Ethical dilemmas experienced by nurses while caring for patients during the COVID-19 pandemic: An integrative review of qualitative studies

Aim This study aimed to identify ethical dilemmas faced by nurses while caring for patients during the COVID-19 pandemic. Background Nurses express several concerns during disease outbreaks, some of which are related to ethical dilemmas. Evaluation It is an integrative review in which four databases were searched. Critical appraisal tools and PRISMA guidelines were used. Content analysis was performed to analyse the obtained data. Key issues A total of 14 studies were identified. The results are presented into four categories: concerns with beneficence-nonmaleficence; awareness of need for autonomy; challenges to justice; and coping with ethical dilemmas. Conclusion While caring for patients during the COVID-19 pandemic, nurses often put their own health and that of their families at risk. The ethical dilemmas faced by nurses are mainly caused by the lack of Protective Personal Equipment (PPE), shortages of medical supplies and personnel and the uncertainties that permeate an environment threatened by a new and highly contagious disease such as COVID-19. Implications for nursing management This review provides information that can inspire nurse managers working during the COVID-19 pandemic to support and empower nurses to act in accordance with ethical principles, which is important in order for nurses to protect themselves while providing efficient and effective care.