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疫情时代的护理伦理。

Nursing ethics in an era of pandemic.

机构信息

Department of Humanities, Penn State College of Medicine, Hershey, PA, United States of America; Nursing Research and Innovation, Penn State Health Milton S. Hershey Medical Center, United States of America.

Office of Nursing Research and Innovation, Penn State Health Milton S. Hershey Medical Center, Hershey, PA 17033, United States of America.

出版信息

Appl Nurs Res. 2021 Dec;62:151508. doi: 10.1016/j.apnr.2021.151508. Epub 2021 Oct 8.

DOI:10.1016/j.apnr.2021.151508
Abstract

BACKGROUND

The ANA Code of Ethics for Nurses, regularly revised since 1896, may not provide guidance in an era of pandemic and sociopolitical unrest.

PURPOSE

This study explored whether the Code of Ethics comprehensively address current nursing challenges.

METHODS

23 nurses participated in six Zoom focus groups to discuss whether provisions were applicable to their current practice. An iterative approach was used to review transcripts independently and then merge findings to identify ethical themes.

FINDINGS

Provisions 4, 6, and 8 were most relevant. None of the provisions addressed the guilt secondary to isolating patients from support systems and not being "on the front lines" of COVID care.

DISCUSSION

The co-occurring crises of COVID-19 and social unrest created an ethical crisis for many nurses. The Code of Ethics provided a useful guide for framing discussion and formulating strategies for change, but did not eliminate distress during a time of novel challenges.

摘要

背景

自 1896 年以来,美国护士协会的《护士伦理准则》定期修订,但在当前大流行和社会政治动荡的时代,它可能无法提供指导。

目的

本研究探讨了《道德准则》是否全面应对当前的护理挑战。

方法

23 名护士参加了六次 Zoom 焦点小组讨论,讨论准则中的规定是否适用于他们目前的实践。采用迭代方法独立审查转录本,然后合并研究结果以确定伦理主题。

结果

第 4、6 和 8 款规定最为相关。没有任何规定涉及因将患者与支持系统隔离开来而产生的内疚感,以及不在 COVID 护理的“前线”。

讨论

新冠疫情和社会动荡的同时发生给许多护士带来了伦理危机。《道德准则》为讨论提供了一个有用的框架,并为制定变革策略提供了指导,但在面临新挑战时,它并不能消除困境。

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本文引用的文献

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Staff Emotional Support at Montefiore Medical Center During the COVID-19 Pandemic.在 COVID-19 大流行期间,Montefiore 医疗中心的员工情感支持。
Jt Comm J Qual Patient Saf. 2021 Mar;47(3):185-189. doi: 10.1016/j.jcjq.2020.11.009. Epub 2020 Nov 18.
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Ethical dilemmas, perceived risk, and motivation among nurses during the COVID-19 pandemic.
Nurs Clin North Am. 2023 Mar;58(1):25-34. doi: 10.1016/j.cnur.2022.10.002. Epub 2022 Dec 26.
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Nurse-sensitive indicators during COVID-19.新冠疫情期间护士敏感指标。
Int J Nurs Knowl. 2022 Jul;33(3):234-244. doi: 10.1111/2047-3095.12372. Epub 2022 May 17.
护士在 COVID-19 大流行期间的伦理困境、感知风险和动机。
Nurs Ethics. 2021 Feb;28(1):9-22. doi: 10.1177/0969733020956376. Epub 2020 Oct 1.
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Implications for COVID-19: A systematic review of nurses' experiences of working in acute care hospital settings during a respiratory pandemic.对 COVID-19 的影响:呼吸系统传染病大流行期间,对护士在急性护理医院环境中工作的体验的系统回顾。
Int J Nurs Stud. 2020 Nov;111:103637. doi: 10.1016/j.ijnurstu.2020.103637. Epub 2020 May 8.
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Challenging times: ethics, nursing and the COVID-19 pandemic.挑战时刻:伦理学、护理与 COVID-19 大流行。
Int Nurs Rev. 2020 Jun;67(2):164-167. doi: 10.1111/inr.12598.
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Preventing a Parallel Pandemic - A National Strategy to Protect Clinicians' Well-Being.预防并行大流行——保护临床医生福祉的国家战略。
N Engl J Med. 2020 Aug 6;383(6):513-515. doi: 10.1056/NEJMp2011027. Epub 2020 May 13.
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J Christ Nurs. 2017 Oct/Dec;34(4):216-224. doi: 10.1097/CNJ.0000000000000419.