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Arries-Kleyenstuber E, Dierckx de Casterlé B, Kynoch K, Ramis MA, Suhonen R, Ventura C, Morley G. Ethical challenges nurses faced during the COVID-19 pandemic: Scoping review. Nurs Ethics 2025:9697330251339417. [PMID: 40349297 DOI: 10.1177/09697330251339417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2025]
Abstract
Nurses encountered a myriad of ethical challenges during the height of the COVID-19 pandemic, such as allocation of scarce resources, the need to balance duty of care with safety of self as well as visitation restrictions. The impact of these challenges on the nursing workforce requires investigation. The aim of this review was to scope and describe the reported literature on ethical challenges faced by nurses during the COVID-19 pandemic, including contextual characteristics and strategies reported to address these challenges. The review was conducted in accordance with JBI methods for scoping reviews and reported using PRISMA-ScR guidance. A published protocol guided conduct of the review. The following databases were searched for eligible studies from November 2019 to January 2023: PubMed, CINAHL, Ovid, PsycINFO, the Cochrane Library, and Scopus. No language restrictions were applied. Studies were reviewed for inclusion by two independent reviewers, and a data extraction form was developed to extract data relevant to the review questions. Results were analyzed and presented according to the concepts of interest, using tables, figures, and supporting narrative synthesis. After searching the databases, 2150 citations were retrieved with 47 studies included in the review. Studies represented 23 countries across five continents. Most of the studies used qualitative designs. Ethical challenges were described in several ways, often without appealing to common ethics language or terms. Few studies reported on strategies to address the specific challenges, which may reflect the dynamic nature of the pandemic. The scoping review highlights the complex and, at times, overwhelming impact of ethical challenges faced by nurses across the globe during the COVID-19 pandemic. Findings from the review can be used as a basis for further research to explore, develop, and implement strategies to address ethical challenges faced by nurses during future public health crises.
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Affiliation(s)
| | | | - Kathryn Kynoch
- Mater Health and JBI Queensland Center for Evidence-Based Health Innovation, Australia
| | - Mary-Anne Ramis
- Mater Health and JBI Queensland Center for Evidence-Based Health Innovation, Australia
| | | | - Carla Ventura
- University of São Paulo at Ribeirão Preto College of Nursing, Brazil
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Feng Y, Li S, Ma W, Chen Y, Zhang J, Luo H, Xue B. The relationship between compassion fatigue, engagement and decent work among nurses: a cross-sectional study. BMC Nurs 2025; 24:74. [PMID: 39838350 PMCID: PMC11752779 DOI: 10.1186/s12912-025-02721-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2024] [Accepted: 01/13/2025] [Indexed: 01/23/2025] Open
Abstract
BACKGROUND Nurses face significant professional challenges arising from global pandemics, inadequate welfare protection, and declining social status. In this context, the decent working conditions for nurses are not adequately safeguarded. This study examines decent work status among Chinese nurses and its links work engagement, and compassion fatigue. METHODS This study is a cross-sectional research. Through the method of convenience sampling, five reputable hospitals in Hangzhou, China, were selected, and a total of 838 nurses were surveyed. Data collection was conducted from April to May 2023. We employed a comprehensive set of assessment tools, including an evaluation of demographic characteristics, the Decent Work Perception Scale (DWPS), the Chinese version of the Compassion Fatigue Short Scale (C-CFSS), and the Gallup Q12 survey scale. RESULTS The findings of this study demonstrated that compassion fatigue was significantly negatively correlated with both decent work (r = -0.482, p < 0.001) and engagement (r = -0.461, p < 0.001). Additionally, decent work was significantly positively correlated with engagement (r = 0.811, p < 0.001). Mediation analysis revealed that compassion fatigue had a direct negative effect on decent work (β = -0.05, p < 0.001), while engagement partially mediated the relationship between compassion fatigue and decent work (β = -0.14, p < 0.001). CONCLUSION This study found that compassion fatigue and engagement significantly influence nurses' perception of decent work, with engagement mediating this relationship. Future research should explore these mechanisms further and develop interventions to enhance engagement and reduce compassion fatigue, improving nurses' perception of decent work.
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Affiliation(s)
- Yaping Feng
- Afliated Hospital of Hangzhou Normal University, Hangzhou, 310015, Zhejiang, China
| | - Sui Li
- Hangzhou Normal University, Hangzhou, 310007, Zhejiang, China
| | - Weilan Ma
- Hangzhou Normal University, Hangzhou, 310007, Zhejiang, China
| | - Yaqian Chen
- Hangzhou Normal University, Hangzhou, 310007, Zhejiang, China
| | - Jingxuan Zhang
- Hangzhou Normal University, Hangzhou, 310007, Zhejiang, China
| | - Hong Luo
- Afliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310007, Zhejiang, China.
| | - Bowen Xue
- Afliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310007, Zhejiang, China.
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Hernandez I, Söderström M, Rudman A, Dahlgren A. Under pressure - Nursing staff's perspectives on working hours and recovery during the COVID-19 pandemic: A qualitative study. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2024; 7:100225. [PMID: 39139601 PMCID: PMC11321373 DOI: 10.1016/j.ijnsa.2024.100225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2024] Open
Abstract
Background The COVID-19 pandemic contributed to increased pressure on healthcare systems. During periods when the demands exceed the capacity of healthcare organizations, adaptive strategies are used to meet these demands. During the COVID-19 pandemic, working hours for nursing staff were reorganized and extended. This has posed challenges for recovery, which may be a key factor for maintaining health and safety under such conditions. Objectives The aim of the study was to bring insights into how nursing staff perceived their working hours and recovery during the COVID-19 pandemic, and if they experienced any changes in their sleep and well-being. Design A qualitative descriptive design was chosen, as it is suitable for gaining insight into perceptions and experiences. Methods Qualitative semi-structured interviews were conducted using an interview guide. The interviews were analyzed using thematic analysis. Sixteen registered nurses and six certified nursing assistants from four Swedish hospitals participated in the study. Results The organization of working hours during the COVID-19 pandemic was considered suboptimal and resulted in more demanding working hours and poor recovery. Nursing staff experienced loss of control as they lost influence over working hours, working hours became more unpredictable and the boundaries between work and leisure became blurred. Nursing staff also experienced a decline in their health and well-being, including extreme fatigue, impaired sleep and physical/mental changes. Conclusion The strategies used by healthcare organizations to meet increasing demands during the COVID-19 pandemic contributed to impaired recovery and well-being of nursing staff, which could generate negative feedback loops contributing to depletion of resources at the organizational level.
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Affiliation(s)
- Isabelle Hernandez
- Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden
| | - Marie Söderström
- Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden
| | - Ann Rudman
- Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Anna Dahlgren
- Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden
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Wang CJ, Chen CJ, Lin SCA, Lin JN. Work-related flow and its correlates among frontline nurses during the COVID-19 pandemic. Int Nurs Rev 2024; 71:949-959. [PMID: 38436490 DOI: 10.1111/inr.12949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 02/08/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Ample evidence across non-healthcare fields highlights the role of work-related flow in enhancing resilience against work stress and work engagement. Understanding flow and its factors can support staff development and management. AIMS This study aimed to investigate the level of work-related flow and its associated factors among frontline nurses during the COVID-19 pandemic. METHODS A cross-sectional multicenter study included 336 nurses caring for COVID-19 patients between March and April 2022. Cluster random sampling was used to select 9 nurse groups from 29 Taiwanese hospitals specialized in COVID-19 care. A web survey link was shared on the selected nurses' social media. Hierarchical regression analyses examined predictor-outcome relationships, following the STROBE checklist for reporting findings. RESULTS Among demographic characteristics, sex (β = -0.11; p = 0.016) and living arrangement (β = -0.12; p = 0.017) reached statistical significance in model 3. Social support from family, friends, and significant others, managerial position, and sufficiency of personal protective equipment showed significant associations with work-related flow (all β > 0.12; p < 0.05). The variables included in the final model accounted for 35% of the variance in work-related flow for COVID-19 patient care tasks. CONCLUSIONS Flow experience is influenced by factors associated with demographics, work conditions, and social support. Nurse administrators should consider these factors when evaluating nurses' flow at work. IMPLICATIONS FOR NURSING PRACTICE AND MANAGEMENT Allocating care tasks to nurses based on their flow levels can be beneficial, particularly during healthcare crises. Ensuring a sufficient supply of personal protective equipment and offering social support to nurses are vital strategies for facilitating their flow experience in the workplace.
