Professionalism in nursing is inseparable from ethics. The ANA Code of Ethics and the Correctional Nursing: Scope & Standards of Practice guide our practice, even when the environment makes ethical action difficult. Ethical integrity means consistently aligning decisions with professional values. Moral courage is the ability to act on those values, even in the face of resistance or risk.

Correctional nurses frequently face ethically complex situations:

• A provider orders a treatment inconsistent with current standards.
• Custody staff deny a patient’s request for outside care, citing “short staffing.”
• A patient reveals suicidal thoughts, but the officer nearby minimizes it.

In these moments, professionalism requires the nurse to advocate, document, and persist — not to retreat. Acting with moral courage may not always change the outcome, but it protects the nurse’s integrity and honors the profession.

A patient is scheduled for a colonoscopy due to rectal bleeding. On the day of transport, custody informs the nurse that “no one is available to take him, maybe next week.” The nurse knows this delay could worsen the patient’s condition.

• An unprofessional response: Accepting custody’s decision without follow-up.
• A professional response: Documenting the refusal, notifying the provider, and escalating through the chain of command. If necessary, filing an incident report.

This nurse may not be able to override the custody decision immediately, but professionalism is demonstrated by ethical persistence and transparent documentation.

Think about a time you knew what the right course of action was, but barriers stood in the way. How did you respond? Did your actions reflect ethical integrity and moral courage?