University of Northern Colorado, Greeley, and St Anthony Hospital, Centura Health, Lakewood, Colorado.
ANS Adv Nurs Sci. 2023;46(1):2-13. doi: 10.1097/ANS.0000000000000458. Epub 2022 Sep 23.
Hospital-based nurses face many occupational risks. In the early days of the coronavirus disease-2019 (COVID-19) pandemic, questions were raised regarding nurses' responsibilities to provide care in the context of risk of exposure to this infectious disease. In the United States, these questions were answered relatively swiftly using a deontological framework. If nurses did not have access to appropriate personal protective equipment, they were not duty bound to provide nursing care to patients with a known infection. Another occupational risk hospital-based nurses face is exposure to patient violence. Questions about nurses' responsibilities to provide care in the context of this occupational risk have not been addressed. The purpose of this article is to examine these 2 occupational risks and ethical decision-making frameworks that can be used to answer questions about the provision of nursing care in the face of personal risk. While useful in the context of COVID-19, a duty-based framework seems insufficient to capture the contextual nuances and moral complexity of providing nursing care to hospitalized patients who exhibit violent behavior. Professional duties are explored as are other ethical frameworks. Ethics of the everyday, virtue ethics, and care ethics are introduced as additional perspectives that can help inform nurses' decision-making and actions when they are exposed to occupational risks such as patient violence and COVID-19.
基于医院的护士面临许多职业风险。在 2019 年冠状病毒病(COVID-19)大流行的早期,就提出了护士在面临接触这种传染病的风险时提供护理的责任问题。在美国,这些问题相对迅速地使用义务论框架来回答。如果护士无法获得适当的个人防护设备,他们没有义务为已知感染的患者提供护理。基于医院的护士面临的另一个职业风险是接触到患者暴力。关于护士在这种职业风险背景下提供护理的责任问题尚未得到解决。本文的目的是研究这 2 种职业风险和伦理决策框架,这些框架可用于回答在个人风险面前提供护理的问题。虽然在 COVID-19 背景下有用,但义务论框架似乎不足以捕捉到为表现出暴力行为的住院患者提供护理的背景细微差别和道德复杂性。探讨了专业职责以及其他伦理框架。介绍了日常伦理、美德伦理和关怀伦理作为其他视角,可以帮助在面临患者暴力和 COVID-19 等职业风险时为护士的决策和行动提供信息。