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Affiliation(s)
- Chi-Jane Wang
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ching-Ju Chen
- Department of Nursing, Fooyin University, Kaohsiung City, Taiwan
| | - Shu-Chuan Amy Lin
- Department of Nursing, National Yang Ming Chiao Tung Hospital, Yilan City, Taiwan
- School of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jong-Ni Lin
- College of Nursing and Health Sciences, Da-Yeh University, Changhua, Taiwan
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Nchabeleng L, Bopape MA, Manamela LE, Ntho TA. Clinical learning of nursing students during the COVID-19 pandemic in Limpopo province, South Africa. Curationis 2024; 47:e1-e8. [PMID: 39354782 PMCID: PMC11447608 DOI: 10.4102/curationis.v47i1.2578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 04/19/2024] [Accepted: 06/20/2024] [Indexed: 10/03/2024] Open
Abstract
BACKGROUND The Nursing Education Programme was affected during the coronavirus disease 2019 (COVID-19) pandemic, resulting in nursing students being unable to participate in the clinical experiential learning required by the South African Nursing Council. OBJECTIVES The study seeks to explore and describe nursing students' experiences of clinical experiential learning during the COVID-19 pandemic. METHOD A qualitative, explorative and descriptive, research design was used in the study. A non-probability purposive sampling method was used, and 55 nursing students participated in the study. Data were collected through six focus group discussions, consisting of 8-12 nursing students in each group. Data were analysed following Tesch's open coding method. RESULTS Three themes emerged from the study's findings: The impact of COVID-19 on the clinical experiential learning of nursing students, the effects of COVID-19 on the mental well-being of nursing students, and nursing students' experiences of support during the COVID-19 pandemic. Notably, 11 sub-themes emerged. CONCLUSION The findings of this study reveal that the COVID-19 pandemic severely disrupted the Nursing Education Programme, highlighting the challenges of inadequate clinical hours, restricted clinical access and the significant psychological impact on students.Contribution: This study adds to the literature on students' experiences during clinical experiential learning in South Africa during the COVID-19 pandemic.
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Affiliation(s)
- Linda Nchabeleng
- Department of Nursing Science, Faculty of Health Sciences, University of Limpopo, Polokwane.
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Huerta-González S, Caro-Alonso PÁ, Rodríguez-Martín B, Castillo-Sarmiento CA, Pedrera-Zamorano JD, Chimpén-López C, Rico-Martín S, López-Espuela F. Nurses' perceptions of the performance of nurse managers and senior hospital management during the COVID-19 pandemic. BMC Nurs 2024; 23:455. [PMID: 38961487 PMCID: PMC11221198 DOI: 10.1186/s12912-024-02123-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 06/24/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND The first waves of the COVID-19 pandemic had a negative impact on health systems and health professionals, due to the high number of cases and a lack of preparation. The aim of this study was to understand how nurses working in hospital units and in intensive care perceived the performance of nurse managers and senior hospital management during the first two waves of the pandemic. METHODS The phenomenological approach proposed by Giorgi was used to investigate perceptions of the performance of nurse managers and senior hospital management during the first two waves of the COVID-19 pandemic in Spain. Fourteen clinical nurses who worked on the front line in inpatient units or intensive care units of the Health Services of Extremadura and Madrid in the first (March-April 2020) and second (October-November 2020) waves of the COVID-19 pandemic participated in this study. The data was collected through semi-structured interviews, following a script of themes, in a theoretical sample of nurses who were worked during the pandemic. RESULTS Two main themes emerged from the analysis of the data: (1) perceptions about the performance of nurse managers and senior hospital managers during the first and second waves of the pandemic (health system failure; belief that senior hospital management professionals could have managed the pandemic better; recognizing the efforts of middle management (nursing supervisors); insufficient institutional support) and (2) strategies employed by nurses to compensate for the weaknesses in pandemic management. CONCLUSIONS The clinical nurses perceived that the nurse managers demonstrated better management of the pandemic than the hospital's senior management, which they attribute to their proximity, empathy, accessibility, and ability to mediate between them and the senior management. The nurses also believe that the senior management of the hospitals was to blame for organisational failures and the poor management of the pandemic.
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Affiliation(s)
| | - Pedro Ángel Caro-Alonso
- Health Service of Castilla-La Mancha, La Algodonera Health Center, Talavera de la Reina, Toledo, Spain
| | - Beatriz Rodríguez-Martín
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Health Sciences, University of Castilla-La Mancha. Talavera de la Reina, Toledo, Spain.
| | - Carlos A Castillo-Sarmiento
- Department of Nursing, Physiotherapy and Occupational Therapy, School of Physiotherapy and Nursing, University of Castilla-La Mancha, Toledo, Spain
| | - Juan Diego Pedrera-Zamorano
- Department of Nursing, Faculty of Nursing and Occupational Therapy, University of Extremadura, Cáceres, Extremadura, Spain
| | - Carlos Chimpén-López
- Department of Nursing, Faculty of Nursing and Occupational Therapy, University of Extremadura, Cáceres, Extremadura, Spain
| | - Sergio Rico-Martín
- Department of Nursing, Faculty of Nursing and Occupational Therapy, University of Extremadura, Cáceres, Extremadura, Spain
| | - Fidel López-Espuela
- Department of Nursing, Faculty of Nursing and Occupational Therapy, University of Extremadura, Cáceres, Extremadura, Spain
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Trettin B, Munk NT, Egmose B, Agerskov H. Nurses on shacking ground-A qualitative study of Danish dermatology and allergology nurses' experiences of relocation during the COVID-19 pandemic. Nurs Open 2024; 11:e2242. [PMID: 38992993 PMCID: PMC11239953 DOI: 10.1002/nop2.2242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 06/23/2024] [Indexed: 07/13/2024] Open
Abstract
AIM To investigate dermatology and allergology nurses' experiences of relocation from an outpatient clinic to a newly established COVID-19 infectious disease ward. DESIGN A phenomenological-hermeneutical approach was applied. METHODS Three focus groups with nurses were conducted from June to August 2020. Data were analysed in accordance with Ricoeur's theory of interpretation. RESULTS The relocation represented a challenging period that involved uncertainty and evoked feelings of excitement and dedication towards the nursing profession. Nurses felt obligated to help; however, they also experienced that they did not have a say in the relocation. The placement on the infectious disease ward was characterized by adaptations in three areas: unfamiliar working environment, unfamiliar team competencies and inadequate nursing training. E-learning training was experienced as insufficient, as it did not enhance the nurses' specific competencies or confidence in caring for patients with COVID-19. CONCLUSION The relocation of nurses from an outpatient clinic to a new COVID-19 infectious disease ward created a dilemma between nurses' sense of duty and their right to self-determination. A prompt relocation into a newly established unfamiliar field caused frustrations because there were no unspoken rules to rely on. Managers should take nurses' experiences and perceptions under careful consideration and strive for more involvement in future scenarios. PATIENT OR PUBLIC CONTRIBUTIONS No patient or public contribution.
