CHAPTER II

DISCUSSION

2.1 The code of ethics of nursing

Nursing ethics are norms that are embraced by nurses in behaving with patients, families,
colleagues, or other health workers in a professional nursing service. Ethical behavior
will be shaped by the values of patients, nurses and social interactions within the
environment.
The goals of nursing ethics are:
1. Identify, organize, examine and justify humanitarian actions by applying certain
principles
2. Affirm the duties of the nurse and seek information on the effects of the nurse's
decision.

While the Code of ethics of nursing is a comprehensive statement of the profession that
provides demands for its members in implementing nursing practice, whether related to
patients, family, peers, self and other health teams. Essentially, the purpose of the
nursing code of ethics is to ensure that nurses, in carrying out their duties and functions,
can respect and respect human dignity.

The purpose of the code of ethics of nursing is as follows:

1. It is the basis in managing the relationship between nurse, client or patient, peers,
society, and professional elements, both in the nursing profession and with other
professions outside the nursing profession.
2. It is a standard to overcome the problems that nursing practitioners who do not
ignore the moral dedication in the implementation of their duties.
3. To defend when practitioners who in carrying out their duties are treated unfairly
by institutions and communities.
4. It is the foundation in preparing the curriculum of nursing education in order to
produce graduates who are oriented towards professional attitude of nursing.
5. Providing an understanding to the user community / users of nursing staff about
the importance of professional attitude in performing nursing practice duties.
(PPNI, 2000)
2.2 Component Code of Nursing Ethics
The code of ethics consists of 5 chapters and 16 chapters. The following is the ethics of
nursing issued by DPP PPNI.
1. Code of Ethics of Nursing According to the PPNI
a. The nurse's responsibility to the client
1) Nurses in carrying out their dedication, always guided by responsibilities
stemming from the need for nursing individuals, families and communities.
2) Nurses maintain an environment that respects the cultural values, customs
and religious survival of individuals, families and communities
3) Nurses are always based on a genuine sense of sincerity in carrying out their
duties in accordance with the dignity and noble tradition of nursing
4) Nurses undergo cooperative relationships with individuals, families and
communities in particular to take initiative and conduct health efforts, as
well as the efforts of the welfare nurses in general.
b. The nurse's responsibility to the task
1) maintain high quality nursing services along with professional honesty in
applying nursing knowledge and skills
2) The nurse is obliged to keep all the things he or she knows about the task
entrusted to him
3) Nurses will not use skills and knowledge for purposes that are contrary to
humanitarian norms
4) Nurses in the duties with full awareness are not affected by the consideration
of kebengasaan, ethnicity, color, age, gender, political flow, religion and
social position
5) Nurses prioritize patient protection and safety as well as mature in
considering the ability to accept or assign responsibilities.
c. The nurse's responsibility to colleagues
1) Nurses maintain good relationships between fellow nurses and other health
workers, be it the atmosphere or work environment
2) The nurse disseminates his / her skills, knowledge, and experience to the
nurse's fellow in order to increase knowledge in the nursing field
d. The nurse's responsibility to the profession
1) Nurses seek to enhance their own professional skills or together that are
beneficial to nursing development
 2) Nurses uphold the reputation of the profession
3) Nurses play a role in nursing care and care, and apply them in the ministry
of service and education
4) Nurses jointly nurture and maintain the quality of the nursing profession
organization as a means of dedication
e. The nurse's responsibility to the State
1) Nurses implement provisions as policies outlined by government in health
and nursing
2) Nurses play an active role in contributing the mind to the government in
improving health and nursing services to the community.
2. Nurse code of ethics according to ANA (American Nurse Association)
1. Nurses provide respectful service to the dignity and civic nature of clients who
are not limited by social / economic status considerations, personal attributes, or
health issues.
2. The nurse protects the client's privacy rights by holding firmly confidential
information.
3. Nurses protect clients and the public when their health and safety are threatened
by the practice of an incompetent, unethical or illegal person.
4. Nurses assume responsibility for the considerations and actions of nurses run by
each individual.
5. The nurse maintains the competency of the county.
6. Nurses carry out reasonable considerations and use individual competence and
qualifications as criteria in seeking consultation, accepting responsibility, and
delegating nursing activities to others.
7. Nurses participate in activities in assisting the development of professional
knowledge.
8. Nurses participate in professional efforts to implement and improve nursing
standards.
9. Nurses participate in pharmaceutical efforts to establish and foster working
conditions that support quality nursing services.
10. Nurses participate in professional endeavors to protect the public against
misinformation and images and maintain the integrity of the nurse.
 11. Perawat co-operation with members of the health profession or other community
