ArticleNursing ethics2023
Ethics and frontline nursing during COVID-19: A qualitative analysis.
Article in Nursing ethics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
What it found
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Who cites it
11 citing papers in PubMed, 20 citations in OpenAlex.
- Evaluating Nurse Conscientious Objection: Application of a Novel Framework.HEC forum : an interdisciplinary journal on hospitals' ethical and legal issues · 2026Article
- Professional identity and moral agency in palliative care: A review.Nursing ethics · 2026Review
- A Journey of Necessity: Moral Injury in Light of the Divine Comedy.Journal of religion and health · 2026Article
- Moral Challenges and Responsibilities in Caring for Relatives of Older Nursing Home Residents During the COVID-19 Pandemic in Sweden.Health care analysis : HCA : journal of health philosophy and policy · 2026Article
- Moral courage as a predictor of patient safety: reflections from the COVID-19 era.BMC health services research · 2025Article
- Comparative analysis of the impact of moral sensitivity on service behavior between Chinese and Pakistani nurses.BMC nursing · 2025Article
- Nurses' priority-setting for older nursing home residents during COVID-19.Nursing ethics · 2024Article
- Stretching oneself too thin and facing ethical challenges: Healthcare professionals' experiences during the COVID-19 pandemic.Nursing ethics · 2024Article
- Description and Analysis of Research on Death and Dying during the COVID-19 Pandemic, Published in Nursing Journals Indexed in SCOPUS.Nursing reports (Pavia, Italy) · 2024Article
- Impact of Nursing Professional Values on Depression, Stress, and Anxiety among Nurses during the COVID-19 Pandemic.Journal of nursing management · 2024Article
- Consequences of Moral Outrage among Nurses: A Scoping Review.Iranian journal of nursing and midwifery researchReview
Corrections and comments
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Authors and funding
10 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNurses experienced intense ethical and moral challenges during the COVID-19 pandemic. Our 2020 qualitative parent study of frontline nurses' experiences during the COVID-19 pandemic identified ethics as a cross-cutting theme with six subthemes: moral dilemmas, moral uncertainty, moral distress, moral injury, moral outrage, and moral courage. We re-analyzed ethics-related findings in light of refined definitions of ethics concepts. RESEARCH
aimTo analyze frontline U.S. nurses' experiences of ethics during the COVID-19 pandemic. RESEARCH
designQualitative analysis using a directed content methodology. PARTICIPANTS AND RESEARCH CONTEXT: The study included 43 nurses from three major metropolitan academic medical centers and one community hospital in the northeastern, mid-Atlantic, midwestern, and western United States. ETHICAL CONSIDERATIONS: Participant privacy and data confidentiality were addressed.
findingsMoral dilemmas arose from many situations, most frequently related to balancing safety and patient care. Moral uncertainty commonly arose from lacking health information or evidence about options. Moral distress occurred when nurses knew the right thing to do, but were prevented from doing so, including with end-of-life issues. Moral injury (accompanied by suffering, shame, or guilt) occurred after doing, seeing, or experiencing wrongdoing, often involving authority figures. Nurses expressed moral outrage at events and people within and outside healthcare. Despite difficult ethical situations, some nurses exemplified moral courage, sometimes by resisting policies they perceived as preventing compassionate care, guided by thinking about what was best for patients. DISCUSSION: This content analysis of ethics-related subthemes revealed conceptual characteristics and clarified distinctions with corresponding exemplars. Conceptual clarity may inform responses and interventions to address ethical quandaries in nursing practice.
conclusionsEthics education in nursing must address the moral dilemmas of pandemics, disasters, and other crises. Nurses need time and resources to heal from trying to provide the best care when no ideal option was available.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.