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Affiliation(s)
- Bettina Trettin
- Department of Dermatology and Allergy CentreOdense University HospitalOdenseDenmark
- Clinical Institute, Health SciencesUniversity of Southern DenmarkOdenseDenmark
| | - Nadja Trier Munk
- Department of Dermatology and Allergy CentreOdense University HospitalOdenseDenmark
| | - Britt Egmose
- Department of Dermatology and Allergy CentreOdense University HospitalOdenseDenmark
- Clinical Institute, Health SciencesUniversity of Southern DenmarkOdenseDenmark
| | - Hanne Agerskov
- Clinical Institute, Health SciencesUniversity of Southern DenmarkOdenseDenmark
- Department of NephrologyOdense University HospitalOdenseDenmark
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Han SJ, Hong HJ, Shin BS. Korean Hospital Nurses' Experiences with COVID-19: A Meta-Synthesis of Qualitative Findings. Healthcare (Basel) 2024; 12:903. [PMID: 38727460 PMCID: PMC11083708 DOI: 10.3390/healthcare12090903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 04/23/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024] Open
Abstract
This study aims to provide a meta-synthesis of qualitative studies examining the perceptions and experiences of nurses who cared for patients in dedicated COVID-19 hospitals in South Korea. We searched key health databases (RISS, KISS, KMbase, NDSL, KoreaMed, DBpia, PubMed, CINAHL, and Cochrane) from September to November 2023. We reviewed and analyzed articles using a thematic synthesis approach. The quality of the studies was ascertained using the Critical Appraisal Skills Program checklist for qualitative research. Ultimately, 13 studies involving 219 nurses were included in the final review. Six major themes and thirteen subthemes emerged. During the unexpected COVID-19 pandemic, nurses were able to overcome difficult situations through their interactions with patients, sense of a professional mission, and commitment to nursing. Most importantly, they persevered through their collaboration and closeness with fellow nurses, despite confusion about their professional identity, the ethical dilemmas they faced in patient care, and the conflicting attitudes of their social support system. To prepare for future infectious disease outbreaks, a multifaceted support system should be established to enable nurses to have positive interactions with their families, colleagues, and patients, which have become central to their resilience.
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Affiliation(s)
- Suk-Jung Han
- College of Nursing, Sahmyook University, Seoul 01795, Republic of Korea;
| | - Hee-Jung Hong
- Department of Nursing, Severance Hospital, Seoul 03722, Republic of Korea
| | - Bok-Soon Shin
- College of Nursing, Inha University, Incheon 22212, Republic of Korea;
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Minehmorad M, Nemati-Vakilabad R, Badpeyma M, Mirzaei A. Examining nurses' understanding and knowledge about preparation for COVID-19 in Ardabil hospitals in Iran. BMC Health Serv Res 2024; 24:312. [PMID: 38454446 PMCID: PMC10921800 DOI: 10.1186/s12913-024-10826-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 03/05/2024] [Indexed: 03/09/2024] Open
Abstract
AIMS The purpose of this study was to evaluate the preparedness of Iranian nurses for potential pandemics. BACKGROUND Nurses play a critical role in managing pandemics. They require adequate training, proper equipment, and organizational support to be well-prepared. METHODS A descriptive cross-sectional study was conducted in Ardabil, Iran, from July to September 2023, involving 233 nurses from five hospitals. The number of nurses required for each hospital was calculated based on the proportion of nurses in each hospital. Data was collected through a paper-based form that included information about the participants' demographic characteristics and their level of pandemic preparedness in health services. The collected data was analyzed using descriptive statistics to determine the demographic characteristics and levels of pandemic preparedness. Pearson's test was also conducted to establish a relationship between different dimensions of pandemic preparedness. RESULTS Most participants relied on clinical measures and supported using human resources and environmental methods to curb the transmission of a pandemic. They felt assured in their ability to explain the preventive measures against the pandemic. However, fewer respondents had access to healthcare improvement programs, and only a few worked remotely from home. CONCLUSIONS According to our study, 90.1% of nurses believe hand washing is the most effective way to prevent spreading infections. Additionally, healthcare professionals can use various tools to respond to the pandemic, including screening for COVID-19 at work, health and wellness programs, telecommuting, COVID-19 Safe programs, social media, and posters. Nurses need continuous education in hand hygiene, health programs, remote work options, and pandemic-safe programs to control infections, reduce risks, and optimize patient care during the pandemic.
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Affiliation(s)
- Milad Minehmorad
- Students Research Committee, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Reza Nemati-Vakilabad
- Students Research Committee, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
- Student Research Committee, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Badpeyma
- Students Research Committee, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Alireza Mirzaei
- Department of Emergency Nursing, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran.
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Wang X, Shao J, Lian J, Weng A, Chang J, Ji M, Wang C, Fang Q, Ye Z, Hu Y. Measuring the Nursing Work Environment during Public Health Emergencies: Scale Adaptation and Validation. J Nurs Manag 2024; 2024:9910079. [PMID: 40224822 PMCID: PMC11919113 DOI: 10.1155/2024/9910079] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 02/06/2024] [Accepted: 02/15/2024] [Indexed: 04/15/2025]
Abstract
Aim To develop a scale for measuring nurse's perceived work environment during the public health emergencies (PHEs) and assess its reliability and validity. Background Although there is extensive research on instruments for measuring nursing work environments in regular healthcare settings, there is a lack of specific scales tailored to address the unique work conditions experienced by nurses during PHEs. Design This study employed a cross-sectional design for psychometric evaluation and adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. Methods A self-report scale, the Chinese Nursing Work Environment Scale for Public Health Emergencies (C-NWE-PHE), was developed, integrating situational characteristics. Data on demographics, adapted scale scores, and subjective evaluations of nursing management performance were collected from 1156 nurses through online surveys conducted between January 2023 and March 2023. Confirmatory factor analysis, Pearson correlations, and Cronbach's alpha analyses were conducted to evaluate the psychometric properties of the scale. Results The adapted C-NWE-PHE scale comprised 28 items organized into five subscales: Workforce and Deployment Support, Leadership and Emergency Management, Autonomy and Empowerment, Teamwork and Collaboration, and Logistics and Humanistic Care. Structural equation modelling showed satisfactory factor loadings for each subscale and a good model fit, confirming construct validity. The content validity and reliability of the total scale were confirmed. Conclusion This study provides empirical evidence for understanding and assessing the nursing work environment during PHEs with a psychometrically sound scale. Implications for Nursing Management. The C-NWE-PHE scale, along with its five identified constructs, provides a nuanced comprehension of working conditions amid PHEs. Implementing this scale could foster specific enhancements, support nurse retention efforts, and enhance the effectiveness of responses during challenging emergency situations.
