthcare. It includes The nurse is sensitive to a person’s situation and
an apology or expression of regret (including the purposefully engages with them using knowledge
word ‘sorry’), a factual explanation of what happened, and skills with respect, compassion and kindness. In
an opportunity for the patient to describe their the relationship, the person’s rights and dignity are
experience, and an explanation of the steps being recognised and respected. The professional nature of
taken to manage the event and prevent recurrence’9 the relationship involves recognition of professional
(Australian Commission on Safety and Quality in boundaries and issues of unequal power.
Health Care).
Referral involves a nurse sending a person to
Over-involvement is when the nurse confuses their obtain an opinion or treatment from another health
needs with the needs of the person in their care and professional or entity. Referral usually involves the
crosses the boundary of a professional relationship. transfer (all or in part) of responsibility for the care
Behaviour may include favouritism, gifts, intimacy or of the person, usually for a defined time and for a
inappropriate relationships with the partner or family particular purpose, such as care that is outside the
member of a person in the nurse’s care. referring practitioner’s expertise or scope of practice.
Person or people refers to those individuals who Social media describes the online and mobile tools
have entered into a therapeutic and/or professional that people use to share opinions, information,
relationship with a nurse. These individuals will experiences, images, and video or audio clips. It
sometimes be healthcare consumers, at other times includes websites and applications used for social
they may be colleagues or students, this will vary networking. Common sources of social media include,
depending on who is the focus of practice at the time. but are not limited to, social networking sites such as
Therefore, the words person or people include all the Facebook and LinkedIn, blogs (personal, professional
patients, clients, consumers, families, carers, groups and those published anonymously), WOMO, True
and/or communities, however named, that are within Local, microblogs such as Twitter, content-sharing
the nurse’s scope and context of practice. websites such as YouTube and Instagram, and
discussion forums and message boards.
Person-centred practice is collaborative and
respectful partnership built on mutual trust and Substitute decision-maker is a general term for a
understanding through good communication. Each person who is either a legally appointed decision-
person is treated as an individual with the aim maker for a person, or has been nominated to make
of respecting people’s ownership of their health healthcare decisions on behalf of a person whose
information, rights and preferences while protecting decision-making capacity is impaired.
their dignity and empowering choice. Person-centred
Supervision includes managerial supervision,
practice recognises the role of family and community
professional supervision and clinically focused
with respect to cultural and religious diversity.
supervision as part of delegation. For details see
Practice means any role, whether remunerated the NMBA Supervision guidelines for nursing and
or not, in which the individual uses their skills and midwifery.
knowledge as a nurse. Practice is not restricted to
Therapeutic relationships are different to personal
the provision of direct clinical care. It also includes
relationships. In a therapeutic relationship the nurse
working in a non-clinical relationship with clients,
is sensitive to a person’s situation and purposefully
working in management, administration, education,
engages with them using knowledge and skills in
research, advisory, regulatory or policy development
respect, compassion and kindness. In the relationship
roles, and any other roles that impact on safe,
the person’s rights and dignity are recognised and
effective delivery of services in the profession and/or
respected. The professional nature of the relationship
use their professional skills.
involves recognition of professional boundaries and
Professional boundaries allow a nurse and a person issues of unequal power.
to engage safely and effectively in a therapeutic and/
Unprofessional conduct includes conduct of a lesser
or professional relationship. Professional boundaries
standard that might reasonably be expected by the
refers to the clear separation that should exist
public or professional peers.
between professional conduct aimed at meeting
the health needs of people, and behaviour which

9 Australian Commission on Safety and Quality in Health Care, National Open Disclosure Framework: https://www.
safetyandquality.gov.au/wp-content/uploads/2013/03/Australian-Open-Disclosure-Framework-Feb-2014.pdf

16 Code of conduct for nurses Effective from 1 March 2018

Bibliography
The Australian Commission on Safety and Quality in Health Care website
www.safetyandquality.gov.au provides relevant guidance on a range of safety and quality issues. Information of
particular relevance to nurses includes:
• end-of-life care
• hand hygiene
• healthcare rights
• health literacy
• medication administration, and
• open disclosure and incident management.
The Australian Health Practitioner Regulation Agency (www.ahpra.gov.au) works in partnership with the NMBA
to regulate nurses and midwives in Australia.
The Australian Human Rights Commission also provides resources that promote and protect human rights.
Resources on workplace bullying include a fact sheet and a ‘get help’ section at www.humanrights.gov.au.
The Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM) website
(catsinam.org.au) ‘promotes, supports and advocates for Aboriginal and Torres Strait Islander nurses and
midwives and to close the gap in health for Aboriginal and Torres Strait Islander peoples.
The National Aboriginal and Torres Strait Islander Health Plan 2013 – 2023 provides an evidence-based
framework for a coordinated approach to improving Aboriginal and/or Torres Strait Islander people’s health.
For additional information go to www.health.gov.au/NATSIHP.
The National Health and Medical Research Council website
www.nhmrc.gov.au provides relevant information on informed
consent and research issues.
The national Nurse & Midwife Support service
www.nmsupport.org.au provides 24 hour access
to health support anywhere in Australia.
The Therapeutic Goods Administration
website www.tga.gov.au provides
relevant information on therapeutic
goods.

17 Code of conduct for nurses Effective from 1 March 2018

Stay in touch with the NMBA.
Stay in touch with the standards of your profession.

www.nursingmidwiferyboard.gov.au

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for study or training purposes subject to an inclusion of an
acknowledgement of the source and is available electronically at
www.nursingmidwiferyboard.gov.au. It may not be reproduced for
commercial use or sale.
Reproduction for purposes other than those indicated above
requires a licence or written permission, which may be obtained
from the Nursing and Midwifery Board of Australia. Requests and
enquiries concerning reproduction rights should be addressed to:
Nursing and Midwifery Board of Australia
GPO Box 9958
Melbourne VIC 3000
Or via email to [email protected].

18 Code of conduct for nurses Effective from 1 March 2018