COVID‐19 as moral breakdown: Entangled ethical demands experienced by hospital‐based nurses in the early onset of the pandemic

Mejdahl, Caroline Trillingsgaard; Nielsen, Berit Kjærside; Mehlsen, Mimi; Hollesen, Maj Rafn; Pedersen, Mathilde Zilén; Engkjaer-Trautwein, Georgij; Funch, Louise Vase; Terkildsen, Morten Deleuran

doi:10.1111/nin.12508

Cited by 7 publications

(6 citation statements)

References 30 publications

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“…The current study has described some of the emotional burdens experienced by frontline nurses. These findings are similar to other studies reporting experiences of burden and moral distress among HCPs witnessing the suffering of patients and relatives who were separated [7,33,34]. Moral distress can occur if an individual is unable to act in accordance with their moral judgement because of external barriers [35].…”

Section: Discussionsupporting

confidence: 89%

Frontline nurses' experiences of managing visitor restrictions during the COVID‐19 pandemic in a Danish university hospital – Lessons learned

Ågård,

Rasmussen,

Mainz

et al. 2024

Scandinavian Caring Sciences

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BackgroundWorldwide visitor restrictions forced nurses to separate patients from their relatives. However, the experience of implementing shifting restrictions from the frontline nurses' perspectives in a Danish context has yet to be assessed.AimThe aim of this descriptive qualitative study was to explore frontline nurses' experiences of managing shifting visitor restrictions in a Danish somatic university hospital during the COVID‐19 pandemic.MethodsAn online questionnaire, including open‐ended questions, was developed. Data were analysed using descriptive statistics and content analysis.Findings116 nurses from 29 departments participated; they were informed about restrictions primarily by their charge nurses and hospital intranet. Shifting visitor restrictions compelled the nurses to constantly adjust and negotiate their practices. When deciding to suggest deviating from the restrictions, they shared their decision‐making with colleagues. Visitor restrictions left the hospital environment quieter, but they also created a lack of overview and predictability, an emotional burden, and a negative impact on the quality of care.ConclusionRestricting relatives' access challenged the nurses' professional values, and it seems to have affirmed their appreciation of relatives' role as important partners in contemporary hospital‐based health care.

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Section: Discussionsupporting

confidence: 89%

Frontline nurses' experiences of managing visitor restrictions during the COVID‐19 pandemic in a Danish university hospital – Lessons learned

Ågård,

Rasmussen,

Mainz

et al. 2024

Scandinavian Caring Sciences

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“…SNs in this study sometimes felt constrained, depending on the power dimensions between the state of politics versus public health. Other research on nurses' experiences during COVID‐19 has found similar societal, personal, and conflicting ethical demands for nurses (Mejdahl et al., 2022; Silverman et al., 2021). The themes generated through this study brought to light how pandemic case management caused situations of moral dilemmas causing moral distress in the context of the school environment and the public health role of SNs.…”

Section: Discussionmentioning

confidence: 78%

A qualitative study of school nurses’ moral distress related to COVID‐19

Baker

Jones

Weiss

et al. 2023

Public Health Nursing

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ObjectiveTo understand school nurses' perceptions and experiences of moral distress related to COVID‐19 case management in the school systems.DesignA descriptive qualitative study guided by Braun and Clarke's reflexive thematic analysis.SampleTwelve school nurses practicing in Colorado from December 2021 to January 2022.MeasurementsSemi‐structured interviews about school nurses’ experiences of COVID‐19. Investigators utilized an iterative reflexive thematic analysis process engaging the participants' and researchers' subjective experiences.ResultsFour themes were created: (1) keeping kids and the community safe, (2) caught in the middle of the “tug of war” between health and politics, (3) distress amid an ocean of COVID‐19 uncertainty, and (4) visibility as a bright spot shining through the COVID‐19 cloud.ConclusionsTwo research questions examined school nurses’ experiences of moral distress and their role and scope of practice that affected their relationships in the educational and public health systems. The results of this study confirm the important role of school nurses and interprofessional case management in school environments in the fight against infectious diseases and pandemics. Building stronger relationships between school nurses and public health is imperative for future collaborative and cohesive public health responses to pandemics.

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“…We then arranged our data in meaningful groups and started identifying themes. During this step, we found a strong resonance between the codes and a potential theoretical framework 28 , 29 based on the concept of institutional logics. 19 , 20 We, therefore, re-coded the material, sorted the codes into new potential themes, and combined the relevant coded extracts into the identified themes.…”

Section: Methodsmentioning

confidence: 97%

How institutional logics shape the adoption of virtual reality in mental health care: A qualitative study

Terkildsen,

Bollerup,

Palmhøj

et al. 2024

DIGITAL HEALTH

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Objective To analyse institutional logics’ role in adopting virtual reality in mental health care. Methods Data were collected via qualitative, semi-structured interviews with four frontline staff and seven administrative and service staff, two focus group interviews with three frontline staff and four administrative and service staff, and via participant observation in meetings between stakeholders working on virtual reality. Data were collected from May 2021 to February 2022, analysed using thematic analysis, and theoretically driven by the framework of Institutional logics. Results We identified two different forms of institutional logics being drawn upon by frontline staff and administrative and service staff, respectively, when working with the adoption of virtual reality in mental health care. Frontline staff drew mainly on a Professional logic; administrative and service staff drew on a Diffusion logic. Each logic defined a unique focal point, causal pathway, and perceptions of a meaningful adoption process for virtual reality. Conclusions By taking institutional logics as our theoretical and analytical point of departure, this study demonstrates how the meaning of virtual reality and its adoption in mental health care is grounded in multiple and sometimes conflicting institutional logics. Acknowledging the existence and influence of often multiple institutional logics in the adoption process is crucial to guide the future adoption of virtual reality in mental health care. Organising collaborative venues for stakeholders where their multiple institutional logics are made the subject of joint reflection is essential to counter frictions.

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COVID‐19 as moral breakdown: Entangled ethical demands experienced by hospital‐based nurses in the early onset of the pandemic

Cited by 7 publications

References 30 publications

Frontline nurses' experiences of managing visitor restrictions during the COVID‐19 pandemic in a Danish university hospital – Lessons learned

Frontline nurses' experiences of managing visitor restrictions during the COVID‐19 pandemic in a Danish university hospital – Lessons learned

A qualitative study of school nurses’ moral distress related to COVID‐19

How institutional logics shape the adoption of virtual reality in mental health care: A qualitative study

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