The Code
Professional standards of practice
and behaviour for nurses, midwives
and nursing associates
prioritise people
practise eectively
preserve safety
promote professionalism
and trust
2
Professional standards of practice and behaviour for nurses, midwives and nursing associates.
All standards apply within your professional scope of practice.
About us
The Nursing and Midwifery Council exists to protect
the public. We do this by making sure that only those who
meet our requirements are allowed to practise as a nurse
or midwife in the UK, or a nursing associate in England.
We take action if concerns are raised about whether a
nurse, midwife or nursing associate is t to practise.
It is against the law to claim to be, or to practise as, a
nurse or midwife in the UK, or as a nursing associate in
England, if you are not on the relevant part of our register.
It is also a criminal oence for anyone who, with intent
to deceive, causes or permits someone else to falsely
represent them as being on the register, or makes a false
representation about them being on the NMC register.
Publication date: 29 January 2015 Eective from: 31 March 2015
Updated to reect the regulation of nursing associates: 10 October 2018
A note on this version of the Code
All regulators review their Codes from time to time to
make sure they continue to reect public expectations.
This new version of the Code is substantially similar
to the 2015 version, but it has been updated to reect
our new responsibilities for the regulation of nursing
associates. In joining the register, nursing associates will
uphold the Code.
The current versions of our Code, standards and guidance
can always be found on our website. Those on our register
should make sure they are using the most up to date
version of the Code.
For more information about the Code, please visit:
www.nmc.org.uk/code
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Professional standards of practice and behaviour for nurses, midwives and nursing associates.
All standards apply within your professional scope of practice.
Introduction
The Code contains the professional standards that
registered nurses, midwives and nursing associates
1
must
uphold. Nurses, midwives and nursing associates must act
in line with the Code, whether they are providing direct
care to individuals, groups or communities or bringing
their professional knowledge to bear on nursing
2
and
midwifery practice in other roles, such as leadership,
education, or research. The values and principles set out in
the Code can be applied in a range of dierent practice
settings, but they are not negotiable or discretionary.
Our role is to set the standards in the Code, but these
are not just our standards. They are the standards that
patients and members of the public tell us they expect
from health professionals. They are the standards shown
every day by those on our register.
When joining our register, and then renewing their
registration, nurses, midwives and nursing associates
commit to upholding these standards. This commitment
to professional standards is fundamental to being part of
a profession. We can take action if those on our register
fail to uphold the Code. In serious cases, this can include
removing them from the register.
1 Anyone practising as a registered nurse or midwife in the UK, or a nursing
associate in England, has to be registered with us. The nursing associate
role is being used only in England.
2
We have used the word ‘nursing’ in this document to apply to the work of
nurses and nursing associates. Nursing associates are a distinct profession
with their own part of our register, but they are part of the nursing team.
4
Professional standards of practice and behaviour for nurses, midwives and nursing associates.
All standards apply within your professional scope of practice.
The Code sets out common standards of conduct and
behaviour for those on our register. This provides a clear,
consistent and positive message to patients, service
users and colleagues about what they can expect of
those who provide nursing or midwifery care.
The professions we regulate have dierent knowledge and
skills, set out in three distinct standards of prociency.
They can work in diverse contexts and have dierent
levels of autonomy and responsibility. However, all of the
professions we regulate exercise professional judgement
and are accountable for their work.
Nurses, midwives and nursing associates uphold the Code
within the limits of their competence. This means, for
example, that while a nurse and nursing associate will
play dierent roles in an aspect of care, they will both
uphold the standards in the Code within the contribution
they make to overall care. The professional commitment
to work within one’s competence is a key underpinning
principle of the Code (see section 13) which, given the
signicance of its impact on public protection, should
be upheld at all times.
In addition, nurses, midwives and nursing associates
are expected to work within the limits of their competence,
which may extend beyond the standards they demonstrated
in order to join the register.
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Professional standards of practice and behaviour for nurses, midwives and nursing associates.
All standards apply within your professional scope of practice.
The Code should be useful for everyone who cares about
good nursing and midwifery.
• Patients and service users, and those who care for them,
can use it to provide feedback to nurses, midwives and
nursing associates about the care they receive.