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Affiliation(s)
- Xiyi Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Jing Shao
- Institute of Nursing Research and Department of Nursing of Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Jiaqi Lian
- School of Nursing, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Aozhou Weng
- School of Nursing, Shanghai Jiao Tong University, Shanghai 200025, China
| | | | - Mengting Ji
- Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Caifeng Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Qiong Fang
- School of Nursing, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Zhihong Ye
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Yun Hu
- School of Nursing, Shanghai Jiao Tong University, Shanghai 200025, China
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Manookian A, Nayeri ND, Dashti S, Shahmari M. Ethical Challenges to the Self-care of Nurses during the Covid-19 Pandemic. Nurs Ethics 2024; 31:161-175. [PMID: 37428123 DOI: 10.1177/09697330231180753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
BACKGROUND The emerging working conditions triggered by the COVID-19 pandemic have imposed numerous ethical challenges on the nurses, which, in turn, can negatively impact the nurses' physical and mental health, and thus their work performance through intensifying negative emotions and psychological pressures. AIM The purpose of this study was to highlight the nurses' perceptions of the ethical challenges that they faced regarding their self-care during the COVID-19 pandemic. RESEARCH DESIGN A qualitative, descriptive study with a content analysis approach. PARTICIPANTS AND RESEARCH CONTEXT The data were collected through semi-structured interviews with 19 nurses working in the COVID-19 wards of two university-affiliated hospitals. These nurses were selected using a purposive sampling method and the data were analyzed using a content analysis approach. ETHICAL CONSIDERATIONS The study was approved by the TUMS Research Council Ethics Committee under the code: IR.TUMS.VCR.REC.1399.594. In addition, it is based on the participants' informed consent and confidentiality. FINDINGS Two themes and five sub-themes were identified, including ethical conflicts (the conflict between self-care and comprehensive patient care, prioritization of life, and inadequate care) and inequalities (intra- and inter-professional inequalities). CONCLUSION The findings demonstrated that the nurses' care is a prerequisite for the patients' care. Considering that the ethical challenges faced by nurses are related to unacceptable working conditions, organizational support, and lack of access to facilities such as personal protective equipment, it seems essential to support nurses and provide adequate working conditions to provide patients with quality care.
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Affiliation(s)
- Arpi Manookian
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Nahid Dehghan Nayeri
- Professor of Nursing, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Seemin Dashti
- Health Education and Promotion Department, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Nursing, Ardabil Branch, Islamic Azad University, Ardabil, Irans
| | - Mehraban Shahmari
- Department of Medical-Surgical, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran and
- USERN CARE (TUMS) Office, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Sperling D. "They choke to death in front of your very eyes": nurses' lived experiences and perspectives on end-of-life care during COVID-19. BMC Palliat Care 2024; 23:35. [PMID: 38331781 PMCID: PMC10854065 DOI: 10.1186/s12904-024-01352-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 01/16/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic led to an intensified fear and threat of dying, combined with dying and grieving in isolation, in turn significantly impacting nursing in end-of-life situations. The study aims (1) to understand the lived experiences of nurses who provided care to end-of-life patients during COVID-19; and (2) to explore whether providing care under such circumstances altered the perspectives of these nurses regarding end-of-life care. METHODS Applying the phenomenological-interpretive qualitative approach, 34 in-depth semi-structured interviews were conducted between March 2020-May 2021 with nurses from eight hospitals in Israel who were recruited through purposive and snowball sampling. Thematic analysis was applied to identify major themes from the interviews. RESULTS Five main themes emerged from the analysis, including: (1) a different death; (2) difficulties in caring for the body after death; (3) the need for family at end-of-life; (4) weaker enforcement of advance care directives; and (5) prolonging the dying process. DISCUSSION During the pandemic, nurses encountered numerous cases of death and dying, while facing ethical and professional issues regarding end-of-life care. They were required to administer more aggressive care than usual and even necessary, leading to their increased moral distress. The nurses' ethical concerns were also triggered by the requirement to wrap the corpse in black garbage-like bags to prevent contagion, which they felt was abusing the dead. The findings also demonstrate how family presence at end-of-life is important for the nursing staff as well as the patient. Finally, end-of-life situations during the pandemic in Israel were managed in an individual and personal manner, rather than as a collective mission, as seen in other countries. CONCLUSIONS The study offers insights into the nurses' attitudes towards death, dying, and end-of-life care. An emphasis should be placed on the key elements that emerged in this study, to assist nurses in overcoming these difficulties during and after medical crises, to enhance end-of-life care and professionalism and decrease burnout.
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Heydarikhayat N, Ghanbarzehi N, Darban F, Kashani ZA, Rohani C. Exploring Lived Experiences of Vulnerability in Nursing Management during the Coronavirus Disease 2019 Pandemic: A Phenomenological Study of Nurse Managers and Nurses. SAGE Open Nurs 2024; 10:23779608241286308. [PMID: 39386173 PMCID: PMC11462562 DOI: 10.1177/23779608241286308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 09/04/2024] [Accepted: 09/06/2024] [Indexed: 10/12/2024] Open
Abstract
Introduction The Coronavirus Disease 2019 (COVID-19) pandemic placed enormous pressure on healthcare systems around the world, but it also provided valuable insights for healthcare organizations during this challenging period. Objective This study aimed to explore nurses' lived experiences of vulnerability in hospital nursing management during the COVID-19 pandemic, and reflect on the lessons learned. Methods In this phenomenological study, 14 participants, including nurse managers at different levels and staff nurses, were selected by purposive sampling from one center university hospital. Data collection was done through in-depth individual semistructured interviews with participants and a review of weekly reports of crisis management meetings at the university hospital. Interviews were analyzed using Colaizzi's method in seven phases by MAXQDA software Version 10. Results One overarching theme, four themes, and 15 subthemes were obtained from analyses of interviews. Four themes of "nurses' attrition," "distrust of society to the organization," "fragility in the organization's performance," and "intensified inequalities" were extracted as threats to nursing management at the hospital. Subsequently, the weekly reports of crisis management meetings at the university hospital were analyzed to extract the solutions and lessons. Conclusion The unpreparedness of the healthcare system against a crisis can led to the loss of organizational assets, including medical staff and the credibility of the healthcare system. Limitations of the infrastructure at hospital became more obvious during the pandemic and caused serious threats to the healthcare system. Despite severe challenges along with the pandemic, it offered four valuable lessons in nursing management.
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Affiliation(s)
- Nastaran Heydarikhayat
- Department of Nursing, School of Medicine, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Nezar Ghanbarzehi
- Department of Nursing, School of Medicine, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Fatemeh Darban
- Department of Nursing, School of Medicine, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Zahra Atarodi Kashani
- Department of Midwifery, School of Medicine, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Camelia Rohani
- Department of Health Care Sciences, Palliative Care Research Center, Marie Cederschiöld Högskola, Stockholm, Sweden
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Gurdap Z, Cengiz Z. Compassion Fatigue and Ethical Attitudes in Nursing Care in Intensive Care Nurses During the COVID-19 Pandemic: A Cross-sectional Study. J Nurs Care Qual 2023; 38:312-318. [PMID: 36917830 DOI: 10.1097/ncq.0000000000000702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
BACKGROUND Intensive care unit (ICU) nurses faced an increased risk of compassion fatigue and ethical concerns during the COVID-19 pandemic. PURPOSE To evaluate compassion fatigue of ICU nurses and their ethical attitudes in care during the COVID-19 pandemic and analyze contributing factors. METHODS An exploratory cross-sectional research design was used. RESULTS A total of 103 ICU nurses participated. The nurses' compassion fatigue and ethical attitude scores were high. Compassion fatigue was explained by the following variables: considering resigning, receiving support for ethical decisions, willingness to work in the ICU, duration of providing activities of daily living in a shift, and number of patients per nurse. CONCLUSIONS Compassion fatigue was high in nurses working in the ICU during COVID-19. The high level of ethical attitudes shows commitment to professional ethics and reflects the development of the nurses' professional identity. Implementation of interventions that help improve compassion fatigue among nurses is needed.
