What Is Fidelity in Nursing?

Imagine a nurse who promises a worried patient that she’ll return in 10 minutes to check on their pain — and she does every time. Even during a hectic shift, she keeps her word, earning the patient’s trust and easing their anxiety. This is fidelity in nursing: a fundamental ethical principle that emphasizes loyalty, faithfulness, and the duty to keep promises made to patients and the healthcare profession.

Understanding and practicing fidelity is essential to building strong therapeutic relationships and ensuring high standards of care. In this article, we’ll explore what fidelity truly means and how you can integrate it into your everyday practice.

Fidelity in Nursing: Definition and Examples

Fidelity is one of nursing’s seven guiding ethical principles, and it centers on trust. It’s about honoring commitments — being honest, reliable, and following through on promises made to patients. This trust-building behavior is essential in nursing, as patients need to feel confident in their care team — after all, they’re entrusting these professionals with their lives.

Here are some fidelity in nursing examples that bring the concept to life:

• Keeping promises: A patient asks for test results. The nurse doesn’t have them yet but says, “I’ll speak with the doctor and update you by the end of the day.” She does as promised.
• Reporting near-misses honestly: A nurse realizes they nearly administered the wrong medication but caught the mistake in time. They report the incident to ensure patient safety.
• Advocating for the patient: A patient expresses concern that a certain medication makes them feel worse. The nurse promises to speak with the provider — and actually does, bringing the concern forward during rounds.
• Respecting confidentiality: A teenage patient shares sensitive information with a nurse and asks that it not be told to their parents. The nurse reassures them and honors confidentiality (within legal and safety limits).
• Documenting accurately: A nurse records exactly what happened during a patient interaction without altering or omitting any details, reflecting honesty and professional integrity.

Fidelity Beyond Patient Care

To define fidelity in nursing, it’s important to look beyond one-on-one patient care. Fidelity also means staying loyal to the values of the nursing profession, working respectfully with colleagues, and following institutional policies and professional standards.

For example, role fidelity reflects a nurse’s commitment to providing competent care by maintaining necessary skills, staying up-to-date with evidence-based practices, and honestly addressing any knowledge gaps (if any). It also involves practicing within your scope of practice, respecting professional boundaries, and not overstepping into roles assigned to other team members (e.g., physicians, social workers, therapists).

Wondering how to demonstrate fidelity in your relationships with coworkers and leadership team? Here are some examples:

• Being reliable and dependable: If you commit to taking on a responsibility, whether it’s covering a shift, helping with a difficult case, or contributing to a team meeting, follow through. Your reliability strengthens the entire team.
• Continue learning and growing: Ensure your knowledge and skills remain up to date. This dedication to professional growth directly benefits patients by ensuring they receive the most effective treatments, and it benefits colleagues by setting a positive example.
• Seek feedback: Regularly ask colleagues for feedback on your work and offer the same in return. Doing so helps strengthen relationships and encourages professional growth.
• Adhere to ethical and institutional guidelines: Follow the broader ethical standards set by the nursing profession and the institution in which you work. Adhering to established standards helps create consistency across the team, so patients receive seamless, coordinated care.

Origin of Fidelity

Being a professional nurse goes far beyond treating illness — it’s also about promoting health, relieving suffering, and advocating for patients and entire communities. To do this responsibly, nurses rely on key professional elements like accredited educational programs, proper licensing, and a strong moral code.

The American Nurses Association (ANA) is an organization that shapes nursing practice through setting clear professional standards, such as scope of practice and code of ethics. One of these core principles is fidelity — the commitment to be trustworthy and follow through, which is essential for creating safe, respectful patient care.

Fidelity is just one of seven core ethical principles that guide nursing practice. These principles form the foundation of ethical decision-making and professional integrity in healthcare.

The ANA updates the Code of Ethics for Nurses approximately every 10 years to ensure it reflects current challenges, ethical dilemmas, and advancements in healthcare. The most recent revision was released in 2025, following the previous edition from 2015. This regular update process helps nurses stay aligned with evolving professional standards and societal expectations.

Importance of Fidelity in Nursing

Fidelity is crucial for the success of any nursing intervention, because without trust, patients may withhold information, resist treatment, or disengage from the care process entirely. Studies show that when patients trust their healthcare providers, they report better health habits, fewer symptoms, a higher quality of life, and greater satisfaction with their care.

And it doesn’t stop with the patient. Fidelity strengthens the entire care team. Nurses who honor their commitments are more likely to foster respectful, collaborative relationships with colleagues and leadership teams, which in turn contributes to creating strong teams and organizations.

Fidelity in Nursing: FAQ

What is the fidelity definition in nursing?

Fidelity in nursing refers to the ethical principle of being loyal, trustworthy, and following through on promises made to patients, colleagues, and the profession. It is one of the seven core ethical principles outlined in the Code of Ethics for Nurses.

Think of ethical principles as the how behind what you do in nursing. Your clinical skills guide your decisions, but ethics shape how you carry them out — because great care isn’t just about completing a medical procedure, it’s also about making patients feel respected, valued, and truly cared for.

Fidelity vs. veracity in nursing: What’s the difference?

While fidelity and veracity are both key ethical principles in nursing, they focus on different aspects of professional behavior and patient care:

• Fidelity is about loyalty, altruism, caring, and keeping your word. It means following through on what you say you’ll do.
• Veracity is the principle of truth-telling. It emphasizes honesty in all communication with patients, which includes giving accurate information about diagnoses, treatments, and outcomes.

What happens when fidelity is breached in nursing?

Fidelity in nursing ethics is the cornerstone of trust in patient care. When it’s breached — whether by breaking a promise, failing to follow through on responsibilities, or acting outside one’s role — the consequences can be significant. Here are some examples:

• Loss of patient trust: Patients may feel betrayed or unsafe, leading them to withhold important information or refuse care.
• Damage to professional relationships: Coworkers may find it difficult to rely on or collaborate with someone who doesn’t keep their word.
• Legal or disciplinary action: In serious cases, breaking commitments can result in complaints to regulatory bodies, formal investigations, or even suspension or revocation of a nursing license.
• Emotional impact on nurses: Nurses who breach fidelity may experience moral distress, guilt, or burnout.

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