Nurses’ ethical challenges caring for people with COVID-19: A qualitative study

Abstract

Background: Ethical challenges are common in clinical nursing practice, and an infectious environment could put nurses under ethical challenges more easily, which may cause nurses to submit to negative emotions and psychological pressure, damaging their mental health. Purpose: To examine the ethical challenges encountered by nurses caring for patients with the novel coronavirus pneumonia (COVID-19) and to provide nurses with suggestions and support regarding promotion of their mental health. Research design and method: A qualitative study was carried out using a qualitative content analysis. The participants were 18 nurses who agreed to attend an interview and describe their own experiences of providing care to COVID-19 patients in China. They were purposively sampled, and structured, in-depth interviews were performed. Data were iteratively collected and analyzed from February to March 2020. Ethical considerations: The proposal was approved by the Research Ethics Committee of the Second Hospital of Shandong University, China. Findings: The findings revealed three main themes and 10 categories. The themes were the following: (1) ethical challenges (people with COVID-19, inequality, professional ethics, and job competency); (2) coping styles (active control and planning, seeking support as well as catharsis, and staying focused); and (3) impacts on career (specialized nursing skills, scientific research ability, and management skills). Conclusion: Nurses faced ethical challenges on multiple fronts in caring for COVID-19 patients. The results may help nurses with more safety, ethics, and humanistic care in nursing practice.

Neonatal nursing during the COVID-19 global pandemic: A thematic analysis of personal reflections

“…Nurses report ‘feeling fearful’ ( Liu et al, 2020 ; Nyashanu et al, 2020 ), ‘feeling overwhelmed’ by the workload ( Iheduru-Anderson, 2020 ; Liu et al, 2020 ), and ‘feeling unprepared’ given challenges of keeping up with dynamically changing guidelines ( Fernandez et al, 2020 ; Nyashanu et al, 2020 ). The physical burdens of using PPE, reported by the neonatal nurses, have also been found in the wider literature ( Jia et al, 2020 ; Liu et al, 2020 ). The negative impact of the COVID-19 pandemic on the well-being of nurses generally, and neonatal nurses specifically, is striking and is particularly notable in the short and powerful prose used by some of the nurses in the study (see Extract 23).…”

“…Key to both of these themes was the identification of new opportunities that were found within adversity, but which were also valuable tools for neonatal nurses beyond the pandemic. New learning opportunities included clinical skills, a theme also reported by nurses caring for COVID-19 patients ( Jia et al, 2020 ). It also included on-line and virtual learning, which were considered new opportunities for flexible learning beyond the pandemic, providing student nurses with different, yet more opportunities to be trained.…”

“…What is notable about the experiences of neonatal nurses, in contrast to adult intensive care nurses, is the tension experienced between providing protection alongside the human quality of care. In adult units, there may be a concern that the use of protective measures could potentially delay care because nurses' responses are slower, and the frequency of contact with patients may be reduced ( Galehdar et al, 2020 ; Jia et al, 2020 ). In neonatal care settings, however, the tension resulting from the use of protective measures disrupts the very nature of the care that is provided to babies and their families and is fundamental to their role as family-centred care facilitators.…”

“…The psychological impact on health care professionals caring for patients with COVID-19 includes high rates of depression, anxiety, insomnia, and for nurses in particular, an increased risk of contracting the infection due to the close and enduring contact with critically ill COVID-19 positive patients ( Pappa et al, 2020 ). A growing body of research has examined the experiences of nurses caring for COVID-19 patients in adult intensive care ( Fernandez et al, 2020 ; Jia et al, 2020 ; Liu et al, 2020 ); however, the impact on nurses working in the neonatal environment where both babies and parents are cared for remains unknown.…”

The mediating role of regulatory emotional self‐efficacy on negative emotions during the COVID‐19 pandemic: A cross‐sectional study

“…Additionally, anticipated shortages of PPE and an increasing influx of suspected and actual cases of COVID‐19 contribute to the pressures and concerns of nurses (Tan et al 2020a,b). The inequality experienced by nurses can cause negative emotions during the process of caring for COVID‐19 patients, mainly because of unequal exposure to the infectious environment and role ambiguity between doctors and nurses (Jia et al 2020). Specifically, nurses mentioned that some doctors expected nurses to assume some of the doctors’ responsibilities, such as checking on patients’ conditions by pulmonary auscultation and bedside blood gas analysis, causing nurses mental and moral distress (Jia et al 2020; Tan et al 2020a,b).…”