Ethical Challenges For Nurses
The massive proliferation of Covid-19 across the globe has influenced citizens of all countries, races and social-economic classes. Furthermore, the magnitude of the epidemic’s symptoms has significantly risen, and the healthcare professionals’ responsibilities to preserve their fellow citizens’ health have been threatened (graham et al., 2020). The sudden and intense spread of this epidemic has culminated in immediate approaches to the detection and diagnosis of patients, the treatment and management of their care and the fight against further infection. At the forefront of the battle against illness, healthcare professionals are at heightened risk of contamination for themselves, their relatives, and those they come into interact with. Consequently, they can opt or may be compelled to be isolated from their family members throughout this time (Sparling, 2021). This essay explores the tension between nurses’ responsibility to their patients and community and their entitlement to self- care through the COVID-19 outbreak.
Caring is tough in periods of pandemics. Nursing is challenging, with nurses facing a substantial rise in the frequency and severity of their jobs while still needing to comply with current guidelines and frequent improvements in the disease’s treatment. This cause of concern is compounded by the fact that more health workers are expected to undertake confinement during the epidemic. The combined high job requirements and limited equipment, particularly protective equipment for health care professionals, such as breathers, gowns, safety goggles, gloves and disinfectants, causes potential pressure and can impair the safety and productivity of nursing staff since they are expected to deliver urgent help under terrible circumstances, often involving making the daunting decision (Sperling et al., 2021). Furthermore, since the patient’s relatives are not available at the quarantine’s facility, nurses assume family as a connection amongst patients and families.
The latest research in China involving more than 800 healthcare professionals during the epidemic predictably shows that the closest the COVID-19 comes to the caregivers, the higher the fear and frustration it creates (Maben & Bridges, 2020). Research on past pandemics often suggests that the tension between the responsibility to care, particularly in periods of disaster and the perceived danger of transmission coupled with a low degree of compliance with infection prevention and control steps, creates more ethical concerns and dilemmas nursing staff. Studies demonstrate that the determination to which caregivers can remain and perform their roles in emergencies relies on their risk appraisal and belief framework, both personal and professional (Graham et al., 2020). Besides, for fear of social exclusion, nurses can hesitate to care for people with infectious diseases. The most emotional challenge is the mind-set between avoiding patients and the desire for treatment for non- infectious causes.
The cornerstone of clinical practice is treating the accompanying duties of alleviating pain, restoring wellbeing, and respecting any patient’s freedom and integrity. However, healthcare workers must reconcile their obligation of caring for patients alongside their responsibility to look after themselves, their family and friends (Rasnick, 2020). These overlapping roles in a disease outbreak can trigger severe social and ethical stress. The obligation of a nurse to take care of patients is not unconditional. When a pandemic such as a COVID-19 virus puts nursing staff at significant risk as they acquire it, it is cruel and unreasonable to ask them to accept such elevated potential risks to perform their obligation of care. When nursing staff are forced to feel obliged to offer support despite the potential dangers, their family and friends feel a tremendous amount of ethical strain. Increasing patients with COVID-19 signs requiring hospitalization are exacerbating this moral dilemma. Many healthcare workers are mindful of the shortage of professional services and therefore have a profound obligation not just for patients but also for the community. In many other nations, a scarcity of nursing staff is getting much more extreme whenever they get sick or quarantined. This is another significant problem that culminates in the lack of nursing staff’s commitment to reporting to work.
In particular, caregivers that experience greater ethical tension have a lower degree of job fulfilment and a higher rate of desire to quit their present role. They may suffer emotional depression, marked by a lack of capacity to deal with their situation, culminating in reduced resilience and burnout levels. The incidence of these causes, which are linked to the propensity of nursing professionals to exit the work, can be much more significant in periods of disease outbreaks where potential risks are elevated, as is the seriousness and fast dissemination of the infection coupled with inadequate knowledge on its cause and solutions. The ethical behaviour of nurses is influenced by their specific history, preparation, practice and guidelines. The Code of Ethics in the American Nurses Association (ANA) abides even during cases of catastrophe or disease outbreak (ANA, 2020). Nevertheless, it recognizes the freedom of nursing professionals to self-care. It encourages nurses to preserve their wellbeing during crises while at the same time keeping a compromise between their jobs and their private lives.
Similarly, the Critical Nursing Framework and the Practice standards include legal guidance for critical healthcare, stating that the health care professional’s primary responsibility is to the patient. Nevertheless, they further indicate that the nurse, during cases of emergencies, must exercise self-recognition and self-care in the promotion of self-health and wellbeing (Rasnick, 2020). As emergency healthcare environments can be overwhelming, the Code specifies that healthcare workers have a personal and ethical commitment to study and improve methods that encourage resilience. It also stresses that a work-life equilibrium is crucial to maintaining personal development, requiring systems and procedures to facilitate such a balance, such as a balanced work atmosphere. This involves shifting priorities and time offs and improving self-satisfaction, earning benefits to maintain economic independence, reading to cultivate an innovative mind, and providing leisure and amusement practices. By outlining higher expectations for nursing, the Code applies to the attributes of nurses. They involve empathy, love, selflessness, and total spiritual uprightness. Centred in the philosophy of social equality, the Code postulates that emergency healthcare workers must assign preference to acuity-based treatment, not social class, size, and so on, and that, in periods of crisis, critical care judgment must be cantered on the utilitarian approach of achieving the greater happiness for the most significant percentage of citizens (ANA, 2020). It can thus be concluded that fostering resilience amongst nursing professionals, particularly in pandemics, natural disasters, or other crises, can strengthen the circumstances under which nurses’ values and ethical obligations can be preserved.
