Abstract:The COVID‐19 pandemic has caused health professionals to deal with new situations they have not encountered before. Nurses were forced to cope with increased workloads, seriously ill patients, numerous patient deaths, and unresolved ethical dilemmas. This study aimed to examine the lived experiences of nurses across Europe during the first wave of the COVID‐19 pandemic. This was a qualitative narrative research study. Eighteen nurses from eight European countries (four each from the UK and Israel, three from P… Show more
“…Yet, ICUs were conceived for patient survival. In previous pandemics, such as MERS-CoV, studies reveal that nurses struggled with the ethical conflict of an evident patient-avoidance mentality in their efforts to dodge infection; however, during COVID-19, having to witness patients' loneliness at the time of death-as reported by several authors (Fernández-Castillo et al, 2020;Melnikov et al, 2022;Moore et al, 2022;Sezgin et al, 2021;Shin & Yoo, 2022)-is revealed as the main factor of ethical stress, given that it comes into conflict with a healthcare worker's responsibility to accompany their patients and to alleviate their suffering. Similarly, albeit to a lesser extent, was the suffering reported by some nurses during the first wave on having to provide post-mortem care-to-date an issue that has received little attention-and which raises the need to train professionals in these disciplines as part of their university education.…”
Aim and Objectives
The aim of this study was to explore the sources of ethical conflict and the decision‐making processes of ICU nurses and physicians during the first and subsequent waves of the COVID‐19 pandemic.
Background
Depside several studies exploring ethical conflicts during COVID‐19 pandemic, few studies have explored in depth the perceptions and experiences of critical care professionals regarding these conflicts, the decision‐making process or which have analysed the complexity of actually implementing the recommendations of scientific societies and professional/healthcare institutions in interdisciplinary samples.
Design
A descriptive phenomenological study.
Methods
Thirty‐eight in‐depth interviews were conducted with critical care nurses and physicians from five hospitals in Spain and Italy between December 2020 and May 2021. A thematic content analysis of the interview transcripts was conducted by two researchers. Consolidated criteria for reporting qualitative research (COREQ) were employed to ensure the quality and transparency of this study.
Results
Two main themes emerged as sources of ethical conflict: the approach to end of life in exceptional circumstances and the lack of humanisation and care resources. The former comprised two subthemes: end‐of‐life care and withholding and withdrawal of life‐sustaining treatment; the latter comprised three subthemes: the impossibility of guaranteeing the same opportunities to all, fear of contagion as a barrier to taking decisions and the need to humanise care.
Conclusions
Professionals sought to take their decisions in line with professional ethics and bioethical principles, but, nevertheless, they experienced moral dilemmas and moral distress when not being able to care for, or to treat, their patients as they believed fit.
Relevance to Clinical Practice
Further education and training are recommended on the provision of end‐of‐life and post‐mortem care, effective communication techniques via video calls, disclosure of bad news and bioethical models for decision‐making in highly demanding situations of uncertainty, such as those experienced during the COVID‐19 pandemic.
“…Yet, ICUs were conceived for patient survival. In previous pandemics, such as MERS-CoV, studies reveal that nurses struggled with the ethical conflict of an evident patient-avoidance mentality in their efforts to dodge infection; however, during COVID-19, having to witness patients' loneliness at the time of death-as reported by several authors (Fernández-Castillo et al, 2020;Melnikov et al, 2022;Moore et al, 2022;Sezgin et al, 2021;Shin & Yoo, 2022)-is revealed as the main factor of ethical stress, given that it comes into conflict with a healthcare worker's responsibility to accompany their patients and to alleviate their suffering. Similarly, albeit to a lesser extent, was the suffering reported by some nurses during the first wave on having to provide post-mortem care-to-date an issue that has received little attention-and which raises the need to train professionals in these disciplines as part of their university education.…”
Aim and Objectives
The aim of this study was to explore the sources of ethical conflict and the decision‐making processes of ICU nurses and physicians during the first and subsequent waves of the COVID‐19 pandemic.
Background
Depside several studies exploring ethical conflicts during COVID‐19 pandemic, few studies have explored in depth the perceptions and experiences of critical care professionals regarding these conflicts, the decision‐making process or which have analysed the complexity of actually implementing the recommendations of scientific societies and professional/healthcare institutions in interdisciplinary samples.
Design
A descriptive phenomenological study.