• Those on our register can use it to promote safe and
eective practice in their place of work.
• Employer organisations should support their sta in
upholding the standards in their professional Code as
part of providing the quality and safety expected by
service users and regulators.
• Educators can use the Code to help students understand
what it means to be a registered professional and how
keeping to the Code helps to achieve that.
For the many committed and expert practitioners on
our register, this Code should be seen as a way of
reinforcing professionalism. Through revalidation, nurses,
midwives and nursing associates provide evidence of
their continued ability to practise safely and eectively.
The Code is central to the revalidation process as a focus
for professional reection. This gives the Code signicance
in the professional life of those on our register, and raises
its status and importance for employers.
The Code contains a series of statements that taken
together signify what good practice by nurses, midwives
and nursing associates looks like. It puts the interests of
patients and service users rst, is safe and eective, and
promotes trust through professionalism.
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Professional standards of practice and behaviour for nurses, midwives and nursing associates.
All standards apply within your professional scope of practice.
Prioritise people
You put the interests of people using or needing nursing
or midwifery services rst. You make their care and safety
your main concern and make sure that their dignity is
preserved and their needs are recognised, assessed and
responded to. You make sure that those receiving care
are treated with respect, that their rights are upheld and
that any discriminatory attitudes and behaviours towards
those receiving care are challenged.
1 Treat people as individuals and uphold their dignity
To achieve this, you must:
1.1
treat people with kindness, respect
and compassion
1.2
make sure you deliver the fundamentals of
care eectively
1
1.3
avoid making assumptions and recognise
diversity and individual choice
1.4
make sure that any treatment, assistance or care
for which you are responsible is delivered without
undue delay
1.5
respect and uphold people’s human rights
The fundamentals of care include, but are not limited to, nutrition, hydration,
bladder and bowel care, physical handling and making sure that those
receiving care are kept in clean and hygienic conditions. It includes making
sure that those receiving care have adequate access to nutrition and hydration,
and making sure that you provide help to those who are not able to feed
themselves or drink uid unaided.
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Professional standards of practice and behaviour for nurses, midwives and nursing associates.
All standards apply within your professional scope of practice.
2 Listen to people and respond to their preferences
and concerns
To achieve this, you must:
2.1
work in partnership with people to make sure you
deliver care eectively
2.2
recognise and respect the contribution that people
can make to their own health and wellbeing
2.3
encourage and empower people to share in
decisions about their treatment and care
2.4
respect the level to which people receiving care
want to be involved in decisions about their own
health, wellbeing and care
2.5
respect, support and document a person’s right to
accept or refuse care and treatment
2.6
recognise when people are anxious or in distress
and respond compassionately and politely
3 Make sure that people’s physical, social and
psychological needs are assessed and responded to
To achieve this, you must:
3.1
pay special attention to promoting wellbeing,
preventing ill health and meeting the changing
health and care needs of people during all life stages
3.2
recognise and respond compassionately to the
needs of those who are in the last few days and
hours of life
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Professional standards of practice and behaviour for nurses, midwives and nursing associates.
All standards apply within your professional scope of practice.
3.3 act in partnership with those receiving care,
helping them to access relevant health and social
care, information and support when they need it
3.4
act as an advocate for the vulnerable, challenging
poor practice and discriminatory attitudes and
behaviour relating to their care
4 Act in the best interests of people at all times
To achieve this, you must:
4.1
balance the need to act in the best interests of
people at all times with the requirement to respect
a person’s right to accept or refuse treatment
4.2
make sure that you get properly informed consent
and document it before carrying out any action
4.3
keep to all relevant laws about mental capacity that
apply in the country in which you are practising,
and make sure that the rights and best interests of
those who lack capacity are still at the centre of
the decision-making process
4.4
tell colleagues, your manager and the person
receiving care if you have a conscientious
objection
2
to a particular procedure and arrange
for a suitably qualied colleague to take over
responsibility for that person’s care
You can only make a ‘conscientious objection’ in limited circumstances.
For more information, please visit our website at www.nmc.org.uk/standards
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Professional standards of practice and behaviour for nurses, midwives and nursing associates.
