A Tale of Two Codes: ASL Interpreting & Nursing
by: Lisa Hendrickson, CI - NIR Coordinator
This blog’s focus is the comparison and contrast of two different Codes of Professional Conduct: One within the field of American Sign Language Interpreting, the other in the field of Nursing. Individual tenets will be examined, and similarities and differences will be highlighted. Another focus will be the values embedded within each code and the influences that shaped them as they stand today. The governing body for Nurses and the Nurses’ Code of Ethics is The American Nursing Association, or ANA, in collaboration with the American Nurses Foundation (“Code of Ethics for Nurses”, n.d.). The corresponding governing body for American Sign Language Interpreters is the Registry of Interpreters for the Deaf, or RID, also in collaboration with another entity, the National Association of the Deaf, or NAD (“NAD-RID CPC”, 2005).
When two professional fields work in conjunction with one another regularly and support each other regularly, it is most imperative that their goals and values are at least somewhat aligned. Within most professions, these goals and values can be evidenced in their Code of Ethics, or Code of Professional Conduct. (For the remainder of this blog, these codes will be referred to as “CPCs” for ease and clarity, since the difference in the title is terminology only, not a difference in their function.) There are many duos of professions that work in cahoots such as: florists and delivery companies, police and fire departments, teachers and therapists, car mechanics and parts distributors, etc. Nurses and American Sign Language Interpreters fit this category as well, as they are each dependent on the other when their professions are both needed simultaneously for the same patient/client. Fortunately, after a deep investigation of their CPCs, it seems their codes, as well as their specific tenets show more similarities than differences.
As a Sign Language Interpreter, I am exceptionally familiar with NAD-RID’s Code of Professional Conduct. Since my early days interpreting, mostly in the community, the Code of Professional Conduct was foremost in my mind before, during, and after each assignment. The Nurses Code of Ethics is a document completely new to me; while I had always assumed the nursing profession also abided by some sort of code, this investigation is my first actual exposure to that document. What follows will be the findings of this investigation with regard to structure and content of each of the two documents, similarities and differences, and their apparent connection to the values they represent.
Similarities
In terms of structure, the ANAs’ CPC and Interpreters’ CPC are very similar. While they do not have the same terminology, “Provision #1” (nurses’) versus “Tenet #1” (interpreters’), their format is nearly identical. Nurses have eight Provisions, while interpreters have seven Tenets. Within RID’s CPC, each of the seven Tenets includes a guiding principle, and a list of several illustrative behaviors (“NAD-RID CPC”, 2005). Again, while the ANA’s CPC does not use the same terminology, it does have a stated principle (similar to RID’s guiding principle), and several sub-statements comparable to RID’s illustrative behaviors (“Code of Ethics for Nurses”, n.d.). These sub-statements are actually numbered identically to RID’s guiding principles, eg., 1.1, 3.4, etc. For the remainder of this blog, I will use RID’s terminology as I am mostly familiar with it, and the ANA’s CPC does not include labels for any of its parts other than the “Provisions”.
The likeness does not end with the structure; many of the Tenets/Provisions overlap in their intent, but even more common ground is evident in specific guiding principles. As these guiding principles are scattered throughout different Tenets and/or Provisions, I will now focus on just the similarities within a couple of the guiding principles, those which seem most striking and most relevant to both professions.
Within the ANA’s CPC, guiding principle 1.4, “The right to self-determination”, recognizes each patient’s autonomy. This principle states, “The nurse shall uphold and encourage the participation and planning of the individual in the decision-making process to the extent that they are willing and able to participate” (Slate, 2018, para. 9). This principle correlates almost directly with RID’s guiding principle 4.4, “Facilitate communication access and equality, and support the full interaction and independence of consumers” (“NAD-RID CPC”, 2005). The value illustrated here is that our consumers, be they patients at a doctor office, or Deaf users of American Sign Language at a conference, have full rights for full access and independence to the extent they are able.
