Intensive care nurses’ experiences of Covid-19 care: A practical and ethical challenge – a qualitative descriptive design

Abstract

The Covid-19 pandemic has generated new experiences of intensive care. It has entailed new working methods, treatment strategies, and ethical dilemmas. The aim of this study was to describe intensive care nurses’ experiences of Covid-19 care and its ethical challenges. Data collection consisted of 11 individual semi-structured interviews and a qualitative content analysis was used. The COREQ checklist was followed. Three main themes emerged: to meet Covid-19 patients’ needs for specifically tailored intensive care; to have a changed approach to the excluded relatives is unethical, but defensible; and to strive to protect ethical values needs to be considered as good enough. In conclusion, ICU nurses shouldered a heavy burden in taking responsibility for the safety of these patients, continuously learning about new treatment strategies. Caring for Covid-19 patients was to strive to make the best of the situation.

Ethical dilemmas experienced by nurses while caring for patients during the COVID‐19 pandemic: An integrative review of qualitative studies

“…A total of seven articles had the main objective related to topics on nurses' ethics during the COVID‐19 pandemic (Abbasinia et al, 2021 ; Alloubani et al, 2021 ; Jia et al, 2021 ; Karaca & Aydin Ozkan, 2021 ; Liu et al, 2021 ; McMillan et al, 2021 ; Rezaee et al, 2020 ; Stenlund & Strandberg, 2021 ), four articles (Kelley et al, 2021 ; Kwon & Choi, 2021 ; Moghaddam‐Tabrizi & Sodeify, 2021 ; Muz & Erdogan Yuce, 2021 ) had nurses' experiences in care of patients with COVID‐19 as main objective, one article (Silverman et al, 2021 ) was about moral distress in nurses caring for patients with COVID‐19, and the remaining article (Mohammadi et al, 2021 ) was conducted with nurses who were infected with COVID‐19. The participants' perceptions of ethical dilemmas are presented in the results of all 14 articles.…”

“…Ethical dilemmas in nursing management were identified as important information was not shared with frontline nurses in time (Kelley et al, 2021 ; Muz & Erdogan Yuce, 2021 ), equipment was not equally distributed and nurses had to work with limited PPE (Kelley et al, 2021 ; Liu et al, 2021 ; Moghaddam‐Tabrizi & Sodeify, 2021 ). Some nurses reported a lack of time (Muz & Erdogan Yuce, 2021 ; Silverman et al, 2021 ; Stenlund & Strandberg, 2021 ), human resources (Liu et al, 2021 ; Moghaddam‐Tabrizi & Sodeify, 2021 ; Muz & Erdogan Yuce, 2021 ) and medical supplies (Jia et al, 2021 ; Liu et al, 2021 ; Silverman et al, 2021 ; Stenlund & Strandberg, 2021 ) to provide the necessary care.…”

“…These dilemmas emerged because nurses had a lack of knowledge and skills to work in COVID‐19 wards (Jia et al, 2021 ; Karaca & Aydin Ozkan, 2021 ; Kelley et al, 2021 ; Liu et al, 2021 ); thus, they feared that they were not doing their job correctly (Jia et al, 2021 ; Kelley et al, 2021 ; Muz & Erdogan Yuce, 2021 ; Silverman et al, 2021 ) and that they were harming the patient due to inexperience or lack of necessary training (Karaca & Aydin Ozkan, 2021 ). In addition, due to nursing shortages and long shifts, nurses were not able to stay at patients' bedsides at the time of need (Rezaee et al, 2020 ; Stenlund & Strandberg, 2021 ).…”

“…Nurses also experienced moral distress because they felt unable to provide the necessary support to patients who suffered from the loss of loved ones or because they felt lonely in isolated rooms (Jia et al, 2021 ; Kelley et al, 2021 ; Kwon & Choi, 2021 ; Stenlund & Strandberg, 2021 ). Nurses faced dilemmas due to the prohibition of visits to patients during the COVID‐19 pandemic, as they had doubts whether this measure was more beneficial or harmful to patients and their families (Kwon & Choi, 2021 ; Stenlund & Strandberg, 2021 ). Nurses pointed out that family visits are not only important to provide emotional support but also to give information about patients (Stenlund & Strandberg, 2021 ).…”

“…Nurses faced dilemmas due to the prohibition of visits to patients during the COVID‐19 pandemic, as they had doubts whether this measure was more beneficial or harmful to patients and their families (Kwon & Choi, 2021 ; Stenlund & Strandberg, 2021 ). Nurses pointed out that family visits are not only important to provide emotional support but also to give information about patients (Stenlund & Strandberg, 2021 ). Especially in palliative care services, visitor restrictions were pointed out as a huge ethical dilemma for nurses, because contact with family is considered a palliative intervention (Kwon & Choi, 2021 ; McMillan et al, 2021 ).…”