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. 2023 Feb;30(1):32-45.
doi: 10.1177/09697330221105631. Epub 2022 Oct 17.

Nurses' ethical challenges when providing care in nursing homes during the COVID-19 pandemic

Hillestad Ah  1 , Rokstad Amm  2   3 , Tretteteig S  3 , Julnes Sg  4 , Lichtwarck B  5 , Eriksen S  1   3
Affiliations

Nurses' ethical challenges when providing care in nursing homes during the COVID-19 pandemic

Hillestad Ah et al. Nurs Ethics. 2023 Feb.

Abstract

Background: Older, frail patients with multimorbidity are at an especially high risk for disease severity and death from COVID-19. The social restrictions proved challenging for the residents, their relatives, and the care staff. While these restrictions clearly impacted daily life in Norwegian nursing homes, knowledge about how the pandemic influenced nursing practice is sparse. Aim: The aim of the study was to illuminate ethical difficult situations experienced by Norwegian nurses working in nursing homes during the COVID-19 pandemic. Research design and participants: The research design involved semistructured individual interviews conducted with 15 nurses working in 8 nursing homes in 3 health regions in Norway, within both urban and rural areas. Ethical considerations: Oral and written information about the study was provided before the participants gave their written consent. The transcribed interviews were de-identified. The study was approved by the Norwegian Centre for Research Data. Findings: Four ethical difficult situations were identified: (a) turning the nursing home into a prison; (b) using medication to maintain peace and order; (c) being left alone with the responsibility; and (d) s. impact on decision-making. Conclusions: The nurses' ethical challenges were intertwined with external factors, such as national and local guidelines, and the nurses' own internalized factors, which were connected to their subjective professionality. This duality inflicted emotional distress and gave nurses few opportunities to perform nursing in a professionally sound and safe manner.

Keywords: COVID-19; ethical challenges; nursing; nursing home.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

    1. Ho FK, Petermann-Rocha F, Gray SR, et al. Is older age associated with COVID-19 mortality in the absence of other risk factors? General population cohort study of 470,034 participants. PloS One 2020; 15(11): e0241824. - PMC - PubMed
    1. Hewitt J, Carter B, Vilches-Moraga A, et al. The effect of fraility on survival in patients with COVID-19 (COPE): a multicentre, European, observational cohort study. Lancet Public Health 2020; 5: S2468–S2667. - PMC - PubMed
    1. Myrstad M, Ranhoff AH. Akutt syke elder i koronaens tid. Tidsskr Nor Legeforen 2020; 140. DOI: 10.4045/tidsskr.20.0227 - DOI - PubMed
    1. The Norwegian Institute of Public Health (FHI) (2020). Forelopige tall for COVID-19-assosierte Dodsfall i Dodsarsaksregisteret. https://www.fhi.no/hn/helseregistre-og-registre/dodsarsaksregisteret/for... 2020. (accessed 22 September 2020).
    1. Jacobsen FF, Arntzen C, Devik SA, et al. Erfaringer med COVID- 19 i norkse sykehjem ( Experiences with COVID-19 in Norwegian nursing homes), 2021. [Norwegian]. Senter for omsorgsforskning (Centre for Care Research ) Report no. 1, 2021. https://hdl.handle.net/11250/2737650