Another overlapping principle that I am relatively sure is common to many fields is confidentiality. Both nurses and ASL interpreters have a guiding principle that directly addresses preserving our client’s/patient’s privacy with regard to information obtained during our interactions. While I was not surprised that both CPCs contained this provision, I was shocked to see how similar the wording is in each of the two guiding principles. RID’s 1.1 guiding principle states, “Share assignment-related information on a confidential and as-needed basis…” (“NAD-RID CPC”, 2005, para. 1). The ANA’s CPC 3.2 guiding principle is worded as such, “The nurse should ensure that information is revealed…on a need-to-know basis…with the patient’s permission…” (Slate, 2018, para. 18). The value exemplified here is that of basic human privacy; interpreters and nurses are privy to all kinds of sensitive, private information. Generally, the patient/client does not choose to share this information with them, but is in a situation where he/she may have no choice but to accept a “third-party” into their private dealings. It is an often unwanted, delicate balance of trust that each member of each of these professions must hold in the highest regard.
Differences
When looking at the two documents, RID’s CPC and ANA’s CPC, it is not easy to find differences. There are a few differences that are found which are not at odds with each other, but, rather, are differences with regard to each profession’s specific functions. For example, ANA’s CPC guiding principles 3.5, “Acting on questionable practice” and 3.6, “Addressing impaired practice” (Slate, 2018, para. 20-21) both center on the nurse’s responsibility to identifying and “taking action against any incompetent, illegal, unethical, or impaired practice by any member of the healthcare team…” and “protect the patient and …assure that the impaired person receives the necessary help…” (Slate, 2018, para. 20-21). These principles have no comparable entities within RID’s CPC as they are not applicable to the role of an interpreter.
Other than these few inconsequential differences, there is one very sharp difference that, as an ASL interpreter, actually threw me for a loop when I saw the verbiage. The ANA’s CPC Provision 5 is worded as such, “The nurse has a duty to self to maintain competence and to continue professional growth” (Slate, 2018, para. 26). This sounds much like RID’s CPC, Tenet 7, “Interpreters are expected to foster and maintain interpreting competence…through ongoing development of knowledge and skills” (“NAD-RID CPC”, 2005, para. 7). At a quick glance, these two seem like similar goals with similar values instilled; a closer glance shows guiding principles that are at almost complete odds with each other. In the AMA’s CPC, guiding principle 5.3, titled, “Wholeness of character”, instructs nurses to “have personal and professional identities…” and “when asked by the patient to give a personal opinion on a subject, the nurse is generally free to do so…” (Slate, 2018, para. 28). This is in stark contrast to RID’s CPC guiding principle 2.5, “Refrain from providing counsel, advice, or personal opinions” (“NAD-RID CPC”, 2005, para. 2). The only caveat is that the ANA’s principle does continue on to say that the nurse is free to give those opinions “provided that the opinion does not hamper or influence the validity of the patient’s informed decision-making” (Slate, 2018, para. 28). So, while the actual practices of sharing opinions and not sharing opinions are complete opposites, the ultimate value of not influencing a patient’s/client’s decision is addressed with that caveat.
Overall, the two profession’s CPCs are generally in alignment; the independence, care, and respect for the client/patient is of the utmost importance in both CPCs. Working side-by-side in two professions can only work effectively and successfully when this is the case.
References
Registry of Interpreters for the Deaf. (2005). NAD-RID Code of Professional Conduct. RID.org: http://rid.org/ethics/codeof-professional-conduct/
American Nursing Association. (n.d.). Code of Ethics for Nurses. NursingWorld.org/practice-policy/nursing-excellence/ethics/code-of-ethics-for-nurses/
Slate, M. K. (2018). Nurses Code of Ethics. RN.org/courses/coursematerial-177.pdf
If you have an interest in more NAD-RID Code of Professional Conduct information, please check out two previous, informative blogs on the Nationwide Interpreter Resource website: https://interpreterresource.com/blog/
Exploring the Code of Professional Conduct: https://interpreterresource.com/interpreter-education/exploring-the-code-of-professional-conduct/
NAD-RID Code of Professional Conduct: for Sign Language Interpreters:
https://interpreterresource.com/interpreter-education/nad-rid-code-of-professional-conduct-for-sign-language-interpreters/
https://interpreterresource.com/freelance-interpreters/new-interpreter-questionnaire/