Video summary

Curso Gratuito | Legislação COFEN | Código de Ética de Enfermagem (Resolução COFEN nº 564/2017)

Main summary

Key takeaways

Educational

Main ideas and lessons conveyed

  • Purpose of the session

    • Professor Sabrina Marçal leads a study session focused on the Nursing Code of Ethics and how it is likely to appear on upcoming COFEN exam questions.
    • The video emphasizes not delaying study until the last minute, since similar content can appear using different wording.

  • Legal framework referenced

    • The applicable rules are based on COFEN Resolution nº 564/2017 (Brazilian Federal Nursing Council).
    • The speaker notes that the code is in a revision/review phase for a future release, but instructs viewers to study what is currently in force.

  • Structure of the Code

    • The code is organized into:
      • Rights
      • Duties
      • Prohibitions
      • Infractions and penalties (including consequences for professional violations)

  • Exam strategy: rights vs duties

    • A key teaching point is distinguishing whether an exam statement is a right or a duty:
      • If the measure benefits the professional, it is typically framed as a right.
      • If the measure is about patient/family/community safety and the professional must prevent harm, it tends to be a duty.
    • Core examples:
      • Right: refuse activities outside one’s technical/scientific/ethical/legal competence or that do not ensure safety.
      • Duty (exception rule): if a prescription has clear error/illegibility that could harm the patient, the professional must refuse/clarify and record—there is no “optional choice” to ignore it.

  • Memory trick

    • When the verb “abstain” appears in a question, the speaker treats it as indicating a right (abstaining as a conscious choice).

Methodology / instruction-like guidance

How to reason through exam items (rights vs duties)

  • For each question:
    • Identify whether the action benefits (a) the professional or (b) the person/family/community.
    • If it benefits the professional → usually a right.
    • If the context involves safety and preventing harm → usually a duty, even if wording looks similar.
  • Apply the specific examples:
    • Refuse competence-lacking tasks → right.
    • Refuse/clarify harmful prescription errors → duty (because administering could harm the patient).

“Abstain” interpretation

  • If the question uses “abstain”:
    • Treat it as a right to consciously refrain from an action (example given: abstaining from voting).

Rights (main rights emphasized and how they were explained)

  • Practice nursing with freedom, autonomy, and technical/scientific/environmental safety.
  • Work without discrimination; be protected from physical/psychological harm and violence.
  • Participate in and support professional dignity movements, when shifts are arranged to maintain continuity of work and care.
    • Example movements mentioned: minimum wage/working hours/PEC approval efforts.
  • Participate in interdisciplinary/multidisciplinary care and care coordination, including:
    • shift handovers and guidance,
    • discussing issues that affect patient outcomes,
    • obtaining/communicating relevant clinical information to the team and to doctors when necessary.
  • Join/participate in professional organizations and bodies that supervise professional practice (with legal requirements met).
  • Seek improvement and stay updated, including technical, scientific, ethical-political, socio-educational, historical, and cultural knowledge.
    • The speaker stresses interpreting “improvement” as a right (not a duty).
  • Access information needed for professional practice from the patient/family/community.
  • Request public redress measures through the COREN/COREM system when offenses affect the profession.
    • Includes public remedies such as apologies, stances, or rules to repair aggression.
  • Appeal to the nursing councils when prevented from complying with nursing legislation and ethics.
  • Participate in creating institutional documents/protocols (e.g., waste management plans, SOPs, standards) through proper ethics committee processes.
  • Form and participate in Nursing Ethics Committees (and interdisciplinary committees), coordinating through COREN/COREN processes.
  • Confidentiality-related right: abstain from revealing professional confidential information when disclosure does not serve a legitimate care purpose.
  • Suspend activities when workplace conditions do not provide safe practice and/or disrespect the law (with procedural formalization requirements; exceptions for urgent/emergency situations).
  • Use the nursing process to plan, implement, evaluate, and document care.
  • Hold management positions (coordination/management within health areas related to nursing practice).
  • Have access to teaching/research/extension activities involving people under professional responsibility.
  • Seek authorship and recognition in research/extension/technical-scientific production.
    • Example: refusing to include a name can be challenged.
  • Use communication vehicles and social media appropriately (e.g., interviews, teaching, lectures, conferences, and promotion of educational/social events within competence).
  • Refuse to be filmed/photographed/exposed on social media while performing professional activities.
  • Refuse/seek termination of professional-user relationship when there is risk to the professional’s physical integrity, within ethics/legal reasoning.
  • Request continuity and communication for care during transitions (e.g., shift handover and ensuring team planning).