All standards apply within your professional scope of practice.
5 Respect people’s right to privacy and condentiality
As a nurse, midwife or nursing associate, you owe a duty
of condentiality to all those who are receiving care.
This includes making sure that they are informed
about their care and that information about them is
shared appropriately.
To achieve this, you must:
5.1
respect a person’s right to privacy in all aspects of
their care
5.2
make sure that people are informed about how and
why information is used and shared by those
who will be providing care
5.3
respect that a person’s right to privacy and
condentiality continues after they have died
5.4
share necessary information with other health and
care professionals and agencies only when the
interests of patient safety and public protection
override the need for condentiality
5.5
share with people, their families and their carers, as
far as the law allows, the information they want or
need to know about their health, care and
ongoing treatment sensitively and in a way they
can understand
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Professional standards of practice and behaviour for nurses, midwives and nursing associates.
All standards apply within your professional scope of practice.
Practise eectively
You assess need and deliver or advise on treatment, or
give help (including preventative or rehabilitative care)
without too much delay, to the best of your abilities, on
the basis of best available evidence. You communicate
eectively, keeping clear and accurate records and sharing
skills, knowledge and experience where appropriate.
You reect and act on any feedback you receive to
improve your practice.
6 Always practise in line with the best
available evidence
To achieve this, you must:
6.1
make sure that any information or advice given is
evidence-based including information relating to
using any health and care products or services
6.2
maintain the knowledge and skills you need for
safe and eective practice
7 Communicate clearly
To achieve this, you must:
7.1
use terms that people in your care, colleagues and
the public can understand
7.2
take reasonable steps to meet people’s language
and communication needs, providing, wherever
possible, assistance to those who need help to
communicate their own or other people’s needs
7.3
use a range of verbal and non-verbal
communication methods, and consider cultural
sensitivities, to better understand and respond to
people’s personal and health needs
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Professional standards of practice and behaviour for nurses, midwives and nursing associates.
All standards apply within your professional scope of practice.
7.4 check people’s understanding from time to time to
keep misunderstanding or mistakes to a minimum
7.5
be able to communicate clearly and eectively
in English
8 Work co-operatively
To achieve this, you must:
8.1
respect the skills, expertise and contributions
of your colleagues, referring matters to them
when appropriate
8.2
maintain eective communication with colleagues
8.3 keep colleagues informed when you are sharing
the care of individuals with other health and care
professionals and sta
8.4
work with colleagues to evaluate the quality of
your work and that of the team
8.5
work with colleagues to preserve the safety of
those receiving care
8.6
share information to identify and reduce risk
8.7 be supportive of colleagues who are encountering
health or performance problems. However, this
support must never compromise or be at the
expense of patient or public safety
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Professional standards of practice and behaviour for nurses, midwives and nursing associates.
All standards apply within your professional scope of practice.
9 Share your skills, knowledge and experience for the
benet of people receiving care and your colleagues
To achieve this, you must:
9.1
provide honest, accurate and constructive
feedback to colleagues
9.2
gather and reect on feedback from a variety
of sources, using it to improve your practice
and performance
9.3
deal with dierences of professional opinion with
colleagues by discussion and informed debate,
respecting their views and opinions and behaving
in a professional way at all times
9.4
support students’ and colleagues’ learning to
help them develop their professional competence
and condence
13
Professional standards of practice and behaviour for nurses, midwives and nursing associates.
All standards apply within your professional scope of practice.
10 Keep clear and accurate records relevant to
your practice
This applies to the records that are relevant to your scope
of practice. It includes but is not limited to patient records.
To achieve this, you must:
10.1
complete records at the time or as soon as possible
after an event, recording if the notes are written
some time after the event
10.2
identify any risks or problems that have arisen
and the steps taken to deal with them, so that
colleagues who use the records have all the
information they need
10.3
complete records accurately and without any
falsication, taking immediate and appropriate
action if you become aware that someone has not
kept to these requirements
10.4
attribute any entries you make in any paper or
electronic records to yourself, making sure they
are clearly written, dated and timed, and do
not include unnecessary abbreviations, jargon
or speculation
10.5
take all steps to make sure that records are
kept securely
10.6
collect, treat and store all data and research
ndings appropriately
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Professional standards of practice and behaviour for nurses, midwives and nursing associates.
