Speech by Prof. Khaled Abdel Ghaffar

Deputy Prime Minister for Human Development and Minister of Health and Population
My sons and daughters, members of the Egyptian Nursing Authority,
I present this speech to you as an appreciation for your efforts to elevate the nursing profession. Nursing is a profession based on scientific and ethical foundations, alongside professional responsibilities and duties, which include literary, behavioral, and professional obligations.
This profession has its own ethical code that governs and regulates work, requiring an understanding and appreciation of ethical principles and behaviors as soon as they are adopted. Practitioners must uphold these standards in both their private and public lives.
The ethics of the nursing profession emphasize human rights, regardless of race, age, religion, disability, or gender.
The ethics of the profession also recommend ensuring justice, equality, and safe healthcare without discrimination. This is achieved by caring for patients and their families, as well as by maintaining a safe healthcare environment that promotes the well-being of Egyptian citizens.
May God protect you and keep you as a pillar of support for our beloved Egypt.

Speech by Prof. Mohamed Mostafa Lotayef

The Executive president of the Egyptian Health Council and Chairman of the Board of Directors of the Egyptian Health Council
Dear colleagues,
I am honored to present to you the Code of Ethics for the Egyptian Nursing Profession, which represents a highly distinguished and participatory precedent among all healthcare workers in the sector, aimed at promoting professional and ethical standards in the field of nursing.
Nursing is one of the fundamental pillars of the healthcare system. Nurses play a vital role in providing medical care and psychological and social support to patients and their families. Hence, the significance of establishing a Code of Ethics for the profession, ensuring adherence to ethical and professional standards.
This charter also reflects the commitment of the Egyptian healthcare system to providing the best healthcare services to all citizens. The ethics of the nursing profession set high-quality healthcare standards that ensure full patient rights and dignity.
Furthermore, this ethical charter aligns with international standards and guidelines issued by global organizations, universities, and civil society institutions.
I extend my sincere gratitude and appreciation to everyone who contributed to the preparation of this charter, which reflects our keenness to uphold ethical and professional standards in all healthcare fields.
Finally, I hope that this charter marks a significant step towards a better future for nursing in Egypt and enhances the quality of healthcare services provided.
I thank you all for your support and dedication to serving the community.

Speech by Dr. Kawthar Mahmoud

General Secretary of Egyptian Nursing
Member of the Egyptian Health Council Board of Directors
"Indeed, nations remain as long as their morals remain; when their morals disappear, they disappear."
My colleagues and fellow members of the Egyptian Nursing Authority, I present to you the Code of Ethics for the Egyptian Nursing Profession, trusting that we will spare no effort in achieving all the values and objectives documented in this charter. It serves as a beacon guiding you towards aspirations and ambitions in developing the Egyptian healthcare system through adherence to humanitarian, ethical, scientific, and practical aspects alike.
The Code of Ethics for the Egyptian Nursing Profession is a consensus among nursing and healthcare leaders in Egypt to commit to and promote awareness of fair, evidence-based, high-quality nursing care that meets the satisfaction of both healthcare providers and recipients, as well as all members of society.
May God protect Egypt and guide you towards what He loves and is pleased with...

Professional Oath

I swear by Almighty God to be sincere in my work, to fear God in my profession, to respect its laws and regulations, and to perform my duties with competence and dedication. I pledge to base my practice on knowledge derived from nursing sciences and to exert my utmost effort in caring for every patient entrusted to me.
I will preserve their dignity, maintain their confidentiality, defend their rights, and protect them from any harm. I will not fear blame when speaking the truth. I will strive to provide a safe environment for patients, families, and society.
I vow to continuously develop myself, respect and cooperate with my colleagues in the profession, and uphold my profession with righteousness and piety.
And God is my witness to what I say…

Introduction and General Principles

Definition of the Ethical Charter:
The ethical charter for the profession is defined as a set of standards, principles, high values, and agreed-upon ethical practices that members of the profession must adopt in their thinking and behavior. It governs their practice at work, determines their duties, and outlines their responsibilities and professional roles.
The introduction and objectives of this charter are an integral part of it and should be read alongside it.
This charter does not replace laws, regulations, or applicable decisions; rather, it complements and enhances them.

Vision:
Elevating the ethics and morals of the nursing profession, as well as the general behavioral conduct and appearance of its members.

Mission:
Enhancing professional responsibility and commitment to the ethical principles of the nursing profession among its members.

General Objective:
Defining the general framework for professional ethics, ethical practices, societal values, responsibilities, and rights that guide nursing ethics through the various roles performed by members of the profession within the healthcare team.
 

