Moral Distress Challenges in Nurses During Early Stage of COVID-19 Pandemic: A Qualitative Study.

Introduction: As a serious crisis, the COVID-19 pandemic put a lot of pressure on nurses, and many ethical challenges arose for them. The aim of the study was to explore the moral distress challenges in nurses during the COVID-19 pandemic. Methods: A qualitative study with a conventional content analysis approach was adopted. A purposive sampling method with maximum variation was used and 13 nurses caring for patients with COVID-19 participated in this study. Data were collected using individual semi-structured interviews until data saturation and concurrently analyzed by MAXQDA software. Results: Three main categories including 'trial and error in care of patients with COVID-19, 'negligence in performing professional duties' and 'inappropriate organizational structure' emerged as the moral distress challenges experienced by the Iranian nurses during COVID-19 pandemic. Conclusion: Providing a codified treatment plan at the first opportunity is effective to prevent trial and error in the treatment and care of patients. Providing the latest information about the disease or the crisis that has happened manages the stress and work pressure to some extent. The existence of instructions for allocating resources and equipment can help in crisis management. Long-term planning for providing sufficient human resources is an issue that should be the priority of the officials. It should be noted that nurses are trained for normal as well as crisis situations, perhaps their insufficient training also has an effect on aggravating challenges in crisis situations.