Methods
Thirty‐eight in‐depth interviews were conducted with critical care nurses and physicians from five hospitals in Spain and Italy between December 2020 and May 2021. A thematic content analysis of the interview transcripts was conducted by two researchers. Consolidated criteria for reporting qualitative research (COREQ) were employed to ensure the quality and transparency of this study.
Results
Two main themes emerged as sources of ethical conflict: the approach to end of life in exceptional circumstances and the lack of humanisation and care resources. The former comprised two subthemes: end‐of‐life care and withholding and withdrawal of life‐sustaining treatment; the latter comprised three subthemes: the impossibility of guaranteeing the same opportunities to all, fear of contagion as a barrier to taking decisions and the need to humanise care.
Conclusions
Professionals sought to take their decisions in line with professional ethics and bioethical principles, but, nevertheless, they experienced moral dilemmas and moral distress when not being able to care for, or to treat, their patients as they believed fit.
Relevance to Clinical Practice
Further education and training are recommended on the provision of end‐of‐life and post‐mortem care, effective communication techniques via video calls, disclosure of bad news and bioethical models for decision‐making in highly demanding situations of uncertainty, such as those experienced during the COVID‐19 pandemic.
“…As the COVID-19 pandemic intensified, there was an urgent need for an in-depth understanding of nurses’ lived experiences and their fear, moral distress, and challenges they experienced when caring for COVID-19 patients. Since the beginning of the pandemic, many studies have explored nurses’ experiences of care of COVID-19 patients in different healthcare settings, including intensive care units ( Brockopp et al, 2021 ; Gunawan et al., 2021 ; Karimi et al, 2020 ; N. Lee & Lee, 2020 ; H. Lee et al, 2022 ; Melnikov et al, 2022 ; Ménard et al, 2022 ; Moore et al, 2022 ; Moradi et al, 2021 ; Perraud et al., 2022 ; Robinson & Stinson, 2021 ) . These studies were conducted in North America (USA, Canada), Europe (Sweden, Italy, France), and Asia (Chania, South Korea, Iran).…”
Since the beginning of the COVID-19 pandemic, several studies worldwide have explored nurses’ experiences of caring for COVID-19 patients in various healthcare settings. However, these studies were conducted in context, culture, and healthcare systems that differ greatly from the Arabian Gulf context. This descriptive phenomenological study aimed to understand nurses’ lived experiences caring for patients diagnosed with COVID-19 in Arabian Gulf countries. Individual virtual interviews were conducted with 36 nurses from five countries and were analyzed using Giorgi’s methodology. Four main themes were identified: (1) living with doubts, (2) living through the chaos of challenges, (3) moving toward professional resilience, and (4) reaching the maximum level of potential. The findings from this study hopefully will guide health organizations in this region in developing strategies and policies to support and prepare nurses for future outbreaks.
“…In many countries, where healthcare systems were overwhelmed by rapid increases in the number of hospitalized patients, frontline healthcare workers continued to provide services. Their working environments were often very challenging, and many endured long work hours, anxiety and fear of infection, deficiencies in communication with middle management, and enormous stress (Barello et al, 2020; Fiabane et al, 2021; Melnikov et al, 2022). Accordingly, the pandemic's impact on healthcare workers, including nurses, and their mental health has attracted attention and many researchers have published reports on this topic (Al Maqbali & Al Khadhuri, 2021; De Kock et al, 2021; Ness et al, 2021).…”
Section: Introductionmentioning
confidence: 99%
“…and many endured long work hours, anxiety and fear of infection, deficiencies in communication with middle management, and enormous stress (Barello et al, 2020;Fiabane et al, 2021;Melnikov et al, 2022).…”
The activities of nursing researchers have been constrained by the COVID‐19 pandemic. Therefore, this study aimed to investigate the types of support and related factors that nursing researchers hope to receive from academic societies during the pandemic, and to obtain suggestions for the role of academic societies in supporting nursing researchers and expanding research. An online survey was conducted with 1,532 Japan Academy of Nursing Science members. The survey included 19 items of potential support from the society during the COVID‐19 pandemic as well as open‐ended questions. Data were analyzed statistically and qualitatively. For 9 of the 19 items, over 50% of respondents reported that they “needed” or “very much needed” support. Multivariate analysis results showed that younger respondents and those with family members requiring care were significantly more likely to report needs for some items. In the open‐ended comments, there were several suggestions for activities, including “Lobbying for revision of regulations on research implementation.” Nursing researchers expressed needs for support that reflect their demographic characteristics and situations, including collaboration across organizations and securing research‐promotion and skill‐development opportunities online.
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