Peter Elizabeth, Mohammed Shan, Variath Caroline
University of Toronto, Toronto, ON, Canada.
Vancouver Island University, Nanaimo, BC, Canada.
Nurs Ethics. 2025 May;32(3):738-751. doi: 10.1177/09697330241272892. Epub 2024 Aug 9.
BackgroundNurses' demonstration of compassion is an ethical and often regulatory expectation. While research has been conducted to examine the barriers and facilitators of compassion in nurses, little is known about how nurses develop and express compassion for patients who may be blamed for their health condition. Unvaccinated COVID-19 patients are an example of such patients.Research questionsHow do nurses provide compassionate care for unvaccinated adults infected with COVID-19? How did the context of COVID-19 vaccination in Canada shape nurses' relationships with unvaccinated patients?Research designA generic qualitative approach using interviews to gather data was used. Martha Nussbaum's conceptualization of compassion and its cognitive requirements was employed to add depth to the analysis.Participants and research contextSeventeen Registered Nurses, from a range of practice settings, who had cared for unvaccinated patients with COVID-19 participated.Ethical considerationsEthics approval was received, and signed informed consent was obtained. Participants who were the current students of the researchers were excluded.FindingsThree themes were identified:1) Encountering Extreme Workplace Impediments to Compassion.2) Managing Emotions to Provide "Nonjudgmental Care."3) Practicing Narrative Imagination.DiscussionThe difficult working conditions during the pandemic impeded nurses' capacity to be compassionate. Yet, none judged their patients' suffering as trivial, and all provided necessary nursing care. Some initially blamed these patients for the severity of their illness and suppressed their emotions to provide what they called "nonjudgmental care." Upon reflection, participants recognized that these patients' life circumstances may have been barriers to vaccination which, in the end, facilitated the development of compassion.ConclusionThis research has implications that go beyond that of caring for patients with COVID-19. The ideal of "nonjudgmental care" requires critical re-examination because judgments and emotions are required for compassion.
背景
护士展现出同情心是一种道德要求，且常常是监管方面的期望。虽然已经开展了研究来探究护士同情心的障碍和促进因素，但对于护士如何培养并向可能因其健康状况而受到指责的患者表达同情心，我们却知之甚少。未接种新冠疫苗的新冠患者就是这类患者的一个例子。
研究问题
护士如何为感染新冠病毒的未接种疫苗的成年人提供富有同情心的护理？加拿大新冠疫苗接种的背景如何塑造护士与未接种疫苗患者的关系？
研究设计
采用了一种通用的定性研究方法，通过访谈收集数据。运用了玛莎·努斯鲍姆对同情心及其认知要求的概念化，以深化分析。
参与者和研究背景
17名来自不同实践环境、护理过感染新冠病毒的未接种疫苗患者的注册护士参与了研究。
伦理考量
获得了伦理批准，并取得了签署的知情同意书。排除了研究人员当前的学生参与者。
研究结果
遭遇同情心的极端工作场所障碍。
管理情绪以提供“无评判护理”。
运用叙事想象力。
讨论
疫情期间艰难的工作条件阻碍了护士表现出同情心的能力。然而，没有人将患者的痛苦视为微不足道，所有人都提供了必要的护理。一些人最初将这些患者病情的严重程度归咎于他们，并压抑自己的情绪以提供他们所谓的“无评判护理”。经过反思，参与者认识到这些患者的生活状况可能是接种疫苗的障碍，而这最终促进了同情心的发展。
结论
这项研究的影响超出了护理新冠患者的范畴。“无评判护理”的理想需要进行批判性的重新审视，因为同情心需要判断和情感。