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Affiliation(s)
- Zuleyha Gurdap
- Department of Fundamentals of Nursing, Nursing Faculty, Inonu University, Malatya, Turkey
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15
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Abstract
BACKGROUND Nurses experienced intense ethical and moral challenges during the COVID-19 pandemic. Our 2020 qualitative parent study of frontline nurses' experiences during the COVID-19 pandemic identified ethics as a cross-cutting theme with six subthemes: moral dilemmas, moral uncertainty, moral distress, moral injury, moral outrage, and moral courage. We re-analyzed ethics-related findings in light of refined definitions of ethics concepts. RESEARCH AIM To analyze frontline U.S. nurses' experiences of ethics during the COVID-19 pandemic. RESEARCH DESIGN Qualitative analysis using a directed content methodology. PARTICIPANTS AND RESEARCH CONTEXT The study included 43 nurses from three major metropolitan academic medical centers and one community hospital in the northeastern, mid-Atlantic, midwestern, and western United States. ETHICAL CONSIDERATIONS Participant privacy and data confidentiality were addressed. FINDINGS Moral dilemmas arose from many situations, most frequently related to balancing safety and patient care. Moral uncertainty commonly arose from lacking health information or evidence about options. Moral distress occurred when nurses knew the right thing to do, but were prevented from doing so, including with end-of-life issues. Moral injury (accompanied by suffering, shame, or guilt) occurred after doing, seeing, or experiencing wrongdoing, often involving authority figures. Nurses expressed moral outrage at events and people within and outside healthcare. Despite difficult ethical situations, some nurses exemplified moral courage, sometimes by resisting policies they perceived as preventing compassionate care, guided by thinking about what was best for patients. DISCUSSION This content analysis of ethics-related subthemes revealed conceptual characteristics and clarified distinctions with corresponding exemplars. Conceptual clarity may inform responses and interventions to address ethical quandaries in nursing practice. CONCLUSIONS Ethics education in nursing must address the moral dilemmas of pandemics, disasters, and other crises. Nurses need time and resources to heal from trying to provide the best care when no ideal option was available.
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Affiliation(s)
- Dónal O’Mathúna
- The Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare, College of Nursing, The Ohio State University, Columbus, OH, USA; Center for Bioethics and Medical Humanities, The Ohio State University, Columbus, OH, USA
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16
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Melaku T, Zeynudin A, Suleman S. Ethical challenges and dilemmas in the rationing of health commodities and provision of high-risk clinical services during COVID-19 pandemic in Ethiopia: the experiences of frontline health workers. Philos Ethics Humanit Med 2023; 18:6. [PMID: 37370151 DOI: 10.1186/s13010-023-00136-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 05/31/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Ethical reasoning and sensitivity are always important in public health, but it is especially important in the sensitive and complex area of public health emergency preparedness. Here, we explored the ethical challenges, and dilemmas encountered by frontline health workers amid the coronavirus disease-19 (COVID-19) pandemic in Ethiopia. METHODS A nationwide survey was conducted amongst the frontline health workers from nineteen public hospitals. Health workers were invited to respond to a self-administered questionnaire. Data were weighted and analyzed using descriptive statistics. RESULTS Of the 285 frontline health workers to whom questionnaires were distributed, 217 of them gave their responses (response rate 76.1%). Respondents frequently reported encountering rationing dilemmas on health commodities directly used for the prevention and treatment of COVID-19. Most (83.9%) of the health workers agreed that they encountered ethical challenges very frequently or frequently. Almost all [215(99.1%)] claimed that the limitation of resources was directly used for the treatment and prevention of COVID-19. The frequency of difficulty in the provision of essential clinical services varied between 77% and 98.7% for different services. More than half of the study participants reported that they had encountered difficulty in the provision of clinical care on a daily or weekly basis. Regarding rationing strategies, isolating COVID-19 treatment units and limiting admission were the most frequent rationing strategies used by two-thirds of health workers on a daily or weekly basis. CONCLUSION Front-line health workers encountered numerous ethically challenging situations during COVID-19. More than half of health workers reported that they encountered ethical challenges in rationing the resources and delivery of different clinical services such as family planning services, maternal and childcare, immunization, and chronic care. With limited resources such as ventilators and hospital beds, healthcare providers have been faced with the difficult task of deciding who gets access to these resources and who doesn't. Overall, the COVID-19 pandemic has presented numerous ethical challenges for healthcare providers, highlighting the importance of ethical considerations in healthcare delivery. By being aware of these dilemmas and having policies in place to address them, healthcare providers can ensure that they are providing the best possible care to their patients while upholding ethical standards.
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Affiliation(s)
- Tsegaye Melaku
- School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia.
| | - Ahmed Zeynudin
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Sultan Suleman
- School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia
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Jokar Z, Torabizadeh C, Rakhshan M, Najafi Kalyani M. From disobedience to struggle for adaptation: nursing students' experiences of attending the clinical learning environment during Covid-19 pandemic. BMC Psychiatry 2023; 23:308. [PMID: 37131134 PMCID: PMC10153046 DOI: 10.1186/s12888-023-04807-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 04/20/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND The Covid-19 pandemic has affected the clinical education of nursing students all over the world. Considering the importance of clinical education and clinical learning environment (CLE) in the education of nursing students, identifying the challenges and problems faced by these students during the covid-19 pandemic helps to plan more effectively in this regard. The aim of this study was to investigate the experiences of nursing students in CLEs during the Covid-19 pandemic. METHODS A descriptive qualitative research was conducted, which used a purposive sampling technique to recruit 15 undergraduate nursing students from Shiraz University of Medical Sciences between July 2021 and September 2022. Data were collected through in-depth semi-structured interviews. For data analysis, conventional qualitative content analysis based on Graneheim and Lundman approach was used. RESULTS The data analysis led to emergence of two themes of "disobedience " and "struggle for adaptation". The disobedience theme consists of two categories: "objection to attend CLE" and "patient marginalization". The theme of struggle for adaptation includes two categories: "using support sources" and "applying problem-oriented strategies". CONCLUSION At the beginning of the pandemic, the students were unfamiliar due to the disease, as well as fear of contracting themselves and infecting others, so they tried not to be in the clinical environment. However, they gradually tried to adapt to the existing conditions by applying support resources and using problem-oriented strategies. Policymakers and educational planners can use the results of this study to plan for solving the challenges of students during future pandemics and improve the condition of CLE.
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Affiliation(s)
- Zeinab Jokar
- Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Camellia Torabizadeh
- Community Based Psychiatric Care Research Center, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahnaz Rakhshan
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Majid Najafi Kalyani
- Department of Medical Emergencies, School of Nursing and Midwifery, Shiraz Univesity of Medical Sciences, Shiraz, Iran.