All standards apply within your professional scope of practice.
11 Be accountable for your decisions to delegate tasks
and duties to other people
To achieve this, you must:
11.1
only delegate tasks and duties that are within the
other person’s scope of competence, making sure
that they fully understand your instructions
11.2
make sure that everyone you delegate tasks to is
adequately supervised and supported so they can
provide safe and compassionate care
11.3
conrm that the outcome of any task you
have delegated to someone else meets the
required standard
12 Have in place an indemnity arrangement which
provides appropriate cover for any practice you take
on as a nurse, midwife or nursing associate in the
United Kingdom
To achieve this, you must:
12.1
make sure that you have an appropriate
indemnity arrangement in place relevant to your
scope of practice
For more information, please visit our website at
www.nmc.org.uk/indemnity
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Professional standards of practice and behaviour for nurses, midwives and nursing associates.
All standards apply within your professional scope of practice.
Preserve safety
You make sure that patient and public safety is not aected.
You work within the limits of your competence, exercising
your professional ‘duty of candour’
1
and raising concerns
immediately whenever you come across situations that put
patients or public safety at risk. You take necessary action
to deal with any concerns where appropriate.
13 Recognise and work within the limits of
your competence
To achieve this, you must, as appropriate:
13.1
accurately identify, observe and assess signs of
normal or worsening physical and mental health in
the person receiving care
13.2
make a timely referral to another practitioner
when any action, care or treatment is required
13.3
ask for help from a suitably qualied and
experienced professional to carry out any
action or procedure that is beyond the limits of
your competence
13.4
take account of your own personal safety as well
as the safety of people in your care
13.5
complete the necessary training before carrying
out a new role
The professional duty of candour is about openness and honesty when
things go wrong. “Every healthcare professional must be open and
honest with patients when something goes wrong with their treatment or
care which causes, or has the potential to cause, harm or distress.”
Joint statement from the Chief Executives of statutory regulators of
healthcare professionals.
16
Professional standards of practice and behaviour for nurses, midwives and nursing associates.
All standards apply within your professional scope of practice.
14 Be open and candid with all service users about all
aspects of care and treatment, including when any
mistakes or harm have taken place
To achieve this, you must:
14.1
act immediately to put right the situation if
someone has suered actual harm for any reason
or an incident has happened which had the
potential for harm
14.2
explain fully and promptly what has happened,
including the likely eects, and apologise to the
person aected and, where appropriate, their
advocate, family or carers
14.3
document all these events formally and take
further action (escalate) if appropriate so they can
be dealt with quickly
15 Always oer help if an emergency arises in your
practice setting or anywhere else
To achieve this, you must:
15.1
only act in an emergency within the limits of your
knowledge and competence
15.2
arrange, wherever possible, for emergency care to
be accessed and provided promptly
15.3
take account of your own safety, the safety of
others and the availability of other options for
providing care
17
Professional standards of practice and behaviour for nurses, midwives and nursing associates.
All standards apply within your professional scope of practice.
16 Act without delay if you believe that there is a risk to
patient safety or public protection
To achieve this, you must:
16.1
raise and, if necessary, escalate any concerns
you may have about patient or public safety,
or the level of care people are receiving in your
workplace or any other health and care setting
and use the channels available to you in line with
our guidance and your local working practices
16.2
raise your concerns immediately if you are being
asked to practise beyond your role, experience
and training
16.3
tell someone in authority at the rst reasonable
opportunity if you experience problems that may
prevent you working within the Code or other
national standards, taking prompt action to tackle
the causes of concern if you can
16.4
acknowledge and act on all concerns raised to
you, investigating, escalating or dealing with those
concerns where it is appropriate for you to do so
16.5
not obstruct, intimidate, victimise or in any way
hinder a colleague, member of sta, person you
care for or member of the public who wants to
raise a concern
16.6
protect anyone you have management
responsibility for from any harm, detriment,
victimisation or unwarranted treatment after a
concern is raised
For more information, please visit our website at
www.nmc.org.uk/raisingconcerns.
