Ethical Challenges for Nurses During Covid-19 Pandemic

People from various nations, colors, and socioeconomic classes have been affected by the massive spread of Covid-19 worldwide. Also, the severity of the epidemic’s symptoms has dramatically increased, posing a threat to the healthcare industry’s obligation to protect the health of its patients (graham et al., 2020). Because of the rapid and strong development of this pandemic, immediate measures are now being taken to find and diagnose patients, treat them, manage their care, and stop the transmission of infection. Healthcare personnel is more likely to become contaminated than the general public since they are at the forefront of the fight against the disease. As a result, individuals may choose to or may be compelled to spend this time apart from their families (Sparling, 2021). In light of the COVID-19 outbreak, this essay examines the conflict between nurses’ obligations to their patients and the community and their right to self-care.

Providing care during pandemics is challenging. Nursing is difficult because nurses must follow current regulations and frequently updated advances in disease treatment while also dealing with a significant increase in the frequency and severity of their work. The fact that more healthcare professionals are anticipated to perform confinement during the outbreak only serves to increase this cause for concern. Because nurses are frequently required to make difficult decisions while providing urgent aid in difficult situations, the high job demands and limited equipment, particularly protective equipment for healthcare professionals, such as breathers, gowns, safety goggles, gloves, and disinfectants, can put pressure on them (Sperling et al., 2021). Also, nurses presume family as a connection between patients and families as the patient’s relatives are not present at the quarantine facility.

The most recent study conducted in China with more than 800 medical workers during the outbreak predictably demonstrates that the closer COVID-19 is to the caretakers, the more dread and annoyance it causes (Maben & Bridges, 2020). Research on previous pandemics frequently contends that nursing staff faces more ethical concerns and conundrums as a result of the tension between the duty to care, particularly during disasters, and the perceived danger of transmission combined with a low level of adherence to infection prevention and control measures. Research shows that carers’ risk assessment and belief framework, both personally and professionally, determine whether they can continue to act in their responsibilities during emergencies (Graham et al., 2020). In addition, nurses may hesitate to treat patients with contagious disorders out of concern for their social inclusion. The mental conflict between wanting to address non-infectious reasons and the desire to avoid patients presents the greatest emotional obstacle.

Clinical practice’s guiding principles include treating patients and upholding their independence and integrity while also reducing suffering and restoring their well-being. However, healthcare professionals must balance their duty to take care of patients with their commitment to take care of themselves, their family, and their friends (Rasnick, 2020). These converging roles in a disease outbreak can lead to a great deal of moral and societal pressure. A nurse’s duty to look after patients are not always mandatory. It is unfair and absurd to expect nursing personnel to incur such high potential dangers in order to carry out their duty of care when a pandemic, like the COVID-19 virus, places them at great risk as they contract it. Families and friends of nursing personnel who are made to feel obligated to provide support despite potential risks experience a great deal of ethical pressure. This ethical conundrum is being made worse by an increase in individuals who need hospitalization due to COVID-19 symptoms. Many healthcare professionals are aware of the lack of qualified professionals in the field and feel a great responsibility to both the patients and the community as a whole. Every time people fall sick or are quarantined, the shortage of nursing staff in many other countries gets considerably worse. Another key issue that leads to the nursing staff’s lack of commitment to going to work is this one.

Particularly, caregivers who feel more ethical conflict report feeling less fulfilled at work and feeling more inclined to leave their current position. Individuals could experience emotional depression, characterized by an inability to cope with their circumstances, leading to lower resilience and burnout levels. In times of disease outbreaks where potential risks are increased, as well as the seriousness and rapid spread of the infection coupled with inadequate knowledge of its cause and solutions, the incidence of these causes, which are linked to the propensity of nursing professionals to leave the work, can be much more significant. The specific history, training, practice, and standards of nurses have an impact on their ethical behavior. Even in instances of calamity or disease epidemic, the American Nurses Association’s (ANA) Code of Ethics is upheld (ANA, 2020). Nevertheless, it acknowledges that nurses have the right to self-care. It promotes nurses to maintain their well-being in times of need while maintaining a balance between their professional and personal life.

The Critical Nursing Framework and the Practice Standards both offer legal advice for critical healthcare and state that the patient is the healthcare professional’s top priority. However, they also suggest that the nurse should practice self-awareness and self-care in emergency situations to support their own health and wellness (Rasnick, 2020). The Code mandates that healthcare professionals have a personal and ethical commitment to research and advance strategies that foster resilience because emergency healthcare environments can be stressful. It also emphasizes the necessity of systems and practices, such as a healthy work environment, to facilitate a work-life balance, which is essential to maintaining personal development. This entails rearranging priorities and vacation schedules, increasing self-satisfaction, earning benefits to keep one’s financial independence, reading to foster creativity, and offering leisure and amusement activities. The Code applies to the characteristics of nurses by outlining higher expectations for nursing. Empathy, love, selflessness, and complete spiritual uprightness are all involved. The Code, which is based on the social equality philosophy, stipulates that emergency medical personnel must give priority to acuity-based treatment rather than social class, size, or other factors and that, during times of crisis, critical care judgment must be based on the utilitarian approach of achieving the greatest happiness for the majority of citizens (ANA, 2020). It may be inferred that encouraging professional nursing resilience can improve the conditions under which nurses’ beliefs and ethical commitments can be upheld, particularly in pandemics, natural disasters, or other crises.

