Fidelity in Nursing – What is it, Why is it Important & Examples

Written By: Darby Faubion BSN, RN

Are you a nurse who wants to positively impact patients, healthcare facilities, and the nursing profession? Have you wondered what you can do to improve your practice and see improved patient and professional outcomes? There are many principles upon which successful nursing careers are built. In this article, I will share information with you about one ethical principle, fidelity. Perhaps you are wondering what is fidelity in nursing? In this article, you find out what fidelity in nursing means and learn about the benefits of implementing it and the consequences related to a lack of it.

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.

5 Reasons Why Fidelity is Important in Nursing

Fidelity is, perhaps, the most important of the ethical principles applied in nursing because it governs how nurses demonstrate the other six principles. Fidelity in nursing demonstrates the nurse's promise to provide competent patient care in a fair, honest, and responsible way. The following are a few reasons why fidelity is essential in nursing.

1. Fidelity in nursing helps foster a trusting relationship between patients, families, nurses, and healthcare team members.

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. When nurses practice fidelity, patients experience more favorable 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. Fidelity in nursing practice 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. Fidelity in nursing promotes patient autonomy, which is beneficial to the patient and the healthcare team.

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.

As a nursing instructor, I always advised my students to find a nursing mentor who is ethical and practices with integrity and follow their lead. 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.

What are Some Examples of Fidelity in Nursing?

Fidelity in nursing involves demonstrating notions of faithfulness and loyalty, the importance of honoring commitments and collaboration in nursing care. There are several ways nurses can demonstrate fidelity, such as the 10 examples listed below. In some examples, I will share personal experiences. The names of the people in the examples have been changed to protect patient and nurse privacy.

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. Putting the patient first, despite friendships with other nurses or healthcare team members

Leigh Anne and Tiffany were two nurses on my team. They were friends outside of work, which is not uncommon and usually not a conflict of interest. One day, Leigh Anne came to me and said she was concerned about Tiffany’s ability to perform a few wound care skills. She was worried about Tiffany being angry with her but also understood patient care and efficient care are every nurse’s responsibility. As the charge nurse, I prioritized my day to include assisting with wound care. Tiffany was open to my help and asked questions about procedures that she did not feel confident performing. In this instance, Leigh Anne’s willingness to put the patient first and practice fidelity in nursing helped strengthen the team and promoted growth for her friend and coworker.

4. Promoting patient autonomy

Patient autonomy is the right of competent adults to make informed decisions about their personal medical care. Nurses who promote patient autonomy demonstrate an excellent example of fidelity in nursing. When nurses encourage patient involvement in care, it creates a more trusting nurse-patient relationship and supports the nurse’s promise to advocate for the patient.

5. Honoring a patient's decision and supporting family, even when you disagree with his choice.

Mr. Young received a Stage IV lung cancer diagnosis that had metastasized to his spine. Although his family was present and attentive, Mr. Young instructed the nurses and physicians that he did not want his family to be told about his diagnosis. He explained he believed his family would try to implement measures to prolong his life, no matter the circumstances or his wishes. I couldn't help but remember when my dad was diagnosed with lung cancer. I was devasted and wanted to stay by his side, trying to find every available option or glimmer of hope. I imagined Mr. Young’s family would feel the same. However, in this situation, I was the nurse and was obligated to recognize my duty to keep my client's confidence and still support his family. 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.

6. 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.

7. Fulfilling commitments

An oath or agreement can be verbal, written, or implied. When nurses keep their word and fulfill commitments, patients and colleagues view them as trustworthy and dependable, which are characteristics of fidelity in nursing.

8. Recognizing and resolving potential risks to fidelity before they become an issue

Fidelity encompasses acts of loyalty and reflects the relationship developed between patients, nurses, the interdisciplinary team, and employers. Each party owes the other loyalty, but nurses are held to a higher standard of this loyalty because of ethical standards of practice. Even the most dedicated nurses may find themselves facing a dilemma related to fidelity. For example, if a nurse promises they will always be there to care for a patient but leaves their job, the patient may feel the nurse has betrayed their loyalty. While it may not be realistic for patients to expect nurses to decline opportunities to advance their careers, it is essential for nurses to understand the bond many patients feel exists between them. In this scenario, one way to practice fidelity in nursing is to talk to your patients and let them know you plan to change jobs or take a break. Although they do not need to know your personal information, taking the time to break the news yourself helps patients maintain a feeling of trust and commitment. You can take this opportunity to assure your patients that the other nursing staff are as dedicated to their care as you have been.

9. 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.

10. 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.

5 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.

My Final Thoughts

Throughout this article, we have addressed the question, “What is fidelity in nursing?" Fidelity is an essential attribute of successful nurses and is associated with many positive patient and professional outcomes. Fidelity in nursing is represented by many characteristics, including dedication, honesty, loyalty, fairness, and advocacy. Nurses who practice fidelity typically experience more job satisfaction because they have better relationships with patients and colleagues, and employers appreciate their efforts. The benefits of fidelity in nursing are far-reaching and should be considered in every aspect of nursing practice.

Darby Faubion BSN, RN
Darby Faubion is a nurse and Allied Health educator with over twenty years of experience. She has assisted in developing curriculum for nursing programs and has instructed students at both community college and university levels. Because of her love of nursing education, Darby became a test-taking strategist and NCLEX prep coach and assists nursing graduates across the United States who are preparing to take the National Council Licensure Examination (NCLEX).