Indonesian Nurses’Codes of EthicsPerspectives on Nursing Student at Universitas Muhammadiyah Yogyakarta Teaching Hospitals
Indonesian Nurses’Codes of EthicsPerspectives on Nursing Student at
Universitas Muhammadiyah Yogyakarta Teaching Hospitals
Wulan Noviani1, Fajar Abrori 2 1Lecturer School of Nursing Faculty
Medicine and Health Sciences 2Student School of Nursing Faculty
Medicine and Health Sciences Universitas Muhammadiyah Yogyakarta
Email: wulan.n@umy.ac.id
ABSTRACT
Background: Nursing students profession as a professional candidate in health care system is commonly faced the dilemma ethics during their clinical experiences. Consequently, they should have knowledge, readiness as well as competencies to solve the complexity problems related ethical issues in modern health care.
Objectives: This studies was conducted to explore the perspectives and to describe level of knowledge of nursing student profession program about nurses ‘codes of ethics in academic hospital Universitas Muhammadiyah Yogyakarta, Indonesia. Methods: Mixed methods with quantitative and qualitative approaches were used. Data was collected from 83 nursing student’s profession for quantitative study and 11 students for qualitative study who had practiced at 3 teaching hospital of UMY. It was collected using questionnaires and in-depth interview during April-June 2016. The data analyzed using software statistic and content analysis.
Findings: Seventy one point one percent (n=83) the knowledge level of nurses codes of ethics were good in questionnaire analyzed. The majority nurses and patient relationship was good (83,1%) and the minority of nurses and their organization was good (74,7%). Students qualitative responses have divided into two thematic
categories including: definitions of ethics codes, contents of ethics (nurses and patients, nurses and practice, nurses and society, nurses and their colleagues, nurses and organization). The qualitative result was good for view of nursing student about definition and the content of nurse’s ethic codes.
Conclusion: The perspectives of nurses ethic codes in nursing student profession is good in quantitative and qualitative analysis. Further research should focus on the implementation of ethic codes of nurses including assessment and evaluation methods.
Keywords: perspective, knowledge, ethic codes, nurses, nursing student
Background
Professional nursing defines as the effort of promotion, optimalization health and ability, disease prevention through diagnosis and treatment for individual, family, community and population (ANA, 2010). Nurses have responsibilities to provide high quality of services for patient, family and society. Nurses have variety of ethical experiences in professional practice and they should recognize ethical codes and they can make good decisions (Zahedi et all, 2013).
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Every nurse that had done their tasks competently and high integrity should have several key elements which is used by as profession guidance such as accreditation in educational institution, license system and certification and relevant ethic codes (Epstein & Turner, 2015).
Nursing is the most popular of profession it has ethic codes which is agreed with each professional group of the world. For instance, International Council of Nurses (ICN), American Nurses Association (ANA) dan Canadian Nurse Association (CAN). The content of ethic codes is how nurses should have ethical behaviour as a profession and how they should make decision when they have obstacles and prevent ethical problems, then their efforts to fulfill professional duties (Zahedi et all, 2013).
The ICN Code of Ethics for Nurses has four principal elements that outline the standards of ethical conduct (International Council of Nurses, 2012). Every nurse in modern and developed countries had ethic codes as a guidance of nursing care practice fundamentally. Research conduct of nurses’ ethic codes inIran revealed that nurses have lack of knowledges. Ethic codes in nursing revised regularly to repair the drawbacks when it was practised by nurses during nursing process, however in
Indonesia revision of ethic codes never done.
Nursing ethic codes are a written statement that showed moral, caring, values and nursing goals. It is a fundamental to nursing practice for professional nurses and it will be characterized by defining, defense and improve nursing profession (Nasrullah, 2014).
Professional nurse should practice nursing care using ethic codes in several settings clinics, academic and community. Nursing ethic codes have content guidances which is used by nurses as a basic nursing practice. For instance relationship between nurses and patient; nurses and practice; nurses and society; nurses and co-workers; nurses and profession (inna-ppni.or.id).
Indonesian nursing ethic codes for all nursing professional in education, research, management, clinical care to shape ethical behaviour nurses’ performance to care patient (Indonesian National Nurses Association, 2000).
Implementation of nursing ethic codes is not optimally in Indonesia. It is scarce about research related to nurses ethic codes and the application for nurses unknown. The application of nurses ethic codes will optimal if it was recognized by
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nursing student in the beginning of their study. Nursing curricula can produce the best outcome of nurses if it can be integrated in the system of academic and clinic learning.