members in improving community and national efforts to meet public health
needs.
3. Nurse Code of Conduct According to ICN
The primary responsibility of the nurse is improving the health of preventing disease,
maintaining health and reducing suffering. For that the nurse must believe:
1. The need for nursing services in different places is the same.
2. Implementation of nursing practice at the point of emphasis on the honor of a life
of dignity and high support of human rights.
3. In carrying out health and or nursing services to individuals, families, groups and
communities, nurses involve groups and agencies concerned.
1) Nurse with client
The main responsibility of the nurse is to carry out nursing care in accordance
with the needs of the community. Therefore, in carrying out the duties of
nurses need to improve the state of the health environment by appreciating
the values that exist in the community, respecting customs and beliefs of
individuals, families, groups, and communities Be patient or client. The nurse
may uphold the privacy of the privacy and can only provide information if it
is needed by the interested parties / courts.
2) Nurses with health services
Nurses play an important role in defining and implementing nursing practice
standards to achieve capabilities that are consistent with nursing education
standards. The nurse can develop the knowledge he possesses actively to
sustain his role in certain situations.
3) Nurse and community environment
Nurses can initiate renewal, responsiveness, initiative and can participate
actively in determining health problems and social problems that occur in the
community.
4) Nurse with peers
Nurses can support cooperative relationships with colleagues, both nursing
staff and other professionals outside nursing. The nurse may protect and
guarantee a person, in the course of his or her treatment feels threatened.
5) Nurse with profession
 Nurses play a large role in determining the implementation of nursing
practice standards and nursing education. Nurses are expected to participate
actively in developing knowledge in supporting professional maintenance.
Nurses as members of professional organizations, participate in maintaining
social and economic stability in accordance with conditions of
implementation of nursing practice.
2.3 Cons Nursis Selfie
The nurse who carries out a selfie with the patient naturally violates the nursing code
of ethics, as it is clearly stated in the nursing code of ethics that the Nurse must keep
confidential everything that is known in connection with the duty entrusted to him unless
required by the authorities in accordance with applicable law. If doing selfie with the
patient as well as not maintaining the privacy of the patient. If the patient or family reports
the act of the nurse then it can be processed legally which will cause harm to the nurse.
The act of nurse who perform selfie with patient strongly shows unprofessional
deeds. Nurses are obliged to do the documentation but not by doing selfie with the
patient.
Conducting selfie with the patient is also included in clinical violation of ethics.
Clinical ethics is part of bioethics that pay more attention to ethical issues during service
delivery to clients. Examples of clinical ethics: the presence of consent or rejection, and
how one should respond to less useful (in vain) medical requests. Selfies are also included
in medical treatment that is less useful if not dilkukan for documentation. If used for
documentation also will not be disseminated in social media because it includes not
maintaining the privacy of patients. It is the duty of a health worker to maintain the
confidentiality of the patient, and if they break it they can be interpreted in violation of
their professional oath. Patients also should not be in situations where they have to
sacrifice privacy for the benefit of health workers.
In addition, the lack of trust and insecurity of the patient. Because patients want care
and attention from health workers when they seek help or others. The lack of privacy
raises stress so that the patient does not trust and feel safe. This condition can interfere
with the healing process because the patient's mental is known to affect the effectiveness
of healing.
Then the incident violates the work ethic of health personnel. In some countries,
there are civil and criminal laws governing health-care services to follow standardized
ethical codes, and the law will ensure they comply with those standards. Carrying a selfie
 without a patient's permission or not giving them the therapy they want is expressed as a
very unethical act, and they may be penalized for doing this. It should be from a health
worker to be aware of this problem and train them how to overcome it so as not to happen
again.
Selfie make someone forget the time, forgot the job so that the same nurse was not
ready to face the various state of the patient because even though the photo is only for
personal pleasure alone, still there must be little in the photo that shows the condition or
condition of the hospital. It is unethical to spread the place where it should be a sterile
place where it should not be disseminated, because the patient's condition is included in
the patient's privacy and will lead to different understandings of each viewer.
Selfish nurses means breaking the nursing rules of the hospital and violating the
patient's privacy. The rule of thumb in the principle of confidentiality is that information
about clients should be kept private. Everything contained in the client's health records
document may only be read in the context of client treatment. No one may obtain such
information unless permitted by the client with evidence of consent.

