Abstract
Background:The global COVID-19 pandemic has imposed challenges on healthcare systems and professionals worldwide and introduced a ´maelstrom´ of ethical dilemmas. How ethically demanding situations are handled affects employees’ moral stress and job satisfaction.Aim:Describe priority-setting dilemmas, moral distress and support experienced by nurses and physicians across medical specialties in the early phase of the COVID-19 pandemic in Western Norway.Research design:A cross-sectional hospital-based survey was conducted from 23 April to 11 May 2020.Ethical considerations:Ethical approval granted by the Regional Research Ethics Committee in Western Norway (131421).Findings:Among the 1606 respondents, 67% had experienced priority-setting dilemmas the previous two weeks. Healthcare workers who were directly involved in COVID-19 care, were redeployed or worked in psychiatry/addiction medicine experienced it more often. Although 59% of the respondents had seen adverse consequences due to resource scarcity, severe consequences were rare. Moral distress levels were generally low (2.9 on a 0–10 scale), but higher in selected groups (redeployed, managers and working in psychiatry/addiction medicine). Backing from existing collegial and managerial structures and routines, such as discussions with colleagues and receiving updates and information from managers that listened and acted upon feedback, were found more helpful than external support mechanisms. Priority-setting guidelines were also helpful.Discussion:By including all medical specialties, nurses and physicians, and various institutions, the study provides information on how the COVID-19 mitigation also influenced those not directly involved in the COVID-19 treatment of patients. In the next stages of the pandemic response, support for healthcare professionals directly involved in outbreak-affected patients, those redeployed or those most impacted by mitigation strategies must be a priority.Conclusion:Empirical research of healthcare workers experiences under a pandemic are important to identify groups at risks and useful support mechanisms.
Highlights
During outbreaks of new diseases such as COVID-19, ethically demanding situations arise.[1,2,3] Prioritysetting dilemmas emerge due to shortage of both medical and human resources.[4,5] Diagnostics, treatment and care that is normally provided and considered useful might be delayed or restricted to redistribute scarce resources in response to the pandemic.[6,7] Employees with one set of skills may be redeployed and expected to perform tasks that require skills in which they are less experienced
The aim of this study is to describe priority-setting dilemmas, moral distress and support experienced by nurses and physicians in the early phase of the COVID-19 pandemic in the Western part of Norway
37% of the respondents had been directly involved in treatment or care for COVID-19-patients, and 21% reported that they had been redeployed as part of the COVID-19 response
Summary
During outbreaks of new diseases such as COVID-19, ethically demanding situations arise.[1,2,3] Prioritysetting dilemmas emerge due to shortage of both medical and human resources.[4,5] Diagnostics, treatment and care that is normally provided and considered useful might be delayed or restricted to redistribute scarce resources in response to the pandemic.[6,7] Employees with one set of skills may be redeployed and expected to perform tasks that require skills in which they are less experienced. Aim: Describe priority-setting dilemmas, moral distress and support experienced by nurses and physicians across medical specialties in the early phase of the COVID-19 pandemic in Western Norway. Healthcare workers who were directly involved in COVID-19 care, were redeployed or worked in psychiatry/addiction medicine experienced it more often. Backing from existing collegial and managerial structures and routines, such as discussions with colleagues and receiving updates and information from managers that listened and Keywords Clinical ethics, ethics and leadership/management, moral distress, moral/ethical climate of organisations, organisational ethics, professional ethics
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