Duties (main duties emphasized)

  • Practice nursing with justice, commitment, equity, decisiveness, dignity, competence, responsibility, honesty, and loyalty.
  • Base relationships on law and prudence, respect, solidarity, and respect for diversity of opinions/ideological positions.
  • Know, comply with, and enforce the Code of Ethics and related council system norms.
  • Encourage and support participation of nursing professionals in professional-category organizations and councils.
  • Formally report ethical/legal violations that may harm professional practice and patient safety.
    • The speaker frames non-reporting as complicity.
  • Notify the councils (COREN/COFEN system) regarding refusal/resignation from positions motivated by the need to comply with ethics and law.
  • Meet deadlines and respond to council processes (notifications, summonses, evaluations).
  • Cooperate with inspection/monitoring, providing access to documents/areas rather than obstructing.
  • Maintain council registration up to date (including financial obligations, correct identification, category, signature/initials).
  • Document properly:
    • clear, objective, chronological, legible, complete, and non-alterable records,
    • certified signatures in electronic systems,
    • accurate documentation for patient safety and legal defense (“if it isn’t written, it wasn’t done” concept).
  • Provide complete and reliable information for continuity of care and safety.
  • Inform patients/family/community about rights, risks, benefits, and incidents, respecting:
    • patient autonomy,
    • free and informed decisions,
    • the right of refusal by the person or legal representative.
  • Provide care without discrimination.
  • Respect advance directives and the expressed will of patients when incapacitated.
  • Respect modesty, privacy, and intimacy in life-cycle and post-mortem situations.
  • Provide minimum safe care even in contexts like strikes/category demands (priority-based delegation and minimum required assistance).
  • Provide care free from harm resulting from incompetence, negligence, or recklessness.
  • Refuse prescriptions in specific circumstances:
    • missing prescriber identification (signature and registration number), except urgency/emergency contexts,
    • illegible/error prescriptions → clarify and record in chart.
  • Do not fulfill prescriptions remotely (except legally permitted urgency/emergency exceptions).
  • Take a stand against wrongdoing and report actions that create risk to patient safety.

Duty of confidentiality (major points)

  • Confidentiality remains even if:
    • the fact becomes public,
    • the patient dies.
  • Disclosure is allowed only in specific situations (examples mentioned):
    • threats to life/dignity,
    • self-defense,
    • multidisciplinary activities where assistance is necessary,
    • when summoned as a witness (professional can state ethical reasons for maintaining confidentiality),
    • mandatory reporting cases involving vulnerable groups (children/adolescents/elderly/incapacitated persons).

Prohibitions (major prohibited behaviors emphasized)

