Office of Nursing Research and Innovation studies nursing ethics in pandemic era

During times of clinical challenges and tension, nurses, like many health care professionals, turn to the standardized ethical guidelines of their profession for direction. However, according to a study by a Penn State College of Medicine and Penn State Health Milton S. Hershey Medical Center research team, there are unique stressors and ethical dilemmas of the COVID-19 pandemic that may not address the public health and social crises of the past two years.   Mary Lou Kanaskie, director of nursing research at the Milton S. Hershey Medical Center and assistant professor of nursing and public health sciences, and Cheryl Dellasega, professor of humanities, interviewed nurses from across Penn State Health to see whether the American Nurses Association (ANA) Code of Ethics, last revised in 2015, addressed COVID-related challenges. Through a series of virtual focus groups, Kanaskie and Dellasega facilitated discussions on the relevance and benefit of these guidelines.

“If we understand the challenges that nurses have dealt with and continue to face in light of the pandemic, we can find new ways to support each other as peers and the profession as a whole,” Kanaskie said.

During the focus groups, the researchers used the nine provisions of the ANA Code of Ethics — which speak of the of the basic values and commitments all nurses share, the parameters of duty and loyalty, and how their role transcends relationships with individual patients — to guide conversation and asked nurses which, if any, of the provisions applied to their practice during the COVID-19 pandemic.

Participants identified how the provisions applied to their work during the pandemic, but also identified additional challenges they faced. Many nurses felt guilty for not being on the “front lines,” while others experienced a fast learning curve in attempting to provide complex care to both their patients and in some cases, their families. Many participants noted that the social and political events happening in the background of the pandemic added to their stress in a way they’d never experienced before. Nurses also said they weren’t just helping patients, but also patient families, and their own families and communities navigate new care systems.

“Nurses are experiencing emotional and physical trauma from the pandemic, while continuing to provide hours of care both at patient bedsides and in the community at large,” Dellasega said. “It was clear from talking with our participants that COVID-19 has created some ethical challenges that will have to be addressed once the crisis of the pandemic subsides.”

Read the full study in Applied Nursing Research

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