Nurses’codes of ethics is reputed as foundation of nurses’ ethical knowledge and as a result of their ethical education. (Numminen et al, 2013). Nursing students profession as a professional candidate in health care system is commonly faced the dillemma ethics during their clinical experiences. They should have knowledge, readiness as well as competencies to solve the complexity problems related ethical issues in modern health care.
Research Problems
How is the perspectives of nursing students profession about Indonesian Nurses’ Codes of Ethics in Universitas Muhammadiyah Yogyakarta teaching hospitals?
Objectives
This studies was conducted to explore the perspectives and to describe level of knowledge of nursing student profession program about nurses ‘codes of ethics in academic hospital Universitas Muhammadiyah Yogyakarta, Indonesia. Methodes
Mixed method with quantitative and qualitative approaches were used. Data was collected from 83 nursing students proffesion for quantitative study and 11 students for qualitative study who had practiced at 3 teaching hospital of UMY. Respondent in this study had selected according to inclusion and exclusion criterias. Inclusion criterias are nursing students in profession program, they have willingness to be respondent, they had practiced 7 months in UMY teaching hospitals including RS PKU Muhammadiyah Yogyakarta, RS PKU Muhammadiyah Gamping, RSUD Tidar Magelang). Exclusion criteria are nursing student in in profession program and they don not have willingness to be respondent.
It was collected using qquestionnaires of Indonesian Nurses’ Ethic Codes and in-depth interview during April-June months 2016. This study was used structured interview guidance to lead the interview processes while recorder to record the result of interview of respondents. The data analyzed using software statistic and content analysis.
The processes of data collection consist of several steps. First of all, this study was administered ethic letter of research. Secondly, the respondent had informed consent. The third step, the respondent divided into two methodes of study. In one hand they are filling the
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questionnaires include demographic data, knowledges of Indonesian nurses’ codes of ethic.
Then data analysis using Descriptive statistic. On the other hand, 11 students have Indepth interviewed with structured interview guidance. In addition, the result of interview analysed the contents and it will be thematic analysis.
Findings
1. Respondent Characteristics
Respondent characteristics in this study is nursing student in profession program. The characteristics according to ages, gender and ethics, it can see in table 1:
Table 1.Frequencies DistributionNursing Student in Profession Program according
to gender, age and ethnics. No. Characteristics
Frequen-cies Percen-tages 1. Gender a. Male b. Female 25 58 30% 70% 2. Ages
a. 21 years b. 22 years c. 23 years d. 24 years e. 25 years f. 26 years
5 32 36 6 3 1 6% 39% 43% 7% 4% 1% 3. Ethnics a. Javanese b. Sundanese c. Dayaknese d. Melayunese e. Bimanese f. Sasaknese g. Minangnese h. Banjarnese i. Malukunese 49 7 5 8 5 5 1 1 1 60% 8% 6% 10% 6% 6% 1% 1% 1%
j. Betawinese 1 1%
Source: Primary Data, 2016
According to table 1, it can know that characteristics of respondent based on gender, the majority respondent is female with 58 people (70%). Most of them are 23 years old with 36 people (43%). The majority respondent came from Javanese culture with 49 people (60%).
Table 2. Knowledges Level of Indonesian Nurses’s Codes of Ethics
The level of knowledges of Indonesian Nurses’ Codes of Ethics in nursing student can see in table 2:
N o Chatagoriz ed Frequenci es Percentage s
1. Good 59 71,1 %
2. Moderate 24 28,9%
3. Less 0 0%
T ot al
83 100%
Source: Primary Data, 2016
According to table 1, it can know that the largest respondent has good knowledge with 59 people (71.1%), the second rank are moderate level with 24 people (28.9%) and none of them have less level in knowledge about Indonesian ethic codes of nurses.
Table 3. Knowledges level of Contents Nurses’s Codes of Ethics
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The level of knowledge of nursing students had divided into 5 aspects, it can see in table 3:
No Nurses’ ethic
codes Chatego-rized Frequen-cies Percen-tages 1 Nurses and
patient ModerateGood 6914 83,1%16,9% 2 Nurses and
practice
Good Moderate
68 15
81,9% 18,1% 3 Nurses and
society Good Moderate 6518 78,3%21,7% 4 Nurses and
co-workers
Good Moderate
68 15
81,9% 18,1% 5 Nurses and
organization Good Moderate 6221 74,7%25,3% Source: Primary Data, 2016
According to table 3, it can know that the majority respondent has good level of knowledge for every aspect in nurses’ ethic codes. The highest percentages is “nurses and patients” with largest respondent have good knowledge with 69 people (83.1%) while the lowest is “ nurses and profession” with 62 people (74.7%).
