A short history
The groundwork goes back to the late 1800s and the founding of the ANA. The first formal code, "The Code for Professional Nurses," was adopted in 1950. The ANA reviews and rewrites it roughly every decade to keep pace with changes in the science and practice of nursing and in society. The current edition is the 2025 revision, which replaced the 2015 version (American Nurses Association). It was shaped by a 49-member revision panel of nurses from different settings and career stages, plus input from more than 6,000 nurses who weighed in during the public comment period. The 2025 revision recognizes racism as a public health crisis, leans harder into nurse wellbeing as inseparable from patient care, and adds a tenth provision focused on global health.
How the Code is used
The Code guides ethical decision-making at every level of nursing, but how strictly you are held to it varies by state. There is no national requirement that nurses pledge to it the way physicians take the Hippocratic Oath. On its own it is not a law. It can still carry legal weight, though, because some states fold it into their nurse practice act, which makes it enforceable for nurses practicing there. Know your own state's practice act and the regulations of your board of nursing.
Ideally you meet the Code early, as a core part of nursing school, because it touches everything you do regardless of where you practice or how far along you are in your career.
The ten provisions
The 2025 Code is built on ten provisions, each backed by interpretive statements that explain how to apply it in practice. Members and nonmembers can read the full text on the ANA website. Here are the provisions in plain terms.
Provision 1. The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person. You honor the dignity and rights of everyone you encounter, patient, family, or colleague, including the patient's right to self-determination and to full, understandable information about their care, even when you disagree with their choices.
Provision 2. A nurse's primary commitment is to the recipient of nursing care, whether an individual, family, group, community, or population. The patient's interests come first. Disclose and address any conflict of interest so care is not compromised, and keep professional boundaries intact.
Provision 3. The nurse establishes a trusting relationship and advocates for the rights, health, and safety of those in their care. Protect patient privacy and confidential information, share data only through approved channels, maintain your competence, report and investigate errors, and act when a colleague's impaired practice puts patients at risk.
Provision 4. Nurses have authority over nursing practice and are responsible and accountable for it, consistent with the duty to promote health, prevent illness, and provide optimal care. Accountability means practicing within the scope and standards of nursing, exercising sound judgment, and delegating within state practice acts, organizational policy, and each person's competence.
Provision 5. The nurse has moral duties to self as a person of inherent dignity and worth, including an expectation of a safe workplace that supports flourishing, authenticity, and self-respect through integrity and competence. Caring for yourself is part of being able to care for others. Protect your own health and safety, hold to your integrity, object to moral violations, and keep learning.
Provision 6. Through individual and collective effort, nurses establish, maintain, and improve the ethical environment of the work setting and the wellbeing of nurses. Build and protect a morally sound workplace, and support fair, equitable conditions that make safe, quality care possible.
Provision 7. Nurses advance the profession through knowledge development, professional standards, and the generation of policy for nursing, health, and social concerns. Whether through direct care, management, or education, every nurse can contribute to research, standards, and health policy.
Provision 8. Nurses build collaborative relationships with other nurses, other disciplines, and the public to achieve greater ends. Health is a universal right, so the need for nursing is universal. Work with others to reduce health disparities and to call out human rights violations, with particular attention to vulnerable groups.
Provision 9. Nurses and their professional organizations work to enact and resource practices, policies, and legislation that promote social justice, eliminate health inequities, and support human flourishing. Professional associations give nurses a united voice to articulate the profession's values and to push for social justice through the political and legislative process.
Provision 10. Nursing, through its organizations and associations, participates in the global nursing and health community to promote human and environmental health, wellbeing, and flourishing. This is the new provision, extending nursing's ethical commitments to the global stage and to environmental health.
Frequently Asked Questions
Who writes the Nursing Code of Ethics? The American Nurses Association (ANA) develops and maintains the Code of Ethics for Nurses with Interpretive Statements. The ANA reviews and rewrites it roughly every decade through a panel of practicing nurses and a public comment period.
What is the most current version of the Code? The 2025 revision is the current edition, replacing the 2015 version. It was shaped by a 49-member revision panel with input from more than 6,000 nurses.
How many provisions are in the Code? Ten. The 2025 revision added a tenth provision focused on the global nursing community and environmental health, expanding on the nine provisions that anchored earlier editions.
Is the Nursing Code of Ethics legally binding? Not on its own. It is a professional standard, not a law. Some states fold the Code into their nurse practice act, which makes it enforceable for nurses practicing in that state, so check your own board of nursing's regulations.
What changed in the 2025 revision? It recognizes racism as a public health crisis, treats nurse wellbeing as inseparable from patient care, and adds Provision 10 on global and environmental health.
Do nurses take an oath to follow the Code? No. Unlike the Hippocratic Oath for physicians, there is no national pledge tied to the Code, though many nursing programs introduce it early as a core part of training.