Alshawish Eman, Benbenishty Julie
Assistant Professor, Faculty of Medicine and Health Sciences, An-Najah National University Palestine, Nabulus, Palestine.
Assistant Professor, Nursing Administration, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
J Res Nurs. 2023 Mar;28(2):92-101. doi: 10.1177/17449871231159612. Epub 2023 Apr 27.
During pandemics, there are considerable ethical dilemmas. It is imperative that nurses are involved in ethical decision-making bringing nursing theory, practice and perspectives to better advocate for patients. In order to prepare nurses to be partners in ethical dilemma decision-making during pandemics, it is vital to understand the extent that nurses are involved in such decision-making during the COVID-19 pandemic.
The purpose of this concept analysis is to identify nurse involvement in ethical decision-making during pandemics.
Concept analysis methodology based on literature searches used bibliographic databases: PubMed - 20 papers; Google Scholar - 8120 papers; EMBASE - 25 papers; Science Direct - 246 papers and hand searches.
Nurse involvement in ethical decision-making during pandemics focused on nurses' physical and emotional stress, communication challenges, saturation and collapse of limited resources and allocation of scarce resources. Additional dilemmas included, changing nature of nurses' relationships with patients and families, questionable ethical equipoise preforming COVID-19 research, triage patient decisions receiving scarce resources, partner participation during labour and delivery and end-of-life decisions.
In order to protect and sustain nurses' well-being and competency, nurses should establish a framework for nurses' involvement in ethical policy development in emergencies, pandemics, education and preparedness and decision-making to be able to deal with public health emergencies.
在大流行期间,存在相当多的伦理困境。护士参与伦理决策并将护理理论、实践和观点融入其中,对于更好地为患者代言至关重要。为使护士在大流行期间成为伦理困境决策的合作伙伴,了解护士在新冠疫情期间参与此类决策的程度至关重要。
本概念分析的目的是确定护士在大流行期间参与伦理决策的情况。
基于文献检索的概念分析方法使用了书目数据库:PubMed——20篇论文;谷歌学术——8120篇论文;EMBASE——25篇论文;Science Direct——246篇论文,并进行了手工检索。
护士在大流行期间参与伦理决策的情况集中在护士的身体和情感压力、沟通挑战、有限资源的饱和与崩溃以及稀缺资源的分配上。其他困境包括护士与患者及家属关系性质的变化、开展新冠研究时可疑的伦理平衡、接受稀缺资源的分诊患者决策、分娩期间伴侣的参与以及临终决策。
为了保护和维持护士的福祉与能力,护士应建立一个框架,以便护士参与紧急情况、大流行、教育、准备和决策方面的伦理政策制定,从而能够应对突发公共卫生事件。