2. Perspectives of Nurses’ Ethic Codes This study have two themes including definition and functions of ethics and contents of nurses’s codes of ethics. A. Knowledge about definition and
function of nursing ethic codes Examples of Students Narrative Comments on Definition and Function Nurse’s Codes of Ethics.
Ethic codes nurse’s is a rules that have to obey by nurses” (R1)
Nurse’s ethic codes is a matters that
direct nurses related to nurses patient relationship and society” (R2)
“Nurse’s ethic codes is like a guidance
or limitations what have to do as a nurses and how to manage the patients without enter the other profession” (R4)
Nurse’s ethic codes are a guidance of us to do nursing action that containing of ethic codes which is good is like what?” (R6)
“Nurse’s ethic codes are values or
norms that has committed to manage
our profession to do their obligations and the contents what have to do and not”(R9)
B. Knowledge about contents nursing ethic codes
2.1 Examples of Students Narrative Comments on Nurses and Patient
Nurses respect the patient, no differences
the ethnic of patients, keep the privacy of patients” (R2)
“Nurse must be fair in view and take care the patients”(R6)
“Nurses have obligations to make patients and their feel comfort, building trust and kindness”(R7)
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“Nurses as a patient’s advocate have role to give advice to patient, maintain mutual trust relationship and practicing their job well done. Nurses have responsibility to do nursing intervention suitable with the patients “(R9)
Nurses have to keep privacy of patients and practice caring “(R10)
2.2 Examples of Students Narrative Comments on Nurses and Practice
“Nurses up hold professionalism and they must follow the rules in services” (R2) “Nurses have responsible to give the best service since hospital admission until the patient get heal” (R5)
Nurses in practice have to caring, know their job description, know their independent nursing intervention and collaborate to solve the patient problems” (R7)
“Nurses in practices maintain ethical principles such as maleficient, beneficiene, veracity, justice, do not distinguish the level of economic, ethnic and gender”(R9) “Nurses have responsible to keep patient safety “(R10)
2.3 Examples of Students Narrative Comments on Nurses and Society
“Nurses attitude are good, openness and ready to help the society. Professional attitude is mutual relationship” (R1)
Nurses have to serve society comprehensively, give the information and justice” (R3)
“Nurses give the health promotion to improve quality of life and wellness “(R4)
“Nurses have mutual relationship, providing medical information and education. Nurses must be prepared according to its competence or knowledge” (R7)
“Society is the priority for the intervention, health education and empowerment to improve health level” (R9)
2.4 Examples of Students Narrative Comments on Nurses and Organization
“Organization have to clear the profession of nurses, the right of nurses” (R4)
Nurses communicate and support all of the people in Indonesian National Nurses Association for example in prevention diseases” (R5)
“ All of the nurses have to join in organizational profession and they have to care about organization of their contribution” (R7)
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“Nurses have to play role in organization and obey their rules” (R10)
“Nurses should up date their knowledge
because the information of health increase significantly”(R11)
2.5 Examples of Students Narrative Comments on Nurses and Co-Workers
“ The relationship between nurses and co-workers should not have problems. Nurses have competencies and knowledge itself, independent, give patient safety and good quality of services” (R7)
“ Nurses and their colleagues should help each other, doing collaboration and
coöperation” (R8)
“Nurses have mutual cooperation , keep
privacy and implement the intervention appropriate with their competencies” (R9) “Nurses should to respect and be a good
team work with their colleagues” (R10) “Nurses know the their competencies to care or cure, they have to communicate with good way, give the suggestion for colleagues” (R11)
Discussion
According to Numminen et al (2009), nurses’ knowledge and use of the codes are deficient. However, the nurses
think that ethic codes are required to guide nursing practice and provide professional status and identity. In the present study, the 79.1% of nurses acquired their knowledge of ethics in nursing school, and 53.6% of them acquired their knowledge of ethics during work also 40.5% of nurses stated that nursing ethic codes is formally given them (Mohajjel et al, 2013).
According the Code, the nurses should be sensitive to the ethical challenges and do their best to fulfill their moral duties including informed consent, respect to privacy and confidentiality of patients/clients, relationship with colleagues, efficient performance of the professional duties, conflicts of interests, ethics in educational activities and protection of participants in research and consultation with the hospital ethics committee for decision-making when are confronted with ethical cases (Zahedi et al, 2013).
