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

Abstract

Background: Older, frail patients with multimorbidity are at an especially high risk for disease severity anddeath from COVID-19. The social restrictions proved challenging for the residents, their relatives, and thecare staff. While these restrictions clearly impacted daily life in Norwegian nursing homes, knowledge abouthow the pandemic influenced nursing practice is sparse. Aim: The aim of the study was to illuminate ethicaldifficult 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 andrural areas. Ethical considerations: Oral and written information about the study was provided before the participantsgave 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) usingmedication to maintain peace and order; (c) being left alone with the responsibility; and (d) s. impact ondecision-making. Conclusions: The nurses’ethical challenges were intertwined with external factors, such as national andlocal guidelines, and the nurses’own internalized factors, which were connected to their subjective pro-fessionality. This duality inflicted emotional distress and gave nurses few opportunities to perform nursing in aprofessionally sound and safe manner. Keywords: COVID-19, nursing home, nursing, ethical challenges. © The Author(s) 2022, Article Reuse Guidelines: https://doi.org/10.1177/09697330221105631

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