Nurses and COVID-19: Ethical Considerations in Pandemic Care

✍ Scribed by Connie M. Ulrich (editor), Christine Grady (editor)

• Publisher: Springer
• Year: 2022
• Tongue: English
• Leaves: 153
• Category: Library

✦ Synopsis

This book addresses the many ethical issues and extraordinary risks that nurses and others are facing during the COVID-19 pandemic, which creates physical, emotional, and economic burdens, affecting nurses' overall health and well-being. Nurses are essential front-line clinicians across all health care settings and in every nation. The COVID-19 pandemic caused by the novel SARs-CoV-2 virus has affected children, adults, and communities within and across all societies. Nurses, too, have contracted the virus and died from the disease. They have also seen their colleagues, family members, and friends hospitalized or in intensive care units struggling to survive. Nursing’s professionalism and disciplinary resolve to care for patients and families amidst confusion, misinformation, and shifting guidelines has been called “heroic” by the public.
How much risk should nurses be expected to accept during a pandemic? How do nurses help patients and families find comfort and dignity at the end-of-life? How do we help nurses who are suffering from moral distress and mental health concerns from what they have seen, been asked to do, or are unable to provide? And, how does society move forward from a pandemic that has challenged our basic ethical principles of justice and what is “fair, good and right” in caring for those who need care, including the most vulnerable and nurses themselves? This book addresses these and other ethical concerns that nurses are facing in their day-to-day clinical practice; experiences shared with patients, families, and colleagues. Although this book was written while the pandemic was still raging across the United States and globally, the events needed to be told as they were unfolding.
This book helps us to learn from both the successes and failures that are affecting so many across the globe, including those on whom the public relies on to provide quality, compassionate, and expert care when they are sick: nurses.

✦ Table of Contents

Preface
Acknowledgments
Contents
Introduction
References
What Are Acceptable Risks during a Pandemic?
1 How Have Acceptable Risks Been Defined in Other Contexts?
2 Defining Risks—And Acceptable Risks—In the Provision of Healthcare
3 How Do Nurses View and Accept Risk?
4 Moral Harms to Nurses
5 Factors of Safety: How Should we Think about and Plan for the Next Pandemic and its Risks?
6 Conclusion
References
Dying in Isolation
1 Palliative Care in the Context of COVID-19
2 Telepalliative Care
3 End-of-Life Care in the Context of the Pandemic
4 Grief and Bereavement
4.1 Impact on Clinicians
5 Future Implications
References
Preparing to Make Difficult Choices: Nursing Triage Decisions and Crisis Standards of Care during COVID-19
1 Introduction
2 Managing a Crisis and the Duty to Care
2.1 Drafting Crisis Standards
2.2 Triage Teams and Officers
2.3 A Modified Resuscitation Standard
3 The Environment of Material Scarcity
3.1 Personal Protective Equipment
4 Nurse Redeployment and Role Changes
5 The Spring Surge (March 2020 to June 2020)
5.1 Elective Procedure Cancellation and Impact on Preoperative Nurses
5.2 Role of Certified Nursing Assistants
5.3 Creative Use of Available Space
5.4 The Fall Surge (September 2020–December 2020): Changes and Challenges
6 Practice Changes for Advanced Practice Providers
7 Patient Family Caregiver Presence and Visitation Guidelines
8 Leadership and Communication
9 Conclusion
References
The Emotional and Moral Remnants of COVID-19: Burnout, Moral Distress, and Mental Health Concerns
1 Moral Distress
References
Unanticipated Consequences: Lack of Essential and Nonessential Patient Care, Furloughs of Health Care Providers, and Institutional Financial Losses
1 Introduction
2 Unanticipated Consequences for Essential and Nonessential Services
2.1 Reductions in Hospital Utilization: Emergency Room Visits and Admissions
2.2 Ambulatory Care
2.3 Delayed and Forgone Care
3 Institutional Losses
4 Furloughs and Layoffs of Health Care Providers
5 Financing of the Health Care Delivery System
6 Conclusion
References
Lingering and Glaring Health Disparities Amidst COVID-19
1 Introduction
1.1 Brief Historical Overview of Racism in Healthcare
1.2 COVID-19 Disparities in Marginalized Groups
2 Black Americans
3 Indigenous Americans
4 Latinx Americans
5 Pacific Islander Americans
5.1 Racism in Nursing
6 Structural Racism
6.1 Structural Racism and COVID-19
6.2 Antiracism in Nursing
7 Conclusion
References
Ethical Challenges for School Nurses during COVID-19
1 Historical Context of School Nursing
2 Modern-Day Context of School Nursing
3 Political Context of School Nursing
3.1 Federal Laws
Education
Civil Rights
Health
3.2 State Laws
3.3 School Nursing Scope of Practice Laws
4 Ethical Principles and COVID-19
5 Ethical Decision-Making: Challenges and Barriers
5.1 School Nurse as Leader
5.2 School Nurse as Community/Public Health Advocate
5.3 School Nurse as Care Coordinator in an Educational Setting
5.4 School Nurses Involved with Quality Improvement
6 Moral Distress
6.1 Reflections on Pandemic Readiness
6.2 Lessons in Management and Adaptation
6.3 Lessons in Establishing Priorities
6.4 Thinking Ahead
7 Conclusion
References
Global Health Ethics: Nursing Voices from China and Brazil
1 Introduction
2 The Chinese Public’s Perceptions of Ethical Issues Faced by Frontline Healthcare Workers as Recorded on the Social Media Platform Weibo
2.1 Introduction
2.2 Study Objective
2.3 Theoretical Framework
2.4 Methods
Sampling
Content Analysis
Coding Scheme
Intercoder Reliability
Ethical Consideration
2.5 Results
2.6 Discussion
2.7 Limitations
2.8 Conclusions
3 Living through the Pandemic: Reflections from Brazilian Nurses in the Context of COVID-19
3.1 General Contextualization of the Pandemic in Brazil
3.2 Socioeconomic Aspects of Brazil and COVID-19
3.3 Multiple Pandemics in Brazil
3.4 Nursing in Brazil during the Pandemic
3.5 Anger, Outrage, and Moral Distress among Brazilian Nurses
3.6 Death and Grief during the Pandemic
3.7 Fighting for Life
Conclusions
References
Moving Forward: Words of Wisdom from Nurse Leaders
1 We Are no Longer Invisible: Nurses Respond to the COVID-19 Syndemic
2 Context, Community, Challenge
2.1 Context
2.2 Community
3 While We Can Not
4 Conclusion
References