Experience and research have shown that nursing students deliberation of ethical matters is practically oriented and connected to their concrete personal experiences (Numminen et al. 2009), and that relating ethics education closely to practical context makes it meaningful to nurses (Gatsmants et al 1998; Meulensberg et. Al, 2004; Van der Arend & Smith, 2003; Woods, 2005)
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According to Numminen et al (2009), several studies might add valuable knowledge of education of the codes in varying educational systems and health care contexts revealing strengths as well as problems area in their teaching. The quality of teaching the codes aiming at educating nurses who can provide ethically high quality care is important (Salvage & Heidjen 1997; Sasso et al. 2008).
Knowledge of ethic codes is a priority foundation for nurses to give nursing care because nurses’ ethic codes is one of the characteristics of nursing profession to keen up, maintain, and increase profession standards that reflected by all of nurses as a moral value for patients, society and co workers (Abrori, 2016; Nasrullah, 2014).
Conclusion
The perspectives of Indonesian nurses’ ethic codes on nursing student profession is good in quantitative and qualitative analysis.
Suggestion
Further research should focus on the implementation of ethic codes of nurses’ including assessment and evaluation methods on nursing students.
References
1. Butts, J. B. Ethics in Professional Nursing Practice. Jones and Bartlett Publishers.
2. ICN revised 2012. The ICN Codes of Ethics for Nurses.
3. Lachman, V, D. (2009). Practical use of Nursing Code of Ethics: Part II. Article. Medsurg Nursing. May/ June 2009-Vol. 18/ No. 3
4. MohajjelAghdam, A., Hassankhani, H., Zamanzadeh, V., Khameneh, S., & Moghaddam, S. (2013). Knowledge and Performance about Nursing Ethic Codes from Nurses’ and Patients’ Perspective in Tabriz Teaching Hospitals, Iran. Journal of Caring
Sciences, 2(3), 219–227.
http://doi.org/10.5681/jcs.2013.027. 5. Numminen, O., Leino-Kilpi, H., van
der Arend, A., & Katajisto, J (2011). 'Comparison of nurse educators’ and nursing students’ descriptions of teaching codes of ethics', Nursing Ethics, 18, 5, pp. 710-724, CINAHL Complete, EBSCOhost
6. Numminen, O, van der Arend, A, & Leino-Kilpi, H. (2009). 'Nurses' codes of ethics in practice and education: a review of the literature', Scandinavian Journal Of Caring Sciences, 23, 2, pp. 380-394, CINAHL Complete, EBSCOhost,
7. Numminen, O, van der Arend, A, & Leino-Kilpi, H. ( 2009). 'Nurse educators' and nursing students' perspectives on teaching codes of ethics', Nursing Ethics, 16, 1, pp. 69-82, CINAHL Complete, EBSCOhost 8. Zahedi, F., Sanjari, M., Aala, M.,
Peymani, M., Aramesh, K., Parsapour, A., … Dastgerdi, M. V. (2013). The Code of Ethics for Nurses. Iranian Journal of Public Health, 42(Supple1), 1–8.
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questionnaires include demographic data, knowledges of Indonesian nurses’ codes of ethic.
Then data analysis using Descriptive statistic. On the other hand, 11 students have Indepth interviewed with structured interview guidance. In addition, the result of interview analysed the contents and it will be thematic analysis.
Findings
1. Respondent Characteristics
Respondent characteristics in this study is nursing student in profession program. The characteristics according to ages, gender and ethics, it can see in table 1:
Table 1.Frequencies DistributionNursing Student in Profession Program according
to gender, age and ethnics. No. Characteristics
Frequen-cies Percen-tages 1. Gender a. Male b. Female 25 58 30% 70% 2. Ages
a. 21 years b. 22 years c. 23 years d. 24 years e. 25 years f. 26 years
5 32 36 6 3 1 6% 39% 43% 7% 4% 1% 3. Ethnics a. Javanese b. Sundanese c. Dayaknese d. Melayunese e. Bimanese f. Sasaknese g. Minangnese h. Banjarnese i. Malukunese 49 7 5 8 5 5 1 1 1 60% 8% 6% 10% 6% 6% 1% 1% 1%
j. Betawinese 1 1%
Source: Primary Data, 2016
According to table 1, it can know that characteristics of respondent based on gender, the majority respondent is female with 58 people (70%). Most of them are 23 years old with 36 people (43%). The majority respondent came from Javanese culture with 49 people (60%).
