Ethical Challenges of Nurses in COVID-19 Pandemic: Integrative Review.

Currently, nurses are in the middle of the battle against COVID-19. The pandemic situation has put these professionals against various ethical challenges. Therefore, this review aims to identify the main ethical challenges faced by nurses during COVID-19 pandemic. This integrative review was guided by the Preferred Reporting Items of Systematic Reviews and Meta-Analysis Protocols. All English version studies that reported ethical challenges of nurses during the COVID-19 pandemic, from November 9, 2019, to November 9, 2020, were eligible for the review. The electronic databases used were PubMed, Google Scholar, JURN, Cochrane Library E-Journals, MEDLINE, Academic Search Complete, CINAHL. Accordingly, 8 articles were included for further analysis and synthesis. The ethical challenges of nurses were categorized into three thematic areas: nurses' safety, role and moral distress, resource allocation, and client-nurse relationship. Thus, the lack of full protection of nurses across the health industry has raised ethical questions such as the extent of their duty, scarce resources, and the failure of personal protective equipment. In connection, a significant number of nurses were also facing moral distress because of prolonged pressure to maintain the resources needed to provide safe and high-quality nursing care. Furthermore, nurses were challenged to restrict many COVID-19 patients from having end-of-life communication with their families. Overall, nurses are still facing various ethical challenges across the globe. Therefore, it is important to mobilize resources and invest in nurses to bring long-lasting solutions.