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RESPONDER: A qualitative study of ethical issues faced by critical care nurses during the COVID-19 pandemic.
Morley, Georgina; Copley, Dianna Jo; Field, Rosemary; Zelinsky, Megan; Albert, Nancy M.
  • Morley G; Center for Bioethics, Stanley S. Zielony Institute for Nursing Excellence, Cleveland Clinic, Cleveland, Ohio, USA.
  • Copley DJ; Center for Bioethics, Stanley S. Zielony Institute for Nursing Excellence, Cleveland Clinic, Cleveland, Ohio, USA.
  • Field R; Stanley S. Zielony Institute for Nursing Excellence, Cleveland Clinic Marymount Hospital, Garfield Heights, Ohio, USA.
  • Zelinsky M; Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.
  • Albert NM; Office of Nursing Research and Innovation, Stanley S. Zielony Institute for Nursing Excellence, Cleveland Clinic Health System, Cleveland, Ohio, USA.
J Nurs Manag ; 30(7): 2403-2415, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2019498
ABSTRACT

AIMS:

To identify and understand ethical challenges arising during COVID-19 in intensive care and nurses' perceptions of how they made "good" decisions and provided "good" care when faced with ethical challenges and use of moral resilience.

BACKGROUND:

Little is known about the ethical challenges that nurses faced during the COVID-19 pandemic and ways they responded.

DESIGN:

Qualitative, descriptive free-text surveys and semi-structured interviews, underpinned by appreciative inquiry.

METHODS:

Nurses working in intensive care in one academic quaternary care centre and three community hospitals in Midwest United States were invited to participate. In total, 49 participants completed free-text surveys, and seven participants completed interviews. Data were analysed using content analysis.

RESULTS:

Five themes captured ethical challenges implementation of the visitation policy; patients dying alone; surrogate decision-making; diminished safety and quality of care; and imbalance and injustice between professionals. Four themes captured nurses' responses personal strength and values, problem-solving, teamwork and peer support and resources.

CONCLUSIONS:

Ethical challenges were not novel but were amplified due to repeated occurrence and duration. Some nurses' demonstrated capacities for moral resilience, but none described drawing on all four capacities. IMPLICATIONS FOR NURSING MANAGEMENT Nurse managers would benefit from greater ethics training to support their nursing teams.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Nurses Type of study: Observational study / Qualitative research Limits: Humans Language: English Journal: J Nurs Manag Journal subject: Nursing Year: 2022 Document Type: Article Affiliation country: Jonm.13792

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Nurses Type of study: Observational study / Qualitative research Limits: Humans Language: English Journal: J Nurs Manag Journal subject: Nursing Year: 2022 Document Type: Article Affiliation country: Jonm.13792