Table 2. Knowledges Level of Indonesian Nurses’s Codes of Ethics
The level of knowledges of Indonesian Nurses’ Codes of Ethics in nursing student can see in table 2:
N o Chatagoriz ed Frequenci es Percentage s
1. Good 59 71,1 %
2. Moderate 24 28,9%
3. Less 0 0%
T ot al
83 100%
Source: Primary Data, 2016
According to table 1, it can know that the largest respondent has good knowledge with 59 people (71.1%), the second rank are moderate level with 24 people (28.9%) and none of them have less level in knowledge about Indonesian ethic codes of nurses.
Table 3. Knowledges level of Contents Nurses’s Codes of Ethics
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The level of knowledge of nursing students had divided into 5 aspects, it can see in table 3:
No Nurses’ ethic
codes Chatego-rized Frequen-cies Percen-tages 1 Nurses and
patient ModerateGood 6914 83,1%16,9% 2 Nurses and
practice
Good Moderate
68 15
81,9% 18,1% 3 Nurses and
society Good Moderate 6518 78,3%21,7% 4 Nurses and
co-workers
Good Moderate
68 15
81,9% 18,1% 5 Nurses and
organization Good Moderate 6221 74,7%25,3%
Source: Primary Data, 2016
According to table 3, it can know that the majority respondent has good level of knowledge for every aspect in nurses’ ethic codes. The highest percentages is “nurses and patients” with largest respondent have good knowledge with 69 people (83.1%) while the lowest is “ nurses and profession” with 62 people (74.7%).
2. Perspectives of Nurses’ Ethic Codes This study have two themes including definition and functions of ethics and contents of nurses’s codes of ethics. A. Knowledge about definition and
function of nursing ethic codes Examples of Students Narrative Comments on Definition and Function Nurse’s Codes of Ethics. Ethic codes nurse’s is a rules that have to obey by nurses” (R1)
Nurse’s ethic codes is a matters that direct nurses related to nurses patient relationship and society” (R2)
“Nurse’s ethic codes is like a guidance or limitations what have to do as a nurses and how to manage the patients without enter the other profession” (R4)
Nurse’s ethic codes are a guidance of us to do nursing action that containing of ethic codes which is good is like what?” (R6)
“Nurse’s ethic codes are values or norms that has committed to manage our profession to do their obligations and the contents what have to do and not”(R9)
B. Knowledge about contents nursing ethic codes
2.1 Examples of Students Narrative Comments on Nurses and Patient Nurses respect the patient, no differences the ethnic of patients, keep the privacy of patients” (R2)
“Nurse must be fair in view and take care the patients”(R6)
“Nurses have obligations to make patients and their feel comfort, building trust and kindness”(R7)
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“Nurses as a patient’s advocate have role to give advice to patient, maintain mutual trust relationship and practicing their job well done. Nurses have responsibility to do nursing intervention suitable with the patients “(R9)
Nurses have to keep privacy of patients and practice caring “(R10)
2.2 Examples of Students Narrative Comments on Nurses and Practice “Nurses up hold professionalism and they must follow the rules in services” (R2) “Nurses have responsible to give the best service since hospital admission until the patient get heal” (R5)
Nurses in practice have to caring, know their job description, know their independent nursing intervention and collaborate to solve the patient problems” (R7)
“Nurses in practices maintain ethical principles such as maleficient, beneficiene, veracity, justice, do not distinguish the level of economic, ethnic and gender”(R9) “Nurses have responsible to keep patient safety “(R10)
2.3 Examples of Students Narrative Comments on Nurses and Society “Nurses attitude are good, openness and ready to help the society. Professional attitude is mutual relationship” (R1)
Nurses have to serve society comprehensively, give the information and justice” (R3)
“Nurses give the health promotion to improve quality of life and wellness “(R4)
“Nurses have mutual relationship, providing medical information and education. Nurses must be prepared according to its competence or knowledge” (R7)
“Society is the priority for the intervention, health education and empowerment to improve health level” (R9)
2.4 Examples of Students Narrative Comments on Nurses and Organization
“Organization have to clear the profession of nurses, the right of nurses” (R4)
Nurses communicate and support all of the people in Indonesian National Nurses Association for example in prevention diseases” (R5)
“ All of the nurses have to join in organizational profession and they have to care about organization of their contribution” (R7)
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“Nurses have to play role in organization and obey their rules” (R10)
“Nurses should up date their knowledge because the information of health increase significantly”(R11)
2.5 Examples of Students Narrative Comments on Nurses and Co-Workers
“ The relationship between nurses and co-workers should not have problems. Nurses have competencies and knowledge itself, independent, give patient safety and good quality of services” (R7)
“ Nurses and their colleagues should help each other, doing collaboration and coöperation” (R8)
“Nurses have mutual cooperation , keep privacy and implement the intervention appropriate with their competencies” (R9) “Nurses should to respect and be a good team work with their colleagues” (R10) “Nurses know the their competencies to care or cure, they have to communicate with good way, give the suggestion for colleagues” (R11)
Discussion
According to Numminen et al (2009), nurses’ knowledge and use of the codes are deficient. However, the nurses
think that ethic codes are required to guide nursing practice and provide professional status and identity. In the present study, the 79.1% of nurses acquired their knowledge of ethics in nursing school, and 53.6% of them acquired their knowledge of ethics during work also 40.5% of nurses stated that nursing ethic codes is formally given them (Mohajjel et al, 2013).
