Ethics and frontline nursing during COVID-19: A qualitative analysis
BackgroundNurses experienced intense ethical and moral challenges during the COVID-19 pandemic. Our 2020 qualitative parent study of frontline nurses’ experiences during the COVID-19 pandemic identified ethics as a cross-cutting theme with six subthemes: moral dilemmas, moral uncertainty, moral dist...
| Authors: | ; ; ; ; ; ; ; ; ; |
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| Format: | Electronic Article |
| Language: | English |
| Check availability: | HBZ Gateway |
| Journals Online & Print: | Drawer...
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| Fernleihe: | Fernleihe für die Fachinformationsdienste |
| Published: |
Sage
2023
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| In: |
Nursing ethics
Year: 2023, Volume: 30, Issue: 6, Pages: 803-821 |
| Further subjects: | B
Ethics
B Covid-19 B moral outrage B moral uncertainty B moral courage B Moral Dilemma B Moral Distress B Moral Injury |
| Online Access: |
Presumably Free Access Volltext (lizenzpflichtig) |
| Summary: | BackgroundNurses experienced intense ethical and moral challenges during the COVID-19 pandemic. Our 2020 qualitative parent study of frontline nurses’ experiences during the COVID-19 pandemic identified ethics as a cross-cutting theme with six subthemes: moral dilemmas, moral uncertainty, moral distress, moral injury, moral outrage, and moral courage. We re-analyzed ethics-related findings in light of refined definitions of ethics concepts.Research aimTo analyze frontline U.S. nurses’ experiences of ethics during the COVID-19 pandemic.Research designQualitative analysis using a directed content methodology.Participants and research contextThe study included 43 nurses from three major metropolitan academic medical centers and one community hospital in the northeastern, mid-Atlantic, midwestern, and western United States.Ethical considerationsParticipant privacy and data confidentiality were addressed.FindingsMoral dilemmas arose from many situations, most frequently related to balancing safety and patient care. Moral uncertainty commonly arose from lacking health information or evidence about options. Moral distress occurred when nurses knew the right thing to do, but were prevented from doing so, including with end-of-life issues. Moral injury (accompanied by suffering, shame, or guilt) occurred after doing, seeing, or experiencing wrongdoing, often involving authority figures. Nurses expressed moral outrage at events and people within and outside healthcare. Despite difficult ethical situations, some nurses exemplified moral courage, sometimes by resisting policies they perceived as preventing compassionate care, guided by thinking about what was best for patients.DiscussionThis content analysis of ethics-related subthemes revealed conceptual characteristics and clarified distinctions with corresponding exemplars. Conceptual clarity may inform responses and interventions to address ethical quandaries in nursing practice.ConclusionsEthics education in nursing must address the moral dilemmas of pandemics, disasters, and other crises. Nurses need time and resources to heal from trying to provide the best care when no ideal option was available. |
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| ISSN: | 1477-0989 |
| Contains: | Enthalten in: Nursing ethics
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| Persistent identifiers: | DOI: 10.1177/09697330221143150 |