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Yang Q, Zheng Z, Pang S, Wu Y, Liu J, Zhang J, Qiu X, Huang Y, Xu J, Xie L. Clinical nurse adherence to professional ethics: A grounded theory. Nurs Ethics 2023; 30:197-209. [PMID: 36282515 DOI: 10.1177/09697330221130594] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Professional ethics is the regulation and discipline of nurses' daily nursing work. Nurses often encounter various ethical challenges and problems in their clinical work, but there are few studies on nurses' adherence to professional ethics. RESEARCH AIM An analysis of nursing adherence to nursing ethics from the perspective of clinical nurses in the Chinese public health system. RESEARCH DESIGN This study adopts the grounded theory approach proposed by Strauss and Corbin. PARTICIPANTS AND RESEARCH CONTEXT Between July 2021 and January 2022, Clinical nurses were recruited for online video interviews using purposive and theoretical sampling methods in seven hospitals in Beijing, Tianjin, Shanxi, Henan, Guangdong, and Fujian, China. Data analysis was conducted using Strauss and Corbin's coding approach. ETHICAL CONSIDERATIONS This study was approved by the Ethics Committee of Sanming First Hospital (MingYiLun 71/2021). FINDINGS A total of 27 participants were included. A theoretical model of nursing staff adherence to professional ethics was constructed. The main core was adherence to professional ethics and the other cores were (1) causal conditions: professional ethics code, individual conscience; (2) intervening conditions: personal growth, social support system, matching career compensation, prediction of adverse consequences; (3) action strategies: sticking to professional values, self-regulation, flexible response, post-event improvement; and (4) outcomes: self-harmony, reduced medical disputes. CONCLUSIONS This study provides an interpretive understanding of why clinical nurses adhere to professional ethics in China and describes the challenges and issues posed by nurses' use of strategies to cope with ethical adversity. The findings can be used to develop future complex studies.
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Affiliation(s)
- Qingqing Yang
- 47858Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Zhihui Zheng
- 47858Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Shuqin Pang
- 47858Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yilong Wu
- 47858Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jujuan Liu
- 47858Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jiahui Zhang
- 47858Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Xiahua Qiu
- 47858Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yufeng Huang
- 47858Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jia Xu
- 47858Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Liyue Xie
- 47858Fujian University of Traditional Chinese Medicine, Fuzhou, China
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19
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Yarahmadi S, Khademi M, Ebrahimzadeh F, Cheraghian T, Shahidi Delshad E. Development and psychometric properties of health care workers' concerns in infectious outbreaks scale. Front Psychol 2023; 13:1108835. [PMID: 36743621 PMCID: PMC9891178 DOI: 10.3389/fpsyg.2022.1108835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 12/26/2022] [Indexed: 01/18/2023] Open
Abstract
Introduction Healthcare workers are a crucial workforce; from a moral perspective, understanding their concerns and how to support them is crucial and makes it possible for health services to keep functioning. This study aimed to develop and validate Health Care Workers' Concerns in Infectious Outbreaks Scale (HCWCIOS). Methods This exploratory sequential mix-method study was employed to design and validate the HCWCIOS. The initial tool was designed after searching similar studies and performing a qualitative phase under the semi-structured approach. Both qualitative and quantitative methods were used to evaluate the face and content validity. The content validity ratio, content validity index, and item-level content validity index were also calculated. Exploratory factor analysis was employed to evaluate the construct validity. Using a convenient sampling method, 354 Iranian healthcare workers participated in the study. Computing Cronbach's alpha coefficient estimated the internal consistency for HCWCIOS and its subscales. Furthermore assessed was test-retest reliability. Results The preliminary scale was designed with 57 items. By eliminating nine items in the content validity phase and 12 items during factor analysis, the final 36-item scale was developed on six factors: inadequate preparedness, lack of knowledge, risk perception, affected social relations, work pressure, and absenteeism. These six factors accounted for 46.507% of the total variance. The whole scale's Cronbach's alpha coefficient was 0.912, and the intra-class correlation coefficient was 0.88. Conclusion A 36-item HCWCIOS has good psychometric properties and is suitable for measuring healthcare workers' concerns during a pandemic.
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Affiliation(s)
- Sajad Yarahmadi
- Social Determinants of Health Research Center, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran,Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran
| | - Mojgan Khademi
- Social Determinants of Health Research Center, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Farzad Ebrahimzadeh
- Nutritional Health Research Center, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Tayebeh Cheraghian
- Cardiovascular Research Center, Shahid Rahimi Hospital, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Elham Shahidi Delshad
- Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran,*Correspondence: Elham Shahidi Delshad, ✉
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Mayers PM, Olckers L, Prinsloo EL, Raine J, Zweigenthal V. Reflections of volunteer counselors working remotely during the COVID-19 pandemic-Implications for policy and practice. J Nurs Scholarsh 2023; 55:239-252. [PMID: 36510097 PMCID: PMC9877706 DOI: 10.1111/jnu.12859] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE We reflect on our experience of running a remote volunteer counseling service, known as the Counseling Collective, to support patients and their families during the second wave of the COVID-19 pandemic in Cape Town, South Africa, and the learning and implications for practice and policy regarding the effective utilization of volunteers during a crisis or disaster context. BACKGROUND The Beta SARS-Co-2 variant dominated the second COVID-19 wave which gained momentum in December 2020, as public sector health teams prepared to deescalate services over the South African summer season. The ferocity with which the wave hit the city soon made it clear that volunteers would be needed to assist with counseling services as the Beta variant caused serious disease, resulting in a significant upswing in hospitalisations and deaths. METHODS Four counselors and a colleague with oversight responsibilities of the volunteers reflected on the service we provided. This was done with the benefit of hindsight a year after the activities of the Counseling Collective were wrapped up. LESSONS LEARNED Virtual volunteers are a largely untapped resource in the South African health care system. Much is to be gained by using this underutilized resource to deliver patient-centred services, especially in times of crisis. CONCLUSION Networks of retired and self-employed health professionals, particularly nurses,-skilled volunteers-are a valuable resource and can be deployed for critical work using their versatile skillsets, in public health emergencies. Telephonic consultations are a useful modality for providing quality care and need to be built into the business of health services. Skills to conduct such consultations and for the provision of palliative care services need to be mainstreamed into the skillsets of health professionals. POLICY AND CLINICAL RELEVANCE Public health disaster plans should include a blueprint for the rapid recruitment and deployment of volunteer counselors to assist permanent staff in providing crucial patient-centred care.
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Affiliation(s)
- Pat M. Mayers
- University of Western CapeCape TownSouth Africa
- University of Cape TownCape TownSouth Africa
| | | | | | - Joy Raine
- Private PracticeCape TownSouth Africa
| | - Virginia Zweigenthal
- School of Public Health and Family MedicineUniversity of Cape TownCape TownSouth Africa
- Western Cape Department of HealthCape TownSouth Africa
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Pourasghari H, Rezapour A, Tahernezhad A, Mazaheri E, Nikoo RM, Jabbari A, Hadian M. Iran's Struggling Health System in the Policy of Managing the COVID-19 Pandemic. Int J Prev Med 2022; 13:131. [PMID: 36452466 PMCID: PMC9704485 DOI: 10.4103/ijpvm.ijpvm_291_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 01/25/2022] [Indexed: 06/17/2023] Open
Abstract
Background Infectious diseases are one of the most important problems that affect the whole world. The World Health Organization (WHO), an active health organization, has identified coronavirus disease 19 (COVID-19) as a public health emergency and advises governments not to waste time on effective measures and interventions to attack and suppress the virus. In Iran, so far, the total number of screening tests has exceeded 21 million tests and more than 5 million doses of vaccine have been injected. However, we are still far from controlling the epidemic wave. Given the current situation, it is necessary to identify the challenges of managing the new coronavirus epidemic (COVID-19) in the country's medical universities. Methods This qualitative study was conducted from January 2020 to January 2021 to explore the views of a group of service providers and staff managers of medical universities who were selected via purposeful sampling (n = 47). Data were collected through semi-structured interviews and analyzed using Graneheim and Lundman's conventional content analysis methods. The trial version of MAXQDA 16 software was used to manage the coding process. Results Upon analysis of data by service providers and staff managers of medical universities, five main themes including governance and leadership, service delivery, human resources, medicine and technology, and financing and 15 sub-themes including management and leadership, culture and society, process, infrastructure, manpower, training and skills, mental pressure, work pressure, nutrition, safety, employee motivation, medical equipment, medicine, payment, and funds were found. Conclusions Identification of the most important challenges of service providers and staff managers can play an important role in improving the management of the new coronavirus epidemic (COVID-19). It seems that in order to solve some of these challenges, coordination is needed outside the field of health, and considering the formation of the National Corona Headquarters at the national level, it is possible to use this infrastructure to provide the necessary policies and strategies.