In view of the challenging moral tensions and complexity offered by COVID-19 and its associated healthcare delivery, as well as their impact on the productivity and morale of the nursing staff, it is vital to study and analyze these pressures and quandaries. Considering the need for the potential absence of protective equipment, it is helpful to look at how these factors interact with the nursing staff’s willingness to work throughout the disease outbreak, their perceptions of dangers, and their general worldview (Maben& bridges, 2020). This report goes into detail about the healthcare provided by nursing professionals during the COVID-19 disease epidemic and its effects on the ethical and job satisfaction aspects of healthcare delivery.

In the following circumstances, the American Nurses Association (ANA) Code of Ethics (ANA, 2015) recognizes the right of nurses to refrain from participating in and responding to epidemics: when they involve marginalized populations, whenever they feel unsafe due to a lack of personal protective equipment or inadequate testing; when there is insufficient support for nurses’ family and personal preferences; or when they are concerned about their legal, ethical, and professional protection. These exclusions were not addressed by the respondents in this study because they were so devoted to getting treatment (Graham et al., 2020). Because of conflicting information provided by the Ministry of Health, nurses’ perceptions of the risk of contracting COVID-19 are likely to be exaggerated. It indicates that everybody, including healthcare professionals, misjudged the risk associated with the COVID-19 epidemic at first; however, as they became more familiar with the pandemic, their mental stress subsided (Sperling, 2021). Healthcare providers may be directed to resolve these paradoxical situations by codes of ethics and professional oaths, but they are not always required to provide feedback. Additionally, according to specific technical codes cited by organizations like the American Academy of Emergency Medicine, nurses and other medical professionals can be excused from work schedules that require close contact with patients who may be infected with COVID-19 due to personal health issues like immunosuppressive therapy or other problems without risking job termination.

Nurses may experience rage, disappointment, physical disease, etc., since they constantly deal with serious ethical challenges and stress. They might think about leaving their profession because they will frequently be interested in internal conflict. It is suggested that assisting care teams during times of disease outbreaks is equivalent to providing post-traumatic stress disorder medication to operational troops in order to ensure their safety, reduce their fear and perception of danger, track the emotional disorders of nurses, and introduce medical treatments as quickly and efficiently as possible (Rasnick, 2020). Any strategies for dealing with the psychological effects of caring for COVID-19 victims, as demonstrated in the background information, such as asking for help from coworkers, family members, friends, and other members of society; practicing gratitude and respect in one’s life and at work; and developing one’s capacity to concentrate on one’s own bravery, strength, and will. According to research, even though caregivers may have a strong level of commitment to providing healthcare services, this must be carefully balanced with other principles and concerns of particular concern. It is important for caregivers to be heard, protected from illness, adequately prepared for delivering treatment, assisted, and provided for.

Finding a sound justification for some decisions during the coronavirus epidemic has proven to be difficult. This could require switching from one nursing technique to another, such as a public health approach. This is so that collective welfare may be maintained, which necessitates placing limitations on individual interests and preferences. There is an ethical requirement to use limited resources where they are most needed and where the greatest number of lives can be saved. According to the utilitarian hypothesis, the best outcome may be achieved for the largest number of people in the face of rising demand and insufficient supply (Maben & Bridges, 2020). In situations like this, distributive fairness—an ethical principle that holds that every person has an unjustified right to the highest quality medical care—is likewise jeopardized. Likewise, choosing to defend one idea at the expense of another can be confusing and stressful for caregivers. For health practitioners, a healthy environment must be maintained. A sizable majority of nurses openly admit that they do not feel properly respected and secure in their work environment. Once their welfare is ensured, a caretaker will find it much easier to do risky medical procedures. Many nurses are prone to leave dangerous situations such as Covid-19 casualties if they feel exposed or intimidated due to insufficient security and protective measures.

In conclusion, there is a value conflict among nurses when caring for patients during COVID-19. Some carers have a strong dedication to caring for people who are unwell and their careers while enduring extreme personal risk and mental problems.

Nonetheless, nurses look for a setting that will support their values and interests in light of the possibility that the coronavirus pandemic will continue in the near future or even that more severe epidemic cycles may be on the horizon, particularly in nations that have returned to some level of normalcy, policymakers and health managers can address these healthcare concerns more successfully by managing outbreaks.

References

American Nurses Association (2015). Code of ethics for nurses with interpretive statements.

Silver Spring, MD.

American Nurses Association. ( 2020). Nurses, ethics and the response to the COVID–19 pandemic. Available at: nurses‐ethics‐and‐the‐response‐to‐the‐covid‐19‐pandemic. Pdf accessed, 13.

Graham, Y., Fox, A., Scott, J., Johnson, M., & Hayes, C. (2020). How a pandemic affects the mental health of the nursing workforce. Nursing Times, 116(8), 20-22.

Maben, J., & Bridges, J. (2020). Covid‐19: Supporting nurses’ psychological and mental health.

Resnick, B. (2020). What have we learned about nursing from the Coronavirus pandemic?. Journal of the American Medical Directors Association, 21(7), 997-998.

Sperling, D. (2021). Ethical dilemmas, perceived risk, and motivation among nurses during the COVID-19 pandemic. Nursing Ethics, 28(1), 9-22.

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Read the article “COVID-19: Ethical Challenges for Nurses” in The Hastings Center Report

Reflect on your own clinical experience, those of other students, a trusted health care colleague, or trusted media reports, and respond to the following in a minimum of 175 words:

In your opinion, what has been the biggest ethical challenge for nurses during the COVID-19 pandemic?
Why do you believe this ethical challenge is the largest?
Provide evidence for your opinion.

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