2.3 Kontra Nursis Selfie

Perawat yang melakukan selfie dengan pasien secara alami melanggar kode etik keperawatan,
seperti yang dinyatakan dengan jelas dalam kode etik keperawatan bahwa Perawat harus
merahasiakan segala hal yang diketahui sehubungan dengan tugas yang dipercayakan
kepadanya kecuali jika diwajibkan oleh Pihak berwenang sesuai dengan hukum yang berlaku.
Jika melakukan selfie dengan pasien serta tidak menjaga kerahasiaan pasien. Jika pasien atau
keluarga melaporkan tindakan perawat maka obat tersebut dapat diproses secara legal yang
akan membahayakan perawat.

Tindakan perawat yang melakukan selfie dengan pasien sangat menunjukkan perbuatan tidak
profesional. Perawat diwajibkan untuk melakukan dokumentasi tapi tidak dengan melakukan
selfie dengan pasien.

Melakukan selfie dengan pasien juga termasuk dalam pelanggaran etika secara klinis. Etika
klinis adalah bagian dari bioetika yang lebih memperhatikan masalah etika selama pemberian
layanan kepada klien. Contoh etika klinis: adanya persetujuan atau penolakan, dan bagaimana
seseorang harus menanggapi permintaan medis yang kurang berguna (sia-sia). Selfies juga
termasuk dalam perawatan medis yang kurang berguna jika tidak dilkukan untuk dokumentasi.
Jika digunakan untuk dokumentasi juga tidak akan disebarluaskan di media sosial karena
termasuk tidak menjaga privasi pasien. Adalah tugas petugas kesehatan untuk menjaga
kerahasiaan pasien, dan jika melanggarnya, mereka dapat ditafsirkan melanggar sumpah
profesional mereka. Pasien juga tidak boleh berada dalam situasi di mana mereka harus
mengorbankan privasi demi kepentingan petugas kesehatan.

Selain itu, kurangnya kepercayaan dan ketidakamanan pasien. Karena pasien menginginkan
perawatan dan perhatian dari petugas kesehatan saat mereka mencari pertolongan atau orang
lain. Kurangnya privasi menimbulkan stres sehingga pasien tidak percaya dan merasa aman.
Kondisi ini bisa mengganggu proses penyembuhan karena mental pasien diketahui
mempengaruhi keefektifan penyembuhan.

Kemudian kejadian tersebut melanggar etika kerja petugas kesehatan. Di beberapa negara, ada
hukum perdata dan pidana yang mengatur layanan kesehatan untuk mengikuti kode etik
standar, dan undang-undang tersebut memastikan mereka mematuhi standar tersebut.
Membawa selfie tanpa izin dari pasien atau tidak memberi mereka terapi yang mereka inginkan
dinyatakan sebagai tindakan yang sangat tidak etis, dan mungkin juga dihukum karena
melakukan hal ini. Seharusnya dari petugas kesehatan menyadari masalah ini dan melatih
mereka cara mengatasinya agar tidak terjadi lagi.

Selfie membuat seseorang lupa waktu, lupa pekerjaan sehingga perawat yang sama tidak siap
menghadapi berbagai keadaan pasien karena meski foto hanya untuk kesenangan pribadi saja,
tetap saja harus ada sedikit foto yang menunjukkan kondisinya. Atau kondisi rumah sakit.
Tidak etis menyebarkan tempat yang seharusnya menjadi tempat steril yang seharusnya tidak
disebarluaskan, karena kondisi pasien termasuk dalam privasi pasien dan akan menimbulkan
perbedaan pemahaman masing-masing pemirsa.

Perawat egois berarti melanggar peraturan keperawatan di rumah sakit dan melanggar privasi
pasien. Aturan praktis dalam prinsip kerahasiaan adalah informasi tentang klien harus dijaga
kerahasiaannya. Segala sesuatu yang terdapat dalam dokumen catatan kesehatan klien hanya
dapat dibaca dalam konteks perawatan klien. Tidak ada yang bisa memperoleh informasi
tersebut kecuali jika diijinkan oleh klien dengan bukti persetujuan.