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Professional standards of practice and behaviour for nurses, midwives and nursing associates.
All standards apply within your professional scope of practice.
17 Raise concerns immediately if you believe a person
is vulnerable or at risk and needs extra support
and protection
To achieve this, you must:
17.1
take all reasonable steps to protect people who are
vulnerable or at risk from harm, neglect or abuse
17.2
share information if you believe someone may be
at risk of harm, in line with the laws relating to the
disclosure of information
17.3
have knowledge of and keep to the relevant laws
and policies about protecting and caring for
vulnerable people
18 Advise on, prescribe, supply, dispense or administer
medicines within the limits of your training and
competence, the law, our guidance and other relevant
policies, guidance and regulations
To achieve this, you must:
18.1
prescribe, advise on, or provide medicines or
treatment, including repeat prescriptions (only
if you are suitably qualied) if you have enough
knowledge of that person’s health and are
satised that the medicines or treatment serve
that person’s health needs
18.2
keep to appropriate guidelines when giving
advice on using controlled drugs and recording
the prescribing, supply, dispensing or administration
of controlled drugs
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Professional standards of practice and behaviour for nurses, midwives and nursing associates.
All standards apply within your professional scope of practice.
18.3 make sure that the care or treatment you advise
on, prescribe, supply, dispense or administer for
each person is compatible with any other care
or treatment they are receiving, including (where
possible) over-the-counter medicines
18.4
take all steps to keep medicines stored securely
18.5 wherever possible, avoid prescribing for yourself
or for anyone with whom you have a close
personal relationship
Prescribing is not within the scope of practice of everyone
on our register. Nursing associates don’t prescribe, but
they may supply, dispense and administer medicines.
Nurses and midwives who have successfully completed a
further qualication in prescribing and recorded it on our
register are the only people on our register that can prescribe.
For more information, please visit our website at
www.nmc.org.uk/standards.
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Professional standards of practice and behaviour for nurses, midwives and nursing associates.
All standards apply within your professional scope of practice.
19 Be aware of, and reduce as far as possible, any
potential for harm associated with your practice
To achieve this, you must:
19.1
take measures to reduce as far as possible, the
likelihood of mistakes, near misses, harm and the
eect of harm if it takes place
19.2
take account of current evidence, knowledge and
developments in reducing mistakes and the eect
of them and the impact of human factors and
system failures (see the note below)
19.3
keep to and promote recommended practice in
relation to controlling and preventing infection
19.4
take all reasonable personal precautions
necessary to avoid any potential health risks to
colleagues, people receiving care and the public
1
Human factors refer to environmental, organisational and job factors, and
human and individual characteristics, which inuence behaviour at work in a
way which can aect health and safety – Health and Safety Executive.
You can nd more information at www.hse.gov.uk
21
Professional standards of practice and behaviour for nurses, midwives and nursing associates.
All standards apply within your professional scope of practice.
Promote professionalism and trust
You uphold the reputation of your profession at all times.
You should display a personal commitment to the standards
of practice and behaviour set out in the Code. You should
be a model of integrity and leadership for others to
aspire to. This should lead to trust and condence in the
professions from patients, people receiving care, other
health and care professionals and the public.
20 Uphold the reputation of your profession at all times
To achieve this, you must:
20.1
keep to and uphold the standards and values set
out in the Code
20.2
act with honesty and integrity at all times,
treating people fairly and without discrimination,
bullying or harassment
20.3
be aware at all times of how your behaviour can
aect and inuence the behaviour of other people
20.4
keep to the laws of the country in which you
are practising
20.5
treat people in a way that does not take
advantage of their vulnerability or cause them
upset or distress
20.6
stay objective and have clear professional
boundaries at all times with people in your care
(including those who have been in your care in
the past), their families and carers
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Professional standards of practice and behaviour for nurses, midwives and nursing associates.
All standards apply within your professional scope of practice.
