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      Ethical dilemmas experienced by nurses while caring for patients during the COVID‐19 pandemic: An integrative review of qualitative studies

      review-article
      , RN, PhD 1 ,
      Journal of Nursing Management
      John Wiley and Sons Inc.
      COVID‐19, ethical dilemmas, integrative review, nurse

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          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.

          Related collections

          Most cited references49

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          The integrative review: updated methodology.

          The aim of this paper is to distinguish the integrative review method from other review methods and to propose methodological strategies specific to the integrative review method to enhance the rigour of the process. Recent evidence-based practice initiatives have increased the need for and the production of all types of reviews of the literature (integrative reviews, systematic reviews, meta-analyses, and qualitative reviews). The integrative review method is the only approach that allows for the combination of diverse methodologies (for example, experimental and non-experimental research), and has the potential to play a greater role in evidence-based practice for nursing. With respect to the integrative review method, strategies to enhance data collection and extraction have been developed; however, methods of analysis, synthesis, and conclusion drawing remain poorly formulated. A modified framework for research reviews is presented to address issues specific to the integrative review method. Issues related to specifying the review purpose, searching the literature, evaluating data from primary sources, analysing data, and presenting the results are discussed. Data analysis methods of qualitative research are proposed as strategies that enhance the rigour of combining diverse methodologies as well as empirical and theoretical sources in an integrative review. An updated integrative review method has the potential to allow for diverse primary research methods to become a greater part of evidence-based practice initiatives.
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            Nurses' experiences of care for patients with Middle East respiratory syndrome-coronavirus in South Korea

            Highlights • Nurses' experiences of care for patients with Middle East respiratory syndrome-coronavirus (MERS-CoV) were categorized by going into a dangerous field, strong pressure because of MERS-CoV, the strength that make me endure, growth as a nurse, remaining task. • It is necessary to examine the difficulties and demands of the healthcare providers who care for infectious patients. • Strategies are needed to establish a safer healthcare system that can protect healthcare providers who care for MERS-CoV patients.
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              Is Open Access

              Ethical dilemmas due to the Covid-19 pandemic

              The devastating pandemic that has stricken the worldwide population induced an unprecedented influx of patients in ICUs, raising ethical concerns not only surrounding triage and withdrawal of life support decisions, but also regarding family visits and quality of end-of-life support. These ingredients are liable to shake up our ethical principles, sharpen our ethical dilemmas, and lead to situations of major caregiver sufferings. Proposals have been made to rationalize triage policies in conjunction with ethical justifications. However, whatever the angle of approach, imbalance between utilitarian and individual ethics leads to unsolvable discomforts that caregivers will need to overcome. With this in mind, we aimed to point out some critical ethical choices with which ICU caregivers have been confronted during the Covid-19 pandemic and to underline their limits. The formalized strategies integrating the relevant tools of ethical reflection were disseminated without deviating from usual practices, leaving to intensivists the ultimate choice of decision.
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                Author and article information

                Contributors
                Role: Assistant Professorluizafl@gmail.com
                Journal
                J Nurs Manag
                J Nurs Manag
                10.1111/(ISSN)1365-2834
                JONM
                Journal of Nursing Management
                John Wiley and Sons Inc. (Hoboken )
                0966-0429
                1365-2834
                16 March 2022
                16 March 2022
                : 10.1111/jonm.13585
                Affiliations
                [ 1 ] Faculty of Health Sciences, Department of Nursing Health and Technology University Istanbul Turkey
                Author notes
                [*] [* ] Correspondence

                Ana Luiza Ferreira Aydogdu, Faculty of Health Sciences, Department of Nursing, Health and Technology University, Seytinizam, Mevlana Cd. No: 85, Zeytinburnu, Istanbul 34015, Turkey.

                Email: luizafl@ 123456gmail.com

                Author information
                https://orcid.org/0000-0002-0411-0886
                Article
                JONM13585
                10.1111/jonm.13585
                9115168
                35266597
                852c3e0f-9362-4a50-8b4f-43a409bcb606
                © 2022 John Wiley & Sons Ltd

                This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

                History
                : 11 February 2022
                : 12 January 2022
                : 02 March 2022
                Page count
                Figures: 1, Tables: 3, Pages: 14, Words: 10063
                Categories
                Review Article
                Review Articles
                Custom metadata
                2.0
                corrected-proof
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.1.6 mode:remove_FC converted:18.05.2022

                covid‐19,ethical dilemmas,integrative review,nurse
                covid‐19, ethical dilemmas, integrative review, nurse

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