Ethical challenges during the COVID-19 pandemic: Perspectives of nursing students

Abstract

Background: The first wave of the COVID-19 pandemic caused a shortage of qualified nurses in Spain. As a result, the government authorized the hiring of senior students. Objectives: To explore the ethical dilemmas and ethical conflicts experienced by final-year nursing students who worked during the first outbreak of the COVID-19 pandemic in Spain. Research design: A qualitative exploratory study was conducted using purposive sampling. Semi-structured interviews were carried out using a question guide. Interviews took place via a private video chat room platform. A thematic, inductive analysis was performed of the information gathered. Participants and research context: Eighteen nursing students were recruited from two universities of Madrid, aged between 18 and 65 years old, enrolled in the fourth year of nursing studies and who were hired under a relief contract for health professionals during the pandemic. Ethical considerations: The present study was carried out in accordance with the Declaration of Helsinki, and the study was approved by the Local Ethics Committee of Universidad Rey Juan Carlos. Results: Three specific themes emerged: (a) coping with patient triage, (b) difficulties in providing end-of-life care, and (c) coping with patient death. Nursing students participated in the process of patient selection for resource allocation and ICU bed occupancy. They were shown how to care for patients who were not admitted to the ICU, in their last moments and were faced with the difficulties of applying end-of-life care. Finally, the nursing students were confronted with the death of their patients, in overwhelming numbers and under adverse conditions. Conclusions: These findings can help shed light on the ethical dilemmas and ethical conflicts faced by novice nursing students, incorporated into the workforce during the COVID-19 pandemic. Moreover, it was described that students may normalize the death due to the exhaustion and overwhelmed routine.

Challenge, fear and pride: nursing students working as nurses in COVID-19 care units

“…Similar to other studies (Barrett, 2022 ; Casafont et al, 2021 ; Palacios-Ceña et al, 2022 ) these results can help nursing schools train their students to future health crises, implementing simulation laboratories and clinical situations that integrate theory and practice. All this would help to improve the abilities of the students and their emotional strategies.…”

The influence of emotional burnout and resilience on the psychological distress of nursing students during the COVID‐19 pandemic

“…Healthcare and nursing education institutions should establish a transition programme, especially for pandemic situations (Palacios‐Ceña et al . 2021 ). Some of the initiatives should promote resilience and prepare students to overcome adversities and stressful situations that may occur when facing the requirements of their degrees in pandemic situations (Hernández‐Martínez et al .…”

“…Novice nursing students had to face different ethical dilemmas and ethical conflicts in a health system aggravated by this global crisis (Palacios‐Ceña et al . 2021 ).…”

“…Emotions of suffering appeared due to the highly complex context and the lack of professional experience (Collado-Boira et al 2020;Roca et al 2021). Novice nursing students had to face different ethical dilemmas and ethical conflicts in a health system aggravated by this global crisis (Palacios-Ceña et al 2021).…”

End of life care during the COVID‐19 pandemic: A qualitative study on the perspectives of nurses and nurse assistants

“…Previous studies focused on emotional and psychological distress that affected health care professionals' well‐being (Huang et al, 2020 , 2021 ; Mitchinson et al, 2021 ; Rathnayake et al, 2021 ). Health care professionals had to balance their duties and competencies with emergent choices and decisions in practice (Galehdar et al, 2020 ; Palacios‐Ceña et al, 2022 ; Turale et al, 2020 ). Patient‐centered care was rarely possible due to a lack of resources, and health care professionals often had to decide whom to provide care to (Jia et al, 2021 ; Palacios‐Ceña et al, 2022 ).…”