  • Perform or order acts contrary to the Code of Ethics and nursing legislation.
  • Perform tasks outside competence (technical/scientific/ethical/legal) or that do not ensure safety.
  • Collude with individuals/legal entities disregarding laws/principles governing nursing practice.
  • Provoke, cooperate in, be complicit in, or remain silent about violence against persons/families/community while practicing.
  • Unfair labor/ethics conflicts, including:
    • accepting roles/jobs resulting from ethical-law violations/unlawful departures,
    • accepting positions held by colleagues via unfair competition,
    • lending one’s name to staffing rosters if not actually performing nursing duties as defined by law.
  • Bribery/coercion/omission to obtain advantages; misuse of position/authority to impose ideologies or prejudice.
  • Use nursing knowledge to commit crimes (example mentioned: abortion-related misuse framed as unethical/illegal).
  • Spread gossip/defamatory conduct or encourage slander/defamation within/against nursing and health teams.
  • Violations in confidentiality and records, including:
    • false or dubious information,
    • inserting identifying images without authorization,
    • recording incomplete/inaccurate/false care data,
    • signing/allowing others to sign for you,
    • sharing documents/information with third parties not involved in care (except authorized by patient/representative or judicial order).
  • Respond to councils dishonestly: no denial/omission/false statements when requested.
  • Improper delegation:
    • cannot delegate exclusive nursing activities to non-nursing roles except narrowly defined emergency/home-care supported self-care contexts and student/intern supervision frameworks.
  • Misconduct in research/ethics:
    • disregarding inalienable rights,
    • foreseeable risk to participants,
    • falsifying/manipulating results,
    • publishing/disclosing without authorization, omitting co-authors, misattributing authorship, or using data without proper consent/agreements.

Infractions and penalties (what the speaker teaches)

Potential penalties mentioned (graduated sanctions)

Possible outcomes include:

  • verbal warning
  • fine
  • censure
  • suspension up to 90 days (no practice during suspension)
  • disqualification up to 30 years
  • revocation of professional practice (described as an ultimate consequence for serious violations)

How penalties are applied (grading factors)

The gradation considers:

  • offender’s background
  • severity of the offense
  • damage caused
  • aggravating or mitigating circumstances

Examples of infraction severity (as described)

  • Minor infraction: limited harm (physical/mental/moral/property/financial damage “slightly affected”).
  • Moderate infraction: temporary impairment/function, measurable mental/moral/material/financial damage.
  • Very serious: includes permanent disability and irreparable moral damage (speaker notes irreparable damage and risk of death).
  • Extreme/most severe: death of the patient described as part of “very serious.”

Aggravating vs mitigating circumstances (examples)

  • Mitigating circumstances (examples)
    • good professional background (distinct from “not having” it)
    • confession (in exam examples)
    • consequence mitigation (e.g., acted quickly: attended to patient, called for help, administered antidote)
    • acting under duress/grave threat
    • use of physical force when forced
  • Aggravating circumstances (examples)
    • repeat offender
    • irreparable damage
    • intent (e.g., “wanted to kill”)
    • frivolous/base motives
    • abusing victim vulnerability or exploiting authority
    • altering/falsifying evidence
    • facilitating concealment/impunity/advantage of another offense

Negligence vs recklessness vs incompetence (definitions given)

  • Negligence: failing to act / failing to do something the professional knows they must do.
    • Example: not raising bed rails when you know you must.
  • Recklessness: acting rashly/hastily without proper precaution or analysis.
    • Example: failing to wait for the doctor when waiting was prudent.
  • Incompetence: performing actions without skill/technical ability/qualification.
    • Example: attempting tasks you are not trained for.

Cumulation / combination of penalties

  • Penalties can be applied cumulatively when multiple provisions/articles are violated (e.g., suspension + fine + other consequences).

Process mechanics and appeals mentioned

  • Penalties must be recorded in the professional’s file.
  • When suspended/disqualified:
    • the council retains the professional license (held up).
  • Appeals:
    • speaker mentions possible appeal to an assembly of presidents of nursing councils, depending on the case and instance.

Speakers / sources featured

  • Speaker: Professor Sabrina Marçal (instructor presenting the course and exam tips)

  • Primary institutional sources referenced:

    • COFEN (Federal Nursing Council) — specifically COFEN Resolution nº 564/2017
    • COREN/COREM (Regional Nursing Council / regional nursing bodies) — referenced throughout as the system for actions, appeals, and inspections
    • COFEN/COREN system and related ethics committee structures
    • Brazilian Penal Code — referenced as additional legal responsibility beyond ethics

Original video