According the Code, the nurses should be sensitive to the ethical challenges and do their best to fulfill their moral duties including informed consent, respect to privacy and confidentiality of patients/clients, relationship with colleagues, efficient performance of the professional duties, conflicts of interests, ethics in educational activities and protection of participants in research and consultation with the hospital ethics committee for decision-making when are confronted with ethical cases (Zahedi et al, 2013).
Experience and research have shown that nursing students deliberation of ethical matters is practically oriented and connected to their concrete personal experiences (Numminen et al. 2009), and that relating ethics education closely to practical context makes it meaningful to nurses (Gatsmants et al 1998; Meulensberg et. Al, 2004; Van der Arend & Smith, 2003; Woods, 2005)
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According to Numminen et al (2009), several studies might add valuable knowledge of education of the codes in varying educational systems and health care contexts revealing strengths as well as problems area in their teaching. The quality of teaching the codes aiming at educating nurses who can provide ethically high quality care is important (Salvage & Heidjen 1997; Sasso et al. 2008).
Knowledge of ethic codes is a priority foundation for nurses to give nursing care because nurses’ ethic codes is one of the characteristics of nursing profession to keen up, maintain, and increase profession standards that reflected by all of nurses as a moral value for patients, society and co workers (Abrori, 2016; Nasrullah, 2014).
Conclusion
The perspectives of Indonesian nurses’ ethic codes on nursing student profession is good in quantitative and qualitative analysis.
Suggestion
Further research should focus on the implementation of ethic codes of nurses’ including assessment and evaluation methods on nursing students.
References
1. Butts, J. B. Ethics in Professional Nursing Practice. Jones and Bartlett Publishers.
2. ICN revised 2012. The ICN Codes of Ethics for Nurses.
3. Lachman, V, D. (2009). Practical use of Nursing Code of Ethics: Part II. Article. Medsurg Nursing. May/ June 2009-Vol. 18/ No. 3
4. MohajjelAghdam, A., Hassankhani, H., Zamanzadeh, V., Khameneh, S., & Moghaddam, S. (2013). Knowledge and Performance about Nursing Ethic Codes from Nurses’ and Patients’ Perspective in Tabriz Teaching Hospitals, Iran. Journal of Caring Sciences, 2(3), 219–227. http://doi.org/10.5681/jcs.2013.027. 5. Numminen, O., Leino-Kilpi, H., van
der Arend, A., & Katajisto, J (2011). 'Comparison of nurse educators’ and nursing students’ descriptions of teaching codes of ethics', Nursing Ethics, 18, 5, pp. 710-724, CINAHL Complete, EBSCOhost
6. Numminen, O, van der Arend, A, & Leino-Kilpi, H. (2009). 'Nurses' codes of ethics in practice and education: a review of the literature', Scandinavian Journal Of Caring Sciences, 23, 2, pp. 380-394, CINAHL Complete, EBSCOhost,
7. Numminen, O, van der Arend, A, & Leino-Kilpi, H. ( 2009). 'Nurse educators' and nursing students' perspectives on teaching codes of ethics', Nursing Ethics, 16, 1, pp. 69-82, CINAHL Complete, EBSCOhost 8. Zahedi, F., Sanjari, M., Aala, M.,
Peymani, M., Aramesh, K., Parsapour, A., … Dastgerdi, M. V. (2013). The Code of Ethics for Nurses. Iranian Journal of Public Health, 42(Supple1), 1–8.
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