Nurses' priority-setting for older nursing home residents during COVID-19

Area of Science:

• Gerontology
• Nursing
• Public Health Ethics

Background:

• Ethical principles in healthcare prioritization are crucial, especially during crises like the COVID-19 pandemic.
• Understanding the specific challenges faced by nursing home nurses in prioritizing care is limited.
• The well-being and health of nursing home residents depend on effective prioritization.

Purpose of the Study:

• To explore how nursing home nurses in Sweden set priorities for older residents during the COVID-19 pandemic.
• To understand the ethical considerations and practical challenges influencing these prioritization decisions.

Main Methods:

• Qualitative interview study with 21 nursing home nurses in Sweden.
• Data collected through in-depth interviews using the critical incident technique (CIT).
• Analysis conducted using content analysis within a defined theoretical framework.

Main Results:

• An overarching theme of nurses struggling "on multiple fronts" was identified.
• Seven categories emerged, including managing urgent care, responding to relatives, combating infection, and adhering to person-centered ideals.
• Nurses sometimes took on responsibilities beyond their official duties.

Conclusions:

• Priority-setting for older nursing home residents during the pandemic caused significant strain and struggle for nurses.
• Conflicting demands and interests impacted nurses' decisions.
• Nursing home nurses need enhanced organizational and managerial support for effective prioritization.