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      Ethical dilemmas, perceived risk, and motivation among nurses during the COVID-19 pandemic

      research-article
      Nursing Ethics
      SAGE Publications
      Allocation of scarce medical resources, COVID-19, duty of care, ethical dilemmas, motivation, risk

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          Abstract

          Background:

          Positioned at the frontlines of the battle against COVID-19 disease, nurses are at increased risk of contraction, yet as they feel obligated to provide care, they also experience ethical pressure.

          Research question and objectives:

          The study examined how Israeli nurses respond to ethical dilemmas and tension during the COVID-19 outbreak, and to what extent this is associated with their perceived risk and motivation to provide care?

          Research design:

          The study implemented a descriptive correlative study using a 53-section online questionnaire, including 4 open-ended questions.

          Participants and research context:

          The questionnaire was complete by 231 registered and intern nurses after being posted on nurses’ Facebook and WhatsApp groups, and through snowball sampling.

          Ethical considerations:

          The research was pre-approved by the ethics committee of the Faculty of Social Welfare and Health Sciences at the University of Haifa, Israel.

          Findings:

          In all, 68.8% of the respondents had received some form of training about COVID-19. Respondents positioned themselves at perceived high risk levels for contracting the virus. About one-third feared going to work because of potential contraction and due to feeling inadequately protected. While 40.9% were scared to care for COVID-19 patients, 74.7% did not believe they have the right to refuse to treat certain patients. When asked about defining an age limit for providing patients with scarce resources (such as ventilation machines) in cases of insufficient supplies, respondents stated that the maximum age in such scenarios should be 84 (standard deviation (SD = 19) – yet most respondents (81.4%) believed that every patient has the right to receive optimal treatment, regardless of their age and medical background.

          Discussion:

          Correlating with their strong commitment to care, nurses did not convey intention to leave the profession despite their stress, perceived risk, and feelings of insufficient support and protection at work. The nurses did not hold a utilitarian approach to resource allocation, thereby acknowledging the value of all people and their entitlement to care, regardless of optimal outcomes.

          Conclusion:

          While experiencing significant personal risk and emotional burden, nurses conveyed strong dedication to providing care, and did not regret working in the nursing profession, yet they did seek a supportive climate for their needs and ethical concerns.

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          Most cited references31

          • Record: found
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          • Article: not found

          Fair Allocation of Scarce Medical Resources in the Time of Covid-19

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            Critical Supply Shortages — The Need for Ventilators and Personal Protective Equipment during the Covid-19 Pandemic

            New England Journal of Medicine
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              • Record: found
              • Abstract: found
              • Article: found

              Understanding and Addressing Sources of Anxiety Among Health Care Professionals During the COVID-19 Pandemic

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                Author and article information

                Contributors
                Journal
                Nurs Ethics
                Nurs Ethics
                NEJ
                spnej
                Nursing Ethics
                SAGE Publications (Sage UK: London, England )
                0969-7330
                1477-0989
                1 October 2020
                : 0969733020956376
                Affiliations
                [1-0969733020956376]Ringgold 26748, universityUniversity of Haifa; , Israel
                Author notes
                [*]Daniel Sperling, Department of Nursing, University of Haifa, 199 Aba Khoushy Ave., Haifa 3498838, Israel. Email: dsperling@ 123456univ.haifa.ac.il
                Author information
                https://orcid.org/0000-0002-4371-7736
                Article
                10.1177_0969733020956376
                10.1177/0969733020956376
                7533465
                33000673
                5016a4b3-5b3d-4049-97c6-479ade933932
                © The Author(s) 2020

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

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                allocation of scarce medical resources,covid-19,duty of care,ethical dilemmas,motivation,risk

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