20.7 make sure you do not express your personal
beliefs (including political, religious or moral
beliefs) to people in an inappropriate way
20.8
act as a role model of professional behaviour for
students and newly qualied nurses, midwives
and nursing associates to aspire to
20.9
maintain the level of health you need to carry out
your professional role
20.10
use all forms of spoken, written and digital
communication (including social media and
networking sites) responsibly, respecting the
right to privacy of others at all times
For more guidance on using social media and networking
sites, please visit our website at www.nmc.org.uk/standards
21 Uphold your position as a registered nurse, midwife or
nursing associate
To achieve this, you must:
21.1
refuse all but the most trivial gifts, favours or
hospitality as accepting them could be interpreted
as an attempt to gain preferential treatment
21.2
never ask for or accept loans from anyone in your
care or anyone close to them
21.3
act with honesty and integrity in any nancial
dealings you have with everyone you have a
professional relationship with, including people in
your care
23
Professional standards of practice and behaviour for nurses, midwives and nursing associates.
All standards apply within your professional scope of practice.
21.4 make sure that any advertisements, publications
or published material you produce or have
produced for your professional services are
accurate, responsible, ethical, do not mislead or
exploit vulnerabilities and accurately reect your
relevant skills, experience and qualications
21.5
never use your status as a registered professional
to promote causes that are not related to health
21.6
cooperate with the media only when it is
appropriate to do so, and then always protecting
the condentiality and dignity of people
receiving treatment or care
22 Full all registration requirements
To achieve this, you must:
22.1
keep to any reasonable requests so we can
oversee the registration process
22.2
keep to our prescribed hours of practice
and carry out continuing professional
development activities
22.3
keep your knowledge and skills up to date,
taking part in appropriate and regular learning
and professional development activities that aim
to maintain and develop your competence and
improve your performance
For more information, please visit our website at
www.nmc.org.uk/standards.
24
23 Cooperate with all investigations and audits
This includes investigations or audits either against you or
relating to others, whether individuals or organisations. It
also includes cooperating with requests to act as a witness
in any hearing that forms part of an investigation, even
after you have left the register.
To achieve this, you must:
23.1
cooperate with any audits of training records,
registration records or other relevant audits that
we may want to carry out to make sure you are
still t to practise
23.2
tell both us and any employers as soon as you
can about any caution or charge against you, or
if you have received a conditional discharge in
relation to, or have been found guilty of, a
criminal oence (other than a protected caution
or conviction)
23.3
tell any employers you work for if you have
had your practice restricted or had any other
conditions imposed on you by us or any other
relevant body
Professional standards of practice and behaviour for nurses, midwives and nursing associates.
All standards apply within your professional scope of practice.
23.4 tell us and your employers at the rst reasonable
opportunity if you are or have been disciplined
by any regulatory or licensing organisation,
including those who operate outside of the
professional health and care environment
1
When telling your employers, this includes telling (i) any person, body or
organisation you are employed by, or intend to be employed by, as a nurse,
midwife or nursing associate; and (ii) any person, body or organisation with
whom you have an arrangement to provide services as a nurse, midwife or
nursing associate.
25
Professional standards of practice and behaviour for nurses, midwives and nursing associates.
All standards apply within your professional scope of practice.
23.5 give your NMC Pin when any reasonable request
for it is made
For more information, please visit our website at
www.nmc.org.uk.
24 Respond to any complaints made against
you professionally
To achieve this, you must:
24.1
never allow someone’s complaint to aect the
care that is provided to them
24.2
use all complaints as a form of feedback and
an opportunity for reection and learning to
improve practice
25 Provide leadership to make sure people’s wellbeing
is protected and to improve their experiences of
the health and care system
To achieve this, you must:
25.1
identify priorities, manage time, sta and
resources eectively and deal with risk to make
sure that the quality of care or service you deliver
is maintained and improved, putting the needs of
those receiving care or services rst
25.2
support any sta you may be responsible for
to follow the Code at all times. They must have
the knowledge, skills and competence for safe
practice; and understand how to raise any
concerns linked to any circumstances where the
Code has, or could be, broken
Throughout their career, all our registrants will have
opportunities to demonstrate leadership qualities, regardless
of whether or not they occupy formal leadership positions.
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