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Affiliation(s)
- Hamid Pourasghari
- Hospital Management Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Aziz Rezapour
- Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Tahernezhad
- Health Management Research Center, Bagiyatallah University of Medical Sciences, Tehran, Iran
| | - Elaheh Mazaheri
- Health Information Technology Research Center, Student Research Committee, Department of Medical Library and Information Sciences, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rouhollah Moghadas Nikoo
- Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Jabbari
- Health Services Management, Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marziye Hadian
- Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
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22
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Aydogdu ALF. Ethical dilemmas experienced by nurses while caring for patients during the COVID-19 pandemic: An integrative review of qualitative studies. J Nurs Manag 2022; 30:2245-2258. [PMID: 35266597 PMCID: PMC9115168 DOI: 10.1111/jonm.13585] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/11/2022] [Accepted: 03/02/2022] [Indexed: 11/28/2022]
Abstract
AIM This study aimed to identify ethical dilemmas faced by nurses while caring for patients during the COVID-19 pandemic. BACKGROUND Nurses express several concerns during disease outbreaks, some of which are related to ethical dilemmas. EVALUATION It is an integrative review in which four databases were searched. Critical appraisal tools and PRISMA guidelines were used. Content analysis was performed to analyse the obtained data. KEY ISSUES A total of 14 studies were identified. The results are presented into four categories: concerns with beneficence-nonmaleficence; awareness of need for autonomy; challenges to justice; and coping with ethical dilemmas. CONCLUSION While caring for patients during the COVID-19 pandemic, nurses often put their own health and that of their families at risk. The ethical dilemmas faced by nurses are mainly caused by the lack of Protective Personal Equipment (PPE), shortages of medical supplies and personnel and the uncertainties that permeate an environment threatened by a new and highly contagious disease such as COVID-19. IMPLICATIONS FOR NURSING MANAGEMENT This review provides information that can inspire nurse managers working during the COVID-19 pandemic to support and empower nurses to act in accordance with ethical principles, which is important in order for nurses to protect themselves while providing efficient and effective care.
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Jabbari A, Salahi S, Hadian M, Khakdel Z, Hosseini E, Sheikhbardsiri H. Exploring the challenges of Iranian government hospitals related to Covid-19 pandemic management: a qualitative content analysis research from the nurses perspective. BMC Nurs 2022; 21:226. [PMID: 35962433 PMCID: PMC9372986 DOI: 10.1186/s12912-022-01008-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 08/05/2022] [Indexed: 11/16/2022] Open
Abstract
Background The COVID-19 pandemic poses a major threat to global public health. As a result, to prepare healthcare systems for this unprecedented threat, a coordinated worldwide response is required. This study aimed to explore the hospitals challenges related to covid-19 pandemic management from the iranian nurses perspective. Methods This study was conducted as a qualitative content analysis in Iran. Using the purposive sampling method, data were collected through in-depth individual interviews with 35 nurse personnel. Graneheim and Lundman’s conventional content analysis methods were used to analyze the data and for the trustworthiness of the data, this study used Lincoln and Guba’s recommendations. Results After multiple rounds of analyzing and summarizing the data and taking into consideration similarities and differences, 5 main categories and 14 subcategories created based on the results of data analysis and including1) Leadership and management 2) Service delivery management 3) Human resources management 4) Equipment and Supplies Management and 5) Economic resources management. Conclusion Identifying the most important challenges of nursing can play an important role in improving the management of COVID-19pandemic. The analysis of the challenges by managers at local, provincial and national levels can lead to the presentation of effective solutions to address these challenges and improve the pandemic management process in the country.
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Affiliation(s)
- Alireza Jabbari
- Health Services Management, Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sahar Salahi
- Department of Nursing, Yasuj branch, Yasuj Islamic Azad University, Yasuj, Iran
| | - Marziye Hadian
- Health Services Management, Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Khakdel
- Health Services Management, Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elaheh Hosseini
- Health Services Management, Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hojjat Sheikhbardsiri
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
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Carvalho-Alves MO, Petrilli-Mazon VA, Brunoni AR, Malbergier A, Fukuti P, Polanczyk GV, Miguel EC, Corchs F, Wang YP. Dimensions of emotional distress among Brazilian workers in a COVID-19 reference hospital: A factor analytical study. World J Psychiatry 2022; 12:843-859. [PMID: 35978972 PMCID: PMC9258270 DOI: 10.5498/wjp.v12.i6.843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 04/22/2022] [Accepted: 05/13/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic is an unprecedented challenge for public health and has caused the loss of millions of lives worldwide. Hospital workers play a key role in averting the collapse of the health system, but the mental health of many has deteriorated during the pandemic. Few studies have been devoted to identifying the needs of workers on frontline duty. AIM To investigate dimensions of common emotional symptoms and associated predictors among Brazilian workers in a COVID-19 reference hospital. METHODS This is an observational study of the mental health of professionals in a COVID-19 hospital in the city of São Paulo. We invited all hospital employees to respond to an online survey between July and August 2020, during the first peak of the pandemic. Data of 1000 participants who completed the survey were analyzed (83.9% were women and 34.3% were aged 30 to 40). Hospital workers self-reported the presence of symptoms of depression, anxiety, trauma-related stress, and burnout through the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7, the Impact of Event Scale-Revised and the Mini-Z Burnout Assessment respectively. Responses were assembled and subjected to exploratory factor analysis to reveal workers' core emotional distress. Multiple linear regression models were subsequently carried out to estimate the likelihood of dimensions of distress using questions on personal motivation, threatening events, and institutional support. RESULTS Around one in three participants in our sample scored above the threshold of depression, anxiety, post-traumatic stress disorder, and burnout. The factor analysis revealed a three-factor structure that explained 58% of the total data variance. Core distressing emotional domains were avoidance and re-experience, depression-anxiety, and sleep changes. Regression analysis revealed that institutional support was a significant protective factor for each of these dimensions (β range = -0.41 to -0.20, P < 0.001). However, participants' personal motivation to work in healthcare service was not associated with these emotional domains. Moreover, the likelihood of presenting the avoidance and re-experience dimension was associated with having a family member or close friend be hospitalized or die due to COVID-19 and having faced an ethical conflict. CONCLUSION Distressing emotional domains among hospital workers were avoidance and re-experience, depression and anxiety, and sleep changes. Improving working conditions through institutional support could protect hospital workers' mental health during devastating public health crises.