Definition of Ethics.
Definition of Profession.
Definition of Nursing Ethics.
Definition of Accountability and Responsibility.
Principles, Values, and Ethics of the Nursing Profession.
Principles and Values of Applied Scientific Research.
Foundations and Laws of the Nursing Profession.
Decision-Making and Mechanisms for Problem-Solving.

Definitions

Definition of Ethics
Ethics refers to a set of moral principles and professional values that guide individuals in their work and decision-making processes. It defines appropriate professional conduct and responsibilities.
Definition of Professionalism
Professionalism involves adherence to a well-defined set of standards, regulations, and ethical principles within the nursing profession. It ensures commitment to high-quality care and accountability in all aspects of practice.
Definition of Nursing Ethics
Nursing ethics encompasses the moral guidelines that govern nursing practice. It ensures that nurses perform their duties while respecting the dignity, rights, and safety of patients.
Accountability and Responsibility
Accountability refers to the obligation of nurses to take responsibility for their actions and decisions. It ensures that healthcare professionals operate within legal and ethical boundaries.
Respect:
Commitment to honoring and valuing each individual while fostering a safe work environment that promotes inclusivity, politeness, trust, and open communication.
Non-Maleficence (Avoiding Harm):
Commitment to refraining from causing harm or injury to service providers, recipients, and the community as a whole.
Justice and Fairness:
Ensuring equality in providing nursing care based on the patient’s condition, regardless of type, age, gender, beliefs, or color.
Integrity:
Adhering to honesty, consistency, and avoiding conflicts of interest while acting in accordance with laws and regulations.
Advocacy:
Protecting the rights of service recipients, providers, individuals, families, and the community in accordance with professional regulations and laws.
Care:
Providing specific nursing services tailored to the needs of the service recipient, in line with healthcare institution policies.
Autonomy:
Respecting service providers and recipients while enabling their participation in healthcare decisions.
Honesty:
Commitment to truthfulness, avoiding deception, and refraining from misleading others.
Accountability:
Holding nursing professionals responsible for their practices, ensuring they fulfill their roles according to ethical and professional standards, while adhering to regulations and disciplinary measures.

Ethical Principles and Values of Nursing

Values originate from religion, culture, personal traits, and professional ethics in the field of the profession.

Some of the most important values in the nursing profession:

 Respecting Patients’ Rights: Nurses must respect patients' rights to make informed decisions about their care as long as it does not contradict their health needs.
Promoting Quality Care: Nurses should ensure quality care for all members of society.
Using Resources Responsibly: Medical resources should be utilized within professional guidelines and only when necessary.
Ensuring Patient Safety: Nurses should protect patients from any harm, ensure safe environments, and deliver appropriate healthcare.
Accountability: Nurses must take responsibility for their actions and be held accountable for professional decisions.
Creating a Supportive Environment: Nurses should provide an ethical, social, economic, and psychological environment conducive to patients' health.

Ethical Principles in Scientific Research

It is necessary to implement the established laws, decisions, and principles in this regard, specifically:
Respect for Individuals: Ensuring the right to make informed decisions and allowing service recipients to independently choose whether to participate. This principle also includes respecting and protecting vulnerable groups such as children and individuals with special needs.
Beneficence: Ensuring that research benefits individuals and serves the public good while maximizing possible advantages.
Non-Maleficence (Do No Harm): Avoiding any harm to participants and ensuring their safety throughout the research process.
Confidentiality and Data Protection: Maintaining confidentiality regarding the information provided by research participants and ensuring that sensitive data is deleted after use.
Commitment to Objectivity: Presenting complete, accurate information about the nature of the research, its objectives, expected benefits, and potential risks.
Informed Consent: Participants must provide written consent to participate in the study or have a legal representative approve it.
Right to Withdraw: Participants have the right to withdraw from the study at any time without consequences.
Researcher’s Responsibility: Ensuring the safety, comfort, and privacy of research participants at all stages of the study.
Right to Access Data: Participants have the right to request access to their data upon request.
Provision of Treatment: Participants in the study should receive free treatment for any illnesses or complications related to the research.
Ethical Compliance: The research should adhere to ethical frameworks and uphold human rights and societal values.
Laws and Foundations of the Nursing Profession

The following laws and foundations must be applied during the practice of the nursing profession, along with any regulations issued in this regard. These include:

• Laws and decisions issued by the Ministry of Health and Population, the Ministry of Higher Education, and the Egyptian Nursing Syndicate.
• The law of the Egyptian Health Council and its executive regulations.
• The law of scientific ethics and confidential research.
• The law of the National Council for Women.
• The National Strategy for Human Rights.
• Laws prohibiting violence and harmful practices against women (such as female genital mutilation and child marriage).

