Assistant Nurses' Experiences of Ethical Challenges While Working in Residential Care Facilities During the Pandemic: An Interview Study.

INTRODUCTION

Early in 2020, the World Health Organisation (WHO) declared COVID-19 to be a pandemic. Older people were especially vulnerable to illness and death from the virus. For care staff, including assistant nurses (ANs) working in residential care facilities (RCFs), many circumstances related to the pandemic caused ethical challenges.

AIM

The aim of this study was to explore ANs' experiences of ethical challenges during the pandemic, while working in RCFs for older people in Sweden.

METHODS

This study used an explorative qualitative design based on focus group interviews with 19 ANs. The interviews were analysed using thematic analysis.

RESULTS

Ethical challenges faced by ANs in RCFs during the pandemic included (a) being unable to give dignified care, depriving older people of their human rights; (b) being duty-bound to follow restrictions despite the suffering of relatives, witnessing injustice; (c) facing the deprioritisation of older people, being part of providing care on unequal terms; (d) being restricted and devalued, feeling abandoned; (e) being forced to adhere to personal constraints, having integrity and autonomy severely violated; and (f) fulfilling duty with life at stake, sensing the fear.

CONCLUSION

During the pandemic, ANs in Sweden experienced ethical challenges in the care of older people in RCFs, as well as personal ethical challenges. Such challenges arose in various situations, and their consequences entailed undignified and compromised care.