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Affiliation(s)
- Marcos O Carvalho-Alves
- Department of Psychiatry, School of Medicine, University of Sao Paulo, Sao Paulo 05403-010, Brazil
- Program in Neuroscience and Behavior, Department of Experimental Psychology, Institute of Psychology, University of Sao Paulo, Sao Paulo 01060-970, Brazil
| | - Vitor A Petrilli-Mazon
- Department of Psychiatry, School of Medicine, University of Sao Paulo, Sao Paulo 05403-010, Brazil
| | - Andre R Brunoni
- Department of Psychiatry, School of Medicine, University of Sao Paulo, Sao Paulo 05403-010, Brazil
| | - Andre Malbergier
- Department of Psychiatry, School of Medicine, University of Sao Paulo, Sao Paulo 05403-010, Brazil
| | - Pedro Fukuti
- Department of Psychiatry, School of Medicine, University of Sao Paulo, Sao Paulo 05403-010, Brazil
| | - Guilherme V Polanczyk
- Department of Psychiatry, School of Medicine, University of Sao Paulo, Sao Paulo 05403-010, Brazil
| | - Euripedes C Miguel
- Department and Institute of Psychiatry, University of Sao Paulo, Sao Paulo 05403-010, Brazil
| | - Felipe Corchs
- Program in Neuroscience and Behavior, Department of Experimental Psychology, Institute of Psychology, University of Sao Paulo, Sao Paulo 01060-970, Brazil
- Department of Psychiatry, University of Sao Paulo, Sao Paulo 05403-010, Brazil
| | - Yuan-Pang Wang
- Department of Psychiatry, School of Medicine, University of Sao Paulo, Sao Paulo 05403-010, Brazil
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Ley CA, Cintron CM, McCamant KL, Karpman MB, Meisenberg BR. COVID-19-related anxieties: Impact on duty to care among nurses. Nurs Ethics 2022; 29:787-801. [PMID: 35235472 PMCID: PMC8891904 DOI: 10.1177/09697330211057192] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Duty to care is integral to nursing practice. Personal obligations that
normally conflict with professional obligations are likely amplified during
a public health emergency such as COVID-19. Organizations can facilitate a
nurse’s ability to fulfill the duty to care without compromising on personal
obligations. Research Aim The study aimed to explore the relationships among duty to care, perception
of supportive environment, perceived stress, and COVID-19-specific anxieties
in nurses working directly with COVID-19 patients. Research Design The study design was a cross-sectional descriptive study using an online
survey. It was conducted at an ANCC Magnet® designated 385-bed acute care
teaching hospital located in a suburban area. Participants and Research Context Included in this study were 339 medical surgical nurses working directly with
COVID-19 patients during the early phase of the pandemic. Ethical Considerations The study was reviewed by the institution’s clinical research committee and
determined to be exempt. A survey invitation letter with a voluntary implied
consent agreement was sent to participants with a description of the
research study attached to the anonymous survey. Results Nurses with specific COVID-19-related anxieties were more likely to agree
that it was ethical to abandon the workplace during a pandemic. Conclusions Organizations can and ought to mitigate the negative effects of COVID-19 on
duty to care in future pandemics and healthcare emergencies by incorporating
several recommendations derived from this study.
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Affiliation(s)
- Cathaleen A Ley
- Nursing Quality and Research, 20615Anne Arundel Medical Center Inc, Annapolis, MD, USA
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Osman M, Aljemaiah A, Alyami A, Alotaibi F. The prevalence of coronaphobia among nursing staff in Saudi Arabia. J Family Med Prim Care 2022; 11:1288-1291. [PMID: 35516687 PMCID: PMC9067171 DOI: 10.4103/jfmpc.jfmpc_1412_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/01/2021] [Accepted: 10/13/2021] [Indexed: 11/04/2022] Open
Abstract
Background: Design and Methods: Results: Conclusion:
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Kandemir D, Yılmaz A, Sönmez B. Professional and psychological perceptions of emergency nurses during the COVID-19 pandemic: A qualitative study. Jpn J Nurs Sci 2021; 19:e12470. [PMID: 34970852 DOI: 10.1111/jjns.12470] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 11/06/2021] [Accepted: 11/30/2021] [Indexed: 12/23/2022]
Abstract
AIM To explore the changing roles and responsibilities, difficulties, feelings, and coping strategies of emergency nurses during the COVID-19 pandemic. METHODS This study was conducted as a qualitative study using a phenomenological approach. A total of 12 emergency nurses were recruited using purposive sampling from a COVID-19-designated hospital in Konya, Turkey for qualitative study. Data were collected through semi-structured individual interviews in January 2021. The data were analyzed using the content analysis method with the MAXQDA 2020 software program. The study conforms to the consolidated criteria for reporting qualitative research checklist. RESULTS Four theme categories emerged from the data analysis: (a) "Increasing roles and responsibilities as an emergency nurse"; (b) "Difficulties of working in pandemic conditions"; (c) "Emotional responses in the pandemic"; and (d) "Strategies for coping with the effects of the pandemic". In this study, it was determined that emergency nurses had increased roles and responsibilities due to physicians being in the background, fulfilled their roles and responsibilities in a chaotic working environment, experienced many positive and negative feelings together or gradually, and applied individual coping strategies. CONCLUSIONS This study indicated that emergency nurses fulfilled their increasing roles and responsibilities on the frontlines in a chaotic working environment during the pandemic. Despite many negative feelings, it was determined that they tried to show psychological adjustment and resilience with a strong professional commitment and social support.
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Affiliation(s)
| | - Ayşegül Yılmaz
- Konya Beyhekim Training and Research Hospital, Konya, Turkey
| | - Betül Sönmez
- Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpasa, Istanbul, Turkey
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Chen Q, Su X, Liu S, Miao K, Fang H. The relationship between moral sensitivity and professional values and ethical decision-making in nursing students. NURSE EDUCATION TODAY 2021; 105:105056. [PMID: 34265538 DOI: 10.1016/j.nedt.2021.105056] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 06/17/2021] [Accepted: 07/05/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND More researchers have paid attention to the ethical decision-making in nursing worldwidely due to the increasing complexity of ethical issues and dilemmas. Ethical decision-making ability is regarded as one of the core competences of nursing practice and has the potential to resolve ethical issues. It is important to identify the key variables related to ethical decision-making and understand their relationship between them respectively. It is also helpful to design interventions to promote nursing students' ability to resolve ethical dilemmas. OBJECTIVE This study aims to examine the relationship between moral sensitivity, professional values and ethical decision-making respectively, and to explore whether professional values have mediating effect on the relationship between moral sensitivity and ethical decision-making among nursing undergraduates in Chinese nursing education context. DESIGN This study is a cross-sectional descriptive correlational design. METHODS 263 nursing undergraduates from Nursing and Health School, Zhengzhou University in Henan province of China participated in the study and received the investigation. Their ethical decision-making, moral sensitivity and professional values were measured through the following three questionnaires, including the Judgement About Nursing Decision (JAND), Chinese Moral Sensitivity Questionnaire-Revised Version (MSQ-R-CV) and Chinese Nurses' Professional Values Scale-Revised Version (NPVS-R-CV). The data were processed and analysed by SPSS 23.0 and AMOS 24.0. The statistical methods included descriptive statistics, independent-samples t-tests, one-way analysis of variance, Pearson's correlation analyses and structural equation modeling. RESULTS Moral sensitivity is positively correlated with ethical decision-making (P < 0.01). Professional values is positively correlated with ethical decision-making (P < 0.01) and also has a mediating effect on the relationship between moral sensitivity and ethical decision-making (P < 0.01). CONCLUSION The investigation contributes to a broader understanding of the factors that influence nursing students' ethical decision-making. Developing ethics education around nursing students' professional values and moral sensitivity can improve their ethical decision-making ability.
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Affiliation(s)
- Qin Chen
- School of Nursing and Health, Zhengzhou University, China.
| | - Xiangdan Su
- No.3 Affiliated Hospital of Zhengzhou University, China
| | - Siyu Liu
- School of Nursing and Health, Zhengzhou University, China
| | - Kangkang Miao
- School of Nursing and Health, Zhengzhou University, China
| | - Huili Fang
- School of Nursing and Health, Zhengzhou University, China
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