________________________________________
Principles for Decision-Making and Mechanisms for Problem-Solving
When practicing the nursing profession, the following principles must be considered when making decisions and resolving problems:
Forming a specialized committee to study issues and make decisions. If no such committee exists in the institution, a specialized committee within the health institution should be established.
Understanding the situation by gathering all necessary information about the problem from scientific, practical, social, and other aspects.
Analyzing the problem and identifying its causes to reach its root.
Studying similar cases and determining factors contributing to the problem.
Developing an action plan and selecting appropriate methods to resolve the issue.
Choosing realistic and achievable goals for problem resolution.
Applying appropriate and systematic approaches within the health institution.
Evaluating the solution to ensure its effectiveness in resolving the issue.

Rights, Responsibilities, and Ethical Aspects in Nursing Care and Relationships Among Nursing Professionals

Providing nursing care is not limited to direct patient service by nursing professionals; rather, it is a comprehensive care service protected by a set of ethical obligations that govern the relationships between nurses and others, including the following:

Responsibilities:
    •    Responsibilities of the professional union.
    •    Responsibilities of nursing professionals towards the profession.
    •    Responsibilities of nursing professionals towards colleagues.
    •    Responsibilities of nursing professionals towards the institution they work in.
    •    The patient.
    •    The nursing team.
    •    Patients’ rights.
    •    Rights of nursing professionals.
    •    Supervisory and regulatory bodies (Ministry of Health, Ministry of Higher Education, university hospitals, other entities).

Union Responsibilities
• Establishing and implementing fundamental principles to regulate work practices and general standards for the nursing profession, ensuring adherence to ethical values and commitments to support the following objectives:
• Providing a safe working environment for nursing professionals.
• Safeguarding the rights of nursing professionals in healthcare institutions.
• Monitoring, evaluating, and promoting professional practices while defending the profession.
• Assisting in updating nursing ethics, raising awareness, and reinforcing adherence to them among nursing professionals.
• Establishing specialized committees within the union to address nursing issues and protect members professionally.
• Guiding nursing professionals in all legal matters related to their practice.

Continuation of Union Responsibilities
• Ensuring compliance with nursing practice requirements through the following certifications:

• Obtaining an accredited qualification from a recognized institution that supports nursing studies, with penalties for violations.
• Obtaining a license to practice the nursing profession.
• Adhering to professional ethics required for nursing practice.
• Complying with the approved job description during nursing practice.

Responsibilities of Nursing Professionals Toward the Profession
• Respecting the rights of service recipients and their right to life and dignity.
• Committing to the application of relevant professional legislation and administrative regulations within the healthcare institution.
• Acting with compassion, wisdom, and fairness in providing and distributing services.
• Maintaining confidentiality, especially regarding patients’ private matters.
• Providing nursing care services to all individuals regardless of gender, race, creed, or religion.
• Providing comprehensive healthcare that ensures the safety of individuals, families, and society, in coordination and communication with team members.
• Overcoming personal emotions to ensure a professional and appropriate interaction with the public.
• Demonstrating honesty in documenting information and conveying it to healthcare team members with complete transparency.
• Reporting to supervisors when facing any situations beyond their professional competence.

Responsibilities of Nursing Professionals Toward Colleagues at Work

• Actively cooperating with healthcare team members and staff while maintaining professional relationships.
• Providing complete and accurate reports regarding the health status of service recipients to other members of the healthcare team.
• Avoiding inappropriate speech about colleagues and refraining from making comments that may undermine their skills or opinions.
• Not withholding information or experiences from newly graduated nursing professionals.
Responsibilities of Nursing Professionals Toward the Healthcare Institution They Work In

• Maintaining the properties and assets of the healthcare institution they work in , as well as protecting its confidential information.
• Respecting the regulations and laws governing work in healthcare institutions.
• Adhering to assigned work schedules and ensuring punctuality.
• Maintaining an appropriate professional appearance while on duty.
• Using the institution’s supplies, equipment, and facilities properly and taking necessary measures to preserve and maintain them.

Responsibilities of Nursing Professionals Toward Society

They should be:
• Good citizens who respect the traditions and customs of society.
• Knowledgeable and respectful of the country’s healthcare regulations.
• Sufficiently aware of the country’s laws and legislation.
• Cooperative with professionals to improve the health status of individuals, families, and communities, addressing societal healthcare needs.
• Refrain from participating in any actions that may harm the dignity or safety of citizens.

