Moral distress facing nurses during the COVID-19 pandemic 

Moral distress facing nurses during the COVID-19 pandemic

Moral distress refers to psychological distress, which happens due to experiencing morally challenging events or situations. Notably, the COVID-19 pandemic has resulted in numerous challenges in all sectors of the economy, including healthcare. Nurses attributing to the largest percentage of healthcare providers are amongst the individuals most affected by the COVID-19, mainly because the pandemic results in new challenges.

One moral distress facing nurses during the COVID-19 pandemic is the restriction of visitation for the patients by their relatives or friends. Notably, a patient’s well-being and healing environment is optimized when they have access to their support. Nonetheless, governments of various countries had to restrict the visitation policies to reduce the disease’s chances of spreading.

Thus, patients now rely more on nurses who are the primary caregivers in hospitals for emotional support. However, there are some situations where the patient seems to be going through so much intense suffering. In some instances, this raises questions on whether the restriction of the visitation in hospitals is justified. For example, nurses looking after a cancer patient who needs to go through chemotherapy have to encourage the patient about their condition, which continually makes patients nauseous and terrified. Thus, in such instances, some nurses feel that the restriction is not justified because still, a nurse cannot always be there to give the patient emotional support since there are other clients to attend to. Additionally, having friends and relatives, whom the patient has a personal relationship with, can be more uplifting for them to go through the challenging situation. Thus, this is moral-constraint distress since, despite nurses knowing that it is right and essential to allow friends and relatives to visit patients, they are constrained due to the COVID-19 pandemic.

Moreover, the restriction in visiting can adversely affect the decision-making process. There are decisions that a patient cannot make for himself or herself since they cannot speak or because they cannot do so, and need a surrogate to help out. Although surrogates can help virtually, the nurses may wonder if the former understands the complexity of the patient’s situation, especially if they cannot see the conditions of their loved ones, for instance, if they are in machine support. Moreover, failing to keep up on the patient’s daily progress could result in the surrogate not making a significant decision. Moreover, this also causes moral distress because the nurses could feel uncertain whether the decision is based on the patient’s best interest or the desperation of the surrogate to see the patient alive again.

Safety of Nurses

Amidst the battle of the COVID-19 pandemic, nurses’ safety alongside other frontline workers is an issue of great concern. Notably, nurses are expected to work under circumstances that pose considerable and inadequately understood risk to their health and general well-being (Morley, Grady, McCarthy, & Ulrich, 2020). Notably, while everyone else is being asked to maintain social distance ad self-quarantine for at least fourteen days after getting in contact with an infected individual, the nurses are always in contact with them almost daily. Although the nurses are always on PPE, there are several instances in different parts of the world where nurses and other healthcare workers have demonstrated because the respective governments are not giving them sufficient PPE. Consequently, several nurses have tested positive for COVID-19, and some even lost their lives, with most of them getting infected in the line of duty. This is an issue of moral distress to the nurses because although they have insufficient PPE, they must care for the ailing, and they still need to work under the tough conditions.

Similarly, the mental health of nurses is also adversely affected by the COVID-19 pandemic. Markedly, the disease’s high rates make nurses work overtime, which can increase burnout (Deying et al., 2020). Moreover, although nurses are used to seeing people suffer and even die due to various ailments, death rates have increased considerably due to COVID-19. This increases anxiety and general stress for the nurses. Markedly, despite nurses understanding the negative impact of COVID-19 on their mental health, the nurses understand that they need to be the patients, making the situation moral distress.

Triage and Allocation of Resources

Notably, COVID-19 has been declared a global pandemic, and nurses are expected to prioritize it to flatten the curve. Markedly, nurses are forced to make some clinical decisions based on the resources available, which could result in not adhering to the nursing profession’s set standards. Thus, there are instances when nurses are forced to make decisions between two equally undesirable moral options, which results in moral distress. For instance, there are places where there are insufficient ventilators, and when probably an eighty-year-old patient gets taken to the emergency unit of the hospital together with a thirty-year-old patient, the nurses had to choose a single person to benefit from the resource. This could bother the patient because despite willing to help both, they had the constraint of resources.

News Article on the Moral Distress of nurses

‘It Feels Like a War Zone’: Doctors and Nurses Plead for Masks on Social Media is an article written by Padilla (2020) and published in the New York Times, explaining some ethical and moral issues distress which nurses are facing during the COVID-19 pandemic. Notably, a nurse in Illinois claimed that she needed to use one mask for five days, despite having to attend to different patients. Similarly, several other nurses and health care providers have been forced to improvise strategies to use due to insufficient PPEs, including putting n dirty masks. Markedly, although nurses understand that this is wrong and poses a great risk not only to themselves but also to the patients they have to attend to, they are forced by the condition to do this, which results in moral and ethical distress. However, through the pandemic, the relevant authorities must provide all healthcare officials with face shields, gowns, and masks, since this makes keeps them safe, thus better service delivery.

Conclusion

Therefore, although during this COVID-19 pandemic, people commonly celebrate the nurses to be the heroes who are helping control the condition. These healthcare practitioners have to deal with several moral and ethical distress daily in their line of duty. For instance, visitors’ restriction to see the ailing patients is a policy they have to adhere to, despite the importance family and friends have on the well-being and recovery of the patents. Similarly, nurses are putting their lives at risk and, in some instances, even without sufficient PPEs, because they have to look after the sick. Furthermore, the limitation in resources, in some instances, is making the nurses have a moral dilemma on the patients they need to prioritize.