It is necessary to explore and analyze these pressures and dilemmas in light of the problematic moral tensions and complexities posed by COVID-19 and its associated delivery of healthcare and their effect on nursing staff’s job performance and work morale. Therefore, it is helpful to examine the interaction between these variables and the willingness of nursing staff to serve throughout the disease outbreak, their views of threats and their general belief framework, considering the necessity and possible lack of protective equipment (Maben& bridges, 2020). Therefore, this paper elaborates on the healthcare delivered by nursing professionals throughout the COVID-19 disease outbreak and its effects on the healthcare delivery ethical and job satisfaction aspects.
The American Nurses Association (ANA) Code of Ethics (ANA, 2015) recognizes the right of nurses not to participate and react to epidemics in the given situations: if they relate to marginalized populations; whenever they feel unsafe because of a shortage of personal protective equipment or inadequate testing; whether there is insufficient assistance for nurses’ family and personal preferences; or whether they’re worried about their legal, ethical and professional protection in caregiving during the pandemic. In this study, the respondents did not reply to these exceptions and were deeply committed to receiving treatment (Graham et al., 2020). The degree of danger anticipated by nurses for acquiring COVID-19 is likely to be inconsistent with fact, possibly due tonce of contradictory messages given by the Ministry of Healand It appears that at the beginning of the outbreak of COVID-19, individuals (such as healthcare providers) have underestimated its related risk; but, as they are more acquainted with the pandemic, their mental strain has decreased (Sperling, 2021). Although codes of ethics and professional oaths can direct health care professionals to resolve these contradictory circumstances, they may not generally compel them to give feedback. Besides, specific technical codes, such as the American Academy of Emergency Medicine, claim that nurses along with much other medical staff can be excluded from work schedules involving close interaction with patients possibly compromised with COVID-19 for personal health conditions, like immunosuppressive treatment or related problems, without the possibility of termination of their jobs.
As nurses frequently face major ethical dilemmas and stress, they can feel anger, disappointment, physical illness, etc. They will be most regularly interested in internal strife and may consider quitting the profession. Besides supplying sufficient and accessible personal protection devices to nurses, to ensure the safety and to minimize their fear and danger perception, and to track the emotional disorders of nurses and to introduce medical treatments as quickly and efficiently as feasible, it is suggested that assisting care teams in periods of disease outbreaks is equivalent to offering post-traumatic pressure disorder medication to operational troops (Rasnick, 2020). Any copying mechanisms for dealing with the mental effects of taking care of COVID-19 victims, as illustrated in the background information, including getting assistance from employers, family friends as well as other segments of society; living and working with gratitude and respect; and enhancing one’s capacity to focus on one’s own will, capability, and bravery. Research also points out; it is considered significant for caregivers to be listened to, safeguarded from illness, adequately prepared for delivering treatment, assisted and provided for, such that even if they do have a strong level of commitment to providing healthcare services, this must be well balanced with other principles and concerns of particular concern.
It has proved challenging to discover an adequate rationale for certain decisions in the coronavirus pandemic. This could entail moving away from a particular nursing technique to public health technique. This is because maintaining the welfare of the community also requires enforcing restrictions on the interests and desires of people. It may be claimed that there exists an ethical obligation to devote scarce resources where needed most where most lives can be rescued. This is expressed in the theory of utilitarianism, whereby, amid increased demand and insufficient supply, the best benefit can be done for the most significant number of people (Maben & Bridges, 2020). In cases like this, another ethical concept, distributive fairness, is also compromised, where every individual has an incompetent privilege to the absolute best in healthcare services. Again, the choice to protect one concept can clash with another, creating uncertainty and tension for caregivers. It is necessary to maintain a healthy atmosphere for health professionals. A considerable proportion of nurses confess to the reality that they feel insufficiently valued and secured in their professional context. It will be much simpler for a caregiver to take dangerous medical actions if their welfare is guaranteed. If healthcare professionals feel vulnerable or intimidated caused by inadequate protection and security procedures, many nurses are likely to step away from danger cases as Covid-19 casualties.
In summary, there exists a clash of values between nurses when taking care of patients during COVID-19. Although facing tremendous personal danger and mental burdens, some caregivers have a deep commitment to caring for people who are ill and careers.
Nevertheless, nurses seek an environment of support for their interests and moral issues. Considering that the coronavirus pandemic could continue in the coming months, or even perhaps more severe epidemic cycles could lay ahead, particularly in countries that have reverted to some regular, policymakers and health managers can resolve these healthcare concerns more effectively outbreak management.
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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