Nurses and the Practice of the Nursing Profession

• Nurses bear personal responsibility for practicing the nursing profession and maintaining competence through continuous education and training.
• Nurses must take care of their own health and avoid exposing themselves to danger. They should not consume or use dangerous substances, medications, or treatment methods intended for patients unless prescribed for themselves.
• Nurses must adhere to ethical standards that reflect positively on the profession and strengthen public trust in them.
•Ensure the use of scientific and technical advancements in nursing care to provide a safe environment that guarantees the rights and well-being of service recipients.

Rights of Service Recipients and Their Families
    •    The right to receive adequate information about the recipient’s medical condition and treatment plan to enable them to participate in decision-making regarding their care, in accordance with established regulations.
    •    The right to access nursing services and receive care without delay.
    •    The right to care without discrimination based on race, nationality, age, payment method for treatment, health status, mental condition, or physical condition.
    •    The right to privacy and confidentiality of medical information, ensuring that patient records are kept private and not accessed by unauthorized individuals, except for healthcare professionals providing treatment.
    •    The right to receive care from trained and specialized personnel.
    •    The right to be informed of their rights and responsibilities based on established criteria.
    •    The right to be informed about the general regulations and guidelines of the healthcare facility and the names of the healthcare team providing services.
    •    The right to refuse any nursing procedure or medication in writing, in accordance with established policies, provided that they are informed about the necessity of treatment and the importance of nursing procedures.
    •    The right to give or withhold written consent to participate in clinical research conducted within the healthcare institution related to their condition.
    •    The right to know the reasons for their transfer from one location to another within or outside the hospital.

Rights of Nursing Professionals

• The existence of legislation that supports nursing professionals in understanding their responsibilities, duties, and professional rights.
• Providing a safe working environment that includes health protection measures.
• Establishing an organizational structure that highlights the administrative independence of nursing and sets performance standards (clinical practice guidelines).
• The right of nursing professionals to receive accredited, high-quality nursing education and continuous learning opportunities at all levels.
• The opportunity to participate in union activities and adhere to its regulations and decisions.
• Consideration of professional, social, and economic conditions that encourage work and meet their needs.
• Respect for nursing professionals, their beliefs, and their privacy.
• The right of nursing professionals to express their opinions and propose improvements to enhance nursing practices.
• The right of nursing professionals to assume senior administrative positions based on established regulations.
• Ensuring that healthcare institutions provide comprehensive healthcare for nursing professionals and their families.

Collaborating Entities and Their Supportive Roles
“Ministry of Health and Population – Ministry of Higher Education (University Hospitals) – and Other Entities”

• Establishing a vision and fundamental principles regarding the rights of service recipients and defining them to ensure respect for human dignity and the protection of their lives. This applies to all nursing facilities, including compliance with privacy requirements in cases of patient transfer or deceased individuals.
• Developing regulations and laws to ensure the provision of safe nursing care in a manner that respects human rights and beliefs.
• Establishing fundamental principles to ensure fair and essential working conditions for nurses, aligned with professional ethics and international labor laws.
• Assisting in providing an adequate number of nursing professionals in a way that meets labor market demands and aligns with approved staffing ratios in healthcare institutions, while ensuring that non-nurses do not practice nursing work.

Continuation of Collaborating Entities and Their Supportive Roles
 “Ministry of Health and Population – Ministry of Higher Education (University Hospitals) – and Other Entities”

• Providing a safe work environment, necessary equipment, and supplies to deliver efficient and high-quality nursing care.
• Supporting opportunities for nursing professionals to develop and receive continuous training while enhancing their roles in care and management.
• Empowering nursing professionals by granting them professional independence and enabling them to participate in the formulation of technical policies and guidelines within healthcare institutions.
• Defining appropriate working hours for nursing staff according to the nature of their work.
• Ensuring the presence of adequate financial resources to improve wages and provide incentives that reflect their efforts and responsibilities.
• Promoting a culture of professional appreciation and respect, ensuring fair treatment for nurses by their colleagues and society.
• Creating pathways for reporting violations or poor professional conduct to the relevant supervisory and regulatory bodies.

Continuation of Collaborating Entities and Their Supportive Roles

• Integrating ethical nursing-related topics into nursing education curricula.
• Encouraging nursing students to engage in professional advocacy and familiarize themselves with the legal and regulatory aspects of nursing practice.
• Training nursing students in making ethical decisions when encountering challenges in their professional practice.
• Conducting, documenting, publishing, and implementing research findings that contribute to the advancement of the nursing profession.
 

Principles of Nursing Ethics:
Respecting human rights, including the right to life, dignity, and humane treatment, is a fundamental principle in the nursing profession. Nursing care should not be influenced by factors such as race, ethnicity, color, gender, beliefs, political system, or social status.

