Fidelity in nursing is the ethical principle of being faithful to commitments and responsibilities—both explicit and implied. It’s about keeping promises, honoring trust, and consistently acting in the best interest of patients, colleagues, and the profession.
What Fidelity Looks Like in Practice
- Following through: If you tell a patient, “I’ll be back in 10 minutes with your medication,” fidelity means you return as promised—or communicate if delayed.
- Maintaining confidentiality: Upholding privacy even when it’s inconvenient or unpopular.
- Being loyal to ethical standards: Acting with integrity, even under pressure from peers or systems.
- Supporting patient autonomy: Respecting choices, even when they differ from your own beliefs.
What Does Fidelity in Nursing Exactly Mean?
Fidelity is defined as faithfulness to a person, belief, or cause. It is demonstrated by being loyal and supportive. Fidelity in nursing means nurses must remain true to professional promises, such as the promise to provide high-quality, competent, safe, and efficient patient care. It also means being supportive of patient decisions, promoting patient autonomy and the furtherance of the profession.
Importance of Fidelity in Nursing
Fidelity in nursing can be demonstrated by being loyal and supportive. Fidelity means nurses must be faithful to professional promises such as high-quality care. It also means promoting patient autonomy and showing respect for a patient’s decisions regarding their healthcare.
1. Strengthens the nurse-patient relationship.
Patients and their loved ones often feel anxious or afraid. When nurses practice fidelity, they create an environment conducive to developing trusting relationships. Trusting relationships can ease the emotional stress of patients, their loved ones, and the nurse by promoting open communication and allowing them to establish attainable goals.
2. Promotes favourable patient outcomes.
Several factors affect patient outcomes. Nurses who conduct themselves professionally and provide quality patient care help improve the likelihood of positive patient outcomes. Patients who feel comfortable with nurses and believe nurses have their best interest in mind are more likely to follow care plans, which also contributes to good outcomes.
3.Results in increased patient satisfaction.
Patients cared for by nurses concerned with honesty, integrity, and other principles of fidelity are more satisfied with the care they receive. Patient satisfaction is instrumental in establishing a public image for healthcare facilities, strengthening the argument in favor of fidelity in nursing.
4. Promotes patients’ autonomy.
When nurses encourage patient autonomy, patients feel empowered to make decisions about their medical care and have the confidence in knowing their decisions are supported by their nurses and healthcare providers. Patients benefit from this by having an increased sense of self-confidence and an increased likelihood of compliance with their treatment plan. Healthcare teams benefit because patient satisfaction and compliance reduce the risk of negative patient outcomes.
5. Good habits are easily duplicated.
When nurses observe ethical practices such as fidelity, they inspire others to demonstrate the same behaviors. One of the benefits of fidelity in nursing is that nurses dedicated to positive patient outcomes and ethical behaviors create an atmosphere conducive to developing and maintaining good practices.
Examples of Fidelity in Nursing?
Fidelity in nursing involves demonstrating notions of faithfulness and loyalty, the importance of honouring commitments and collaboration in nursing care.
1. If you tell a patient you will be back to check on them, follow through by doing so.
It is common for nurses to have several patients for whom they provide care each day. If you go to a patient’s room to check on them, perform an assessment, administer medication or treatment, it is reasonable for them to expect you to return. Fidelity in nursing means following through with your promises. If you see the need to reprioritize the order you see patients or if an emergency occurs, ask another staff member to check on the patient and explain why you have not yet returned.
2. Patients often feel overwhelmed or afraid and may act rude or disgruntled toward nurses.
If you have not yet experienced the rudeness of a patient or one of their family members, wait for it; you will. Sometimes it may be challenging to avoid lashing out or responding inappropriately to others’ behavior. As nurses, our commitment to fidelity means always doing what is right… even if others do not. When we actively practice fidelity in nursing, we learn to respond to uncomfortable or stressful situations by considering what the patient is experiencing and finding a peaceful way to resolve issues.
3. Honouring a patient’s decision and supporting family, even when you disagree with his choice.
It can sometimes feel difficult to separate personal feelings and emotions from patient situations. As nurses, it is our responsibility to know where to draw the line and honor fidelity in nursing.
4. Being faithful to the nursing profession
Nursing is a rewarding profession with endless opportunities. However, at times it can be stressful. Fidelity in nursing practice is demonstrated by nurses who work to promote and protect the profession, despite stress or conflicts.
5. Fulfilling commitments
An oath or agreement can be verbal, written, or implied. When nurses keep their word and fulfil commitments, patients and colleagues view them as trustworthy and dependable, which are characteristics of fidelity in nursing.
6. Protecting patient confidentiality
Fidelity involves not only truth-telling but confidentiality as well. Nurses must keep personal patient information confidential. While some circumstances allow sharing of information, it is the nurse’s responsibility to follow legal and ethical guidelines to ensure patient privacy and confidentiality. Failure to do so can be detrimental to the nurse-patient relationship and can result in legal ramifications for the nurse and the organization they represent.
7. Demonstrating role fidelity
Role fidelity is defined as the “faithful practice of the duties contained in a particular practice.” Nurses demonstrate fidelity in nursing by meeting the patient’s reasonable expectations of the nursing profession. For example, patients should reasonably expect nurses to be competent, respectful, and professional.
Consequences of Lack of Fidelity in Nursing
Just as there are benefits to practicing fidelity in nursing, there are also consequences associated with a lack of fidelity. Nurses are obligated to provide quality patient care and represent patient interests with honesty and integrity. Failure to do so can have profound effects on patients, nurses, the nurse profession, and healthcare organizations. The following are a few examples of the consequences of a lack of fidelity in nursing.
1. Loss of credibility with colleagues:
Fidelity in nursing means practicing honesty and integrity. When there is a lack of fidelity on the part of the nurse, colleagues may feel jilted or believe the nurse is not dependable. The lack of fidelity can lead to the nurse losing credibility among peers and can impact interprofessional relationships.
2. Lack of fidelity in nursing can lead to career disruptions, including loss of a job or revoked license.
Employers and state Boards of Nursing expect ethical standards of practice to be upheld. When nurses compromise the integrity of patient care or organizations by demonstrating a lack of fidelity, it can negatively impact patients, nurses, employers, organizations, and the nursing profession. Nurses must learn to recognize when instances of poor acts of fidelity occur and implement measures to correct those issues. Failure to do so can result in termination from a job or, in some cases, loss of nursing license.
3. When nurses lack fidelity, patients lose confidence in them and their ability to provide effective care.
This lack of trust leads to noncompliance to treatment plans which can negatively impact patient outcomes and nurse-patient relationships and strain professional relationships.
4. Increased risk to patient and nurse safety:
Fidelity is associated with the principle of integrity. Nurses who lack fidelity may not demonstrate integrity in their practice which can lead to increased risks to the safety and well-being of patients, their loved ones, and teams.
5. Lack of fidelity in nursing practice can be detrimental to the reputation of a healthcare facility.
As nurses, it is essential to understand our behavior directly impacts the reputation of our team and the organizations for whom we work. Nurses must understand and appreciate the importance of ethical practices and the role they play in representing a healthcare facility, nurse, or team.
REFERENCES:
- Code of Ethics for Registered Nurses. 2017 edition. Canadian Nurses Association; 2017.
- Ethical decision-making. Nurs Made Incred Easy. 2018;16(2):4-5. doi:10.1097/01.NME.0000529954.89032.f2
- Code of Ethics for Nurses. Published online 2015. Accessed February 23, 2023. https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/code-of-ethics-for-nurses/coe-view-only/
- Haddad L, Geiger R. Nursing Ethical Considerations. StatPearls. Accessed February 23, 2023. https://www-ncbi-nlm-nih-gov.ezproxy.library.ubc.ca/books/NBK526054/
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