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Healthy Work Environment

Nurses have the potential to lead the way in improving health and health care for all, but in order to realize that potential they must operate in an environment that is safe, empowering, and satisfying.

Just as health care workers have a duty of care to their patients, employers have a fundamental duty of care to their employees – to create a healthy work environment for them.


It isn’t just about making sure health care settings are free from potential threats to a practitioner’s physical welfare – the World Health Organization (WHO) defines a healthy environment as a place of “physical, mental, and social well-being,” supporting optimal health and safety.

The Nurses Bill Of Rights 

The American Nurses Association (ANA) believes that in order to be sure that a work environment fulfills these criteria, and allows nurses to perform to the best of their ability, there are certain fundamentals which have to be in place.

To that end, we created the Nurses’ Bill Of Rights, a document setting forth seven basic principles concerning workplace expectations and environments that we believe every nurse has a fundamental right to see fulfilled.

Drawing from policy statements, standards of practice documents, and The Code of Ethics for Nurses with Interpretive Statements, the document has been created with the interests of both nurses and those they care for in mind.

While not legally binding, we strongly believe that it establishes a framework upon which all organizations that employ nurses should build their policies and procedures, and gives nurses a template to help them understand their basic rights in the workplace:

Nurses have the right to practice in a manner that fulfills their obligations to society and to those who receive nursing care.

Nurses have always expressed a strong commitment to serving society. In ANA’s Nursing’s Social Policy Statement, 2nd Edition (2010), the profession clearly articulates that the authority for the practice of nursing is based on a social contract that acknowledges professional rights and responsibilities as well as mechanisms for public accountability (p.3). The Code of Ethics for Nurses with Interpretive Statements (2015) serves the following purposes: "it is a succinct statement of the ethical values, obligations, duties and professional ideals of nurses individually and collectively; the profession’s non-negotiable ethical standard; and  an expression of nursing’s own understanding of its commitment to society" (p. viii).

Nurses have the right to practice in environments that allow them to act in accordance with professional standards and legally authorized scopes of practice.

ANA has published Nursing: Scope and Standards of Practice (2010), which sets forth the professional standards that apply to the practice of all professional nurses. The ANA also has published or endorsed standards for specialty nurse practice.

In addition, the nurse practice act of each state governs the practice of nursing. Each nurse should have a copy of the practice act, the regulations, and any other official documents governing nursing practice for each state where he or she is employed. All of these documents define the legal scope of nursing practice, and guide and protect nurses in performing their duties.

Nurses have the right to a work environment that supports and facilitates ethical practice, in accordance with the Code of Ethics for Nurses with Interpretive Statements.

The Code of Ethics for Nurses (2015) and its interpretive statements establish the ethical standards for the profession and calls for nurses to foster an ethical environment in the work setting to support ethical practice.


Nurses have the right to freely and openly advocate for themselves and their patients, without fear of retribution.

The Code of Ethics for Nurses (2015) asserts that the nurse promotes, advocates for and protects the rights, health and safety of the patient, as one of its non-negotiable tenets. Unfortunately, nurses have experienced adverse consequences for stepping forward to advocate for patients’ safety and informed decision-making. Some states have enacted whistle-blower legislation to protect employees who report unsafe or unethical situations, but there are no federal whistleblower protections. In addition, state nurse practice acts, as well as state human service laws, include mandatory reporting provisions that hold nurses accountable for implementing state hospital laws and regulations, as advocates for their patients.

Nurses have the right to fair compensation for their work, consistent with their knowledge, experience, and professional responsibilities.

There are no laws or provisions that define "fair compensation" beyond the minimum wage. Nurses can become informed about current market wages for their region of employment in order to negotiate or seek employment with appropriate compensation. Employers cannot artificially control wages by collaborating with other employers in their region to set salary scales. Doing so may be illegal under state and federal anti-competition laws.

Nurses have the right to a work environment that is safe for themselves and for their patients.

The federal Occupational Safety and Health Act of 1970 requires that an employer provide a workplace free from recognized hazards that could cause harm or death to employees. Some states have additional requirements that exceed federal mandates and address specific issues in each individual state. 

Nurses have the right to negotiate the conditions of their employment, either as individuals or collectively, in all practice settings.

Nurses have the right to negotiate employment terms and conditions, and to have letters of employment that set forth wages, work schedules, how work performance will be evaluated, and orientation information. Under the National Labor Relations Act (NLRA, 1935; 1947; 1959), employees may form, join, or assist labor organizations; and engage in collective bargaining over wages, hours and other terms and conditions of employment. The NLRA also protects non-union employees who, as a group, engage in certain activities related to their employment. While nurses employed in collective bargaining settings are prohibited from individual negotiation, the principles contained in the Bill of Rights for Registered Nurses are applicable to group negotiations. 

Practical ways of putting the Nurses Bill Of Rights into action

Many of the challenges nurses face in their professional lives come under the scope of a healthy work environment, and ANA is actively involved in all of them, advocating for positive change as an organization, while arming individual nurses with the resources they need to take action for themselves.


Group of nurses

Read about Healthy Nurse, Healthy Nation, a nationwide movement to connect and engage nurses and organizations to take positive action in physical activity, sleep, nutrition, quality of life, and safety.

Learn more

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