Therefore, the roles of nursing professionals must be aligned with ethical standards, and their responsibilities should be clearly defined according to nursing competencies, which are linked to performance standards in nursing care.

Components of Effective Nursing Practice
•  Legislations that regulate professional practice within the framework of relevant laws and regulations.
• Internal work systems in healthcare institutions that follow established performance standards.
• Effective management, supervision, and collaboration among healthcare team members.
• A suitable work environment.
• Adequate resources.
• Developing self-regulation and professional accountability.
• Nursing professionals possessing ethical, professional, and scientifically competent qualities.

Fundamentals of Nursing Care
• Practicing nursing only after obtaining the required professional license.
• Commitment to the ethics and code of conduct of the nursing profession.
• Identifying service priorities and developing a care plan in coordination with healthcare team members.
• Providing sufficient and effective nursing care based on recognized standards that meet the physical, psychological, and moral needs of service recipients and their families.
• Maintaining patient confidentiality and allowing them to participate in decision-making.
• Implementing technology and scientific advancements in nursing care based on established standards.
• Ensuring patient safety according to recognized performance standards.
• Conducting regular assessments to measure patient satisfaction with the provided nursing care, following established performance evaluation criteria.

The qualities that members of the nursing profession should possess.

•    Definition of error.
•    Definition of negligence.
•    Types of errors.
•    Examples of nursing errors.
•    Factors leading to errors.
•    Manifestations of negligence in nursing practices.
•    Scope of legal responsibility.
•    Types of damage.

Error:

It is a behavior that results from a lack of knowledge of the assigned tasks while providing nursing care. Some errors can be so severe that they cause harm to the service recipient, lead to a permanent disability, or even result in death.

Negligence:

Failure to adhere to professional rules and regulations, along with a lack of attention, excessive carelessness, failure to respond appropriately to situations, and underestimating the importance of tasks.

Examples of Potential Nursing Errors
Nursing procedures that are carried out incorrectly, such as:

•    Mistakes and negligence in providing the prescribed nursing care.
•    Practicing nursing without obtaining the necessary license from the competent authorities.
•    Refusal of nursing professionals to provide nursing care.
•    Disclosing patient secrets.
•    Giving the patient the wrong medication due to failure to follow the five rights of medication administration (right name, right dose, right route, right time, right patient).
•    Failure or negligence in monitoring the patient's condition.
•    Performing nursing procedures incorrectly, in violation of established protocols.

Factors Leading to Errors
•    Rushing to make judgments.
•    Lack of knowledge and proper nursing practices.
•    Incorrect assessment.
•    Laziness, forgetfulness, and loss of concentration due to fatigue.
•    Weak follow-up and observation.
•    Postponing scheduled tasks to a later time.
•    Oversimplifying matters and relying on others.
•    Lack of good judgment of surrounding circumstances.
•    Resorting to lying to avoid difficult situations.

Forms of Negligence in Nursing Work

•    Failure to report any incident that requires reporting.
•    Neglect in providing appropriate nursing care.
•    Failure to write reports and relying only on verbal reports.
•    Negligence in dealing with patients and responsible colleagues.

Scope of Legal Responsibility

•    Practicing the profession without a license from the competent authorities.
•    Working outside the approved employment system.
•    Providing false or inaccurate information.
•    Impersonating titles specific to healthcare professionals.
•    Participating in any unauthorized medical procedure.
•    Engaging in any form of violence, including female genital mutilation.

Types of Harm

Intentional Tort 

• Assault 
• False Imprisonment 

(Wrongful restraint of a service recipient without written consent from them or their guardians.)

• Violation of Privacy 

(Such as searching a patient's belongings or publicly displaying their medical records and distorting them.)

Unintentional Tort 

• Negligence

(Failure in responsibility or a mistake resulting from an act.)

• Malpractice 

(Improper professional practice.)

Avoiding the Consequences of Mistakes: Nurses Must Do the Following:
•    Act appropriately and quickly to correct the mistake.
•    Report the type of mistake immediately once it occurs.
•    Record the mistake, its type, timing, and occurrence in the patient's notes.
•    Continuously and intensively monitor the patient's condition until the risk period passes.
•    Increase specialized training programs and continuous education for nurses.
•    Adhere to the job description assigned to different nursing staff.
•    Perform accurate and timely documentation and apply modern documentation methods.
•    Establish the concept of "Self Monitoring" in nursing curricula and practices.
•    Organize and attend training courses for nurses, educate them about their rights and responsibilities, and focus on ethics and professional practices.