Fidelity: The bedrock of the nurse-patient relationship
In nursing, fidelity means keeping your promises to patients and maintaining their trust. It’s about loyalty and “unswerving adherence to duty.” In fact, it’s one of the core ethical principles that guide nursing practice.
Fidelity is essential for patient safety, building strong therapeutic relationships, and maintaining a good professional reputation. We’ll explore what fidelity in nursing truly means, including the key elements that make it up, how it plays out in day-to-day practice, and the potential consequences of falling short.
What does fidelity mean in nursing? More than just keeping promises
In nursing ethics, fidelity means staying true to your values, principles, and professional standards. It’s about being trustworthy, fulfilling your commitments, and maintaining your patients’ trust in you. Nurses who are known for their fidelity are more likely to be seen as leaders.
Fidelity includes both explicit and implicit promises. Explicit promises are the ones you state directly (“I’ll be back in a few minutes with your pain medicine”). Implicit promises are the expectations that are understood but not necessarily spoken aloud (that you’ll make sure patients receive timely care, for example).
Fidelity vs. veracity: What’s the difference?
It’s easy to confuse fidelity with veracity, but they’re not quite the same. Fidelity is about being faithful to your commitments and promises. Veracity is simply about being truthful.
Both are critical in ethical nursing practice. Honest communication builds trust, and trust is essential for fulfilling your commitments to your patients.
Key elements of fidelity: Building blocks of trust
Trust is built on a few key behaviors. Here’s a look at some of the most important.
Maintaining confidentiality
It’s essential that nurses protect their patients’ privacy and follow all HIPAA regulations about sharing protected health information (PHI). PHI should never be shared with anyone who isn’t authorized to see it, and then only on a “need to know” basis.
Nurses should be very aware of the ethical and legal problems that can arise if they breach confidentiality.
Fulfilling promises and commitments
Keeping your promises, both big and small, is essential for building trust with patients. If you tell a patient you’ll be back in five minutes, be back in five minutes. Delivering on your commitments related to patient care, treatment plans, and referrals is a must.
Upholding professional standards
Nurses need to follow the profession’s code of conduct and maintain their competency. They should act in accordance with the American Nurses Association (ANA) Code of Ethics and stay current with best practices. Keeping their licenses up to date is also essential.
It’s also critical that nurses practice within the scope of their licenses and expertise.
The role of fidelity in nursing practice: A multifaceted impact
When nurses act with fidelity, that has a ripple effect that can improve all aspects of care.
Building trust and therapeutic relationships
Fidelity helps foster trust between patients and their healthcare providers. When patients believe that their nurses are dedicated to their best interests, they’re more likely to trust them and share important information. That feeling of trust is key to the success of any intervention, and a solid therapeutic relationship is linked to better patient outcomes and improved adherence to treatment plans.
Ensuring patient advocacy and safety
Nurses are often called upon to act as patient advocates, ensuring that patients receive the care and resources they need. Fidelity requires nurses to put their patients’ best interests first, whether that means advocating for referrals to specialists or just ensuring that patients’ needs and safety are always the top priority.
Promoting collaboration and teamwork
Nurses don’t work in a vacuum. Effective communication and collaboration among all members of the healthcare team are essential for providing quality care. Fidelity extends to colleagues, requiring nurses to interact honestly and respectfully with their fellow professionals. When there’s a culture of fidelity within a healthcare setting, it enhances teamwork and coordination of care, leading to better outcomes for patients.
Examples of Fidelity in Nursing: Real-World Scenarios
Fidelity is a core principle in nursing. Here are some examples of what it looks like in practice:
Providing Correct Medication and Treatment
Fidelity includes ensuring patients receive the correct medication, in the right dosage, at the right time. Nurses maintain fidelity by following established protocols and double-checking orders to minimize errors.
Respecting Patient Autonomy and Choices
Nurses demonstrate fidelity by honoring patient choices, even when those choices go against medical advice. This might include respecting a patient’s right to refuse treatment based on religious beliefs or personal preferences, or respecting DNR (Do Not Resuscitate) orders and other advance directives. As one article in the journal AMA puts it, “Expressing respect for patients’ autonomy means acknowledging that patients who have decision-making capacity have the right to make decisions regarding their care, even when their decisions contradict their clinicians’ recommendations.”
Accurate and Consistent Documentation
Fidelity in nursing also involves accurate and consistent charting of patient interactions, assessments, and treatment plans.
Truthful Communication About Conditions and Treatment
Being truthful and straightforward with patients about their conditions, prognoses, and treatment plans is another example of fidelity. This may be seen in caring for a patient diagnosed with cancer, openly discussing their prognosis and treatment options, and accurately documenting those conversations.
Consequences of lack of fidelity: Damaging trust and compromising care
When nurses aren’t faithful to their ethical obligations, the result can be devastating for patients and for the nursing profession.
Eroding trust and damaging the therapeutic relationship
Fidelity violations erode patient trust, and when patients don’t trust their healthcare providers, they’re less likely to be open and honest about their symptoms and less likely to follow through with their treatment plans. Trust is hard to build and incredibly easy to break.
Compromising patient safety and well-being
Breaches of fidelity can directly harm patients. Medication errors, inadequate monitoring, and a failure to advocate for your patients can all have negative consequences.
Nurses have an ethical obligation to put patient safety first.
Legal and professional repercussions
Violating patient confidentiality and failing to uphold professional standards can have legal consequences, including fines, lawsuits, and even the loss of your nursing license. Your professional reputation and your career prospects can be damaged, perhaps irreparably.
In Conclusion
Fidelity is more than just a word; it’s a foundational ethical principle in nursing. When nurses are faithful to their commitments, they build trust, keep patients safe, and help them achieve the best possible outcomes.
As a nurse, upholding fidelity is an ongoing responsibility in every aspect of your practice. That means prioritizing your patients’ needs, protecting their privacy, and always acting with honesty and integrity.
To provide the best possible care, nurses should always be learning and reflecting on ethical principles. By doing so, you can ensure you’re always acting in the best interests of your patients and upholding the highest standards of nursing practice.