Ethical dilemmas for nursing home doctors during the COVID-19 pandemic

McLean, Emily; Onarheim, Kristine Husøy; Schanche, Elisabeth; Schaufel, Margrethe Aase; Miljeteig, Ingrid

doi:10.4045/tidsskr.22.0156

Cited by 3 publications

(4 citation statements)

References 15 publications

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“…This is in line with results from McLean et al. [ 29 ], who found that physicians in Norway working in nursing homes during the COVID-19 pandemic experienced difficulties in prioritizing care. The emphasized moral distress perceived during the pandemic could in part be attributed to the shortage of hospital beds, which might have impacted the medical decisions made in nursing homes, thus resulting in another aspect of restricting care.…”

Section: Discussionsupporting

confidence: 91%

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Ethical challenges causing moral distress: nursing home staff’s experiences of working during the COVID-19 pandemic

Ariander,

Olaison,

Andersson

et al. 2024

Scandinavian Journal of Primary Health Care

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Objective To investigate the experiences of healthcare staff in nursing homes during the COVID-19 pandemic. Design Individual interviews. Latent qualitative content analysis. Setting Ten nursing homes in Sweden. Subjects Physicians, nurses and nurse assistants working in Swedish nursing homes. Main outcome measures Participants’ experiences of working in nursing homes during the COVID-19 pandemic. Results Four manifest categories were found, namely: Balancing restrictions and allocation of scarce resources with care needs ; Prioritizing and acting against moral values in advance care planning ; Distrust in cooperation and Leadership and staff turnover – a factor for moral distress . The latent theme Experiences of handling ethical challenges caused by the COVID-19 pandemic gave a deeper meaning to the categories. Conclusion During the pandemic, nursing home staff encountered ethical challenges that caused moral distress. Moral distress stemmed from not being given adequate conditions to perform their work properly, and thus not being able to give the residents adequate care. Another aspect of moral distress originated from feeling forced to act against their moral values when a course of action was considered to cause discomfort or harm to a resident. Alerting employers and policymakers to the harm and inequality experienced by staff and the difficulty in delivering appropriate care is essential. Making proposals for improvements and developing guidelines together with staff to recognize their role and to develop better guidance for good care is vital in order to support and sustain the nursing home workforce.

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Section: Discussionsupporting

confidence: 91%

“…Similarly, McLean et al. [ 29 ] found that physicians experienced ethical challenges, due to the conflicts involved in providing good care to one resident while trying to protect others.…”

Section: Discussionmentioning

confidence: 99%

Ethical challenges causing moral distress: nursing home staff’s experiences of working during the COVID-19 pandemic

Ariander,

Olaison,

Andersson

et al. 2024

Scandinavian Journal of Primary Health Care

View full text Add to dashboard Cite

show abstract

“… 24 This has created heterogeneity across NHs, triggering also ethical dilemmas among HCPs, for example, regarding the implications on residents, or the need to make choices sometimes against the recommendations. 38 …”

Section: Discussionmentioning

confidence: 99%

“…Risk Management and Healthcare Policy 2022:15 triggering also ethical dilemmas among HCPs, for example, regarding the implications on residents, or the need to make choices sometimes against the recommendations. 38 At first, NHs focused on interventions at environmental levels, mainly implementing national and/or regional guidelines 13,[29][30][31] and available evidence. 21,22,27,37 Visitors' restrictions (including volunteers) were implemented immediately, and compartmentalization was applied in all NHs, whereas other interventions (eg, quarantine area for residents returning from hospital, dressing rooms for staff) were implemented in only some.…”

Section: Dovepressmentioning

confidence: 99%

What Kind of Interventions Were Perceived as Effective Against Coronavirus-19 in Nursing Homes in Italy? A Descriptive Qualitative Study

Palese¹,

Chiappinotto²,

Peghin³

et al. 2022

RMHP

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Purpose To identify interventions implemented during the first, second and third waves of the Coronavirus disease 2019 (COVID-19) among Italian Nursing Homes (NHs). Patients and Methods A descriptive qualitative design according to COnsolidated criteria for REporting Qualitative (COREQ) guideline. A purposeful sample of five public NHs, located in the north-east of Italy, equipped with from 60 to 151 beds, participated. Six nurse managers, four clinical nurses and one NH director were interviewed in depth at the end of 2021. These interviews were audio-recorded and then transcribed verbatim. A qualitative content analysis was performed to identify effective interventions as perceived by participants to protect facilities and residents from the pandemic. Results Three main sets of interventions have been applied, at the environmental, nurse staff and at the resident levels. Some have been enacted in all facilities, others in a few but in a homogeneous fashion, while other interventions have been implemented in some NHs also in contrast with available national or local recommendations. Conclusion Despite their documented frailty and precarious system, NHs implemented several interventions to protect their residents from the COVID-19. All interventions have been designed and implemented during the event, suggesting the need to increase the NHs’ preparedness to face future disasters. Regarding those interventions enacted in contrast to the recommendations or not homogeneously across NHs, future investigations are suggested to assess their actual effectiveness and accumulate evidence for the future.

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Balancing burdens of infection control: Norwegian district medical officers’ ethical challenges during the COVID-19 pandemic

Brøderud,

Pedersen,

Magelssen

2023

BMC Health Serv Res

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Background In several countries, district medical officers (DMOs) are public health experts with duties including infection control measures. The Norwegian DMOs have been key actors in the local handling of the COVID-19 pandemic. Methods The aim of the study was to explore the ethical challenges experienced by Norwegian DMOs during the COVID-19 pandemic, and how the DMOs have handled these challenges. 15 in-depth individual research interviews were performed and analyzed with a manifest approach. Results Norwegian DMOs have had to handle a large range of significant ethical problems during the COVID-19 pandemic. Often, a common denominator has been the need to balance burdens of the contagion control measures for different individuals and groups. In another large set of issues, the challenge was to achieve a balance between safety understood as effective contagion prevention on the one hand, and freedom, autonomy and quality of life for the same individuals on the other. Conclusions The DMOs have a central role in the municipality’s handling of the pandemic, and they wield significant influence. Thus, there is a need for support in decision-making, both from national authorities and regulations, and from discussions with colleagues.

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Ethical dilemmas for nursing home doctors during the COVID-19 pandemic

Cited by 3 publications

References 15 publications

Ethical challenges causing moral distress: nursing home staff’s experiences of working during the COVID-19 pandemic

Ethical challenges causing moral distress: nursing home staff’s experiences of working during the COVID-19 pandemic

What Kind of Interventions Were Perceived as Effective Against Coronavirus-19 in Nursing Homes in Italy? A Descriptive Qualitative Study

Balancing burdens of infection control: Norwegian district medical officers’ ethical challenges during the COVID-19 pandemic

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