Reopening Schools During COVID-19: School Nurse Ethical Conflicts and Moral Dilemmas

Ethical Challenges of Nurses in COVID-19 Pandemic: Integrative Review

“…The initial search for articles generated 2529 articles, of which 8 articles fit the inclusion and exclusion criteria set in this integrative review for further analysis and synthesis. Of these, seven articles 4 , 7–12 has focused on the ethical issues of nurses working in hospitals while the remaining one 13 have discussed school nurses’ ethical concerns. Six articles 4 , 7–10 , 13 were discussion papers of authors whereas one was conducted in qualitative approach, 12 and the other was employed in descriptive correlation design.…”

“…Of these, seven articles 4 , 7–12 has focused on the ethical issues of nurses working in hospitals while the remaining one 13 have discussed school nurses’ ethical concerns. Six articles 4 , 7–10 , 13 were discussion papers of authors whereas one was conducted in qualitative approach, 12 and the other was employed in descriptive correlation design. 11 The maximum sample size among the included articles was 231 registered nurses ( Table 1 ).…”

“…Similarly, the issue of scarce personnel protective equipment for nurses is another burning ethical topic as stated by different authors. 4 , 8–11 , 13 …”

“…16 But, in reality, during the COVID-19 pandemic, nurses were making blurred decisions on various issues, such aswhich patients are most likely to get into a scarce intensive care unit bed and mechanical ventilation, or extracorporeal membrane oxygenation. 4 , 8–11 , 13 In the middle of the pandemic, we were observing that COVID-19 patients lying on the floor and waiting for medical care and/or with substandard level of care because they were beyond the capacity of hospital resources.…”

Best Interest Standard in School Health: A Concept Analysis

“…Some ethical challenges identified by school nurses are related to conflicts with administrators and/or parents, delegation of nursing tasks, confidentiality, resuscitation policy, and mandatory reporting (Savage, 2017). COVID-19 has introduced further ethical dilemmas for school nurses including a lack of role clarity, challenges in delivering continuous nursing care for students attending virtually, hybrid, or otherwise, a lack of PPE, and ambiguous reopening guidelines (Combe, 2020;Heggestad et al, 2020). Ethical challenges may be emotionally charged and lead to moral distress whereby school nurses feel they are prevented from what they feels is the correct action.…”