Ethical challenges experienced by nurses during COVID-19: are we ready for tomorrow?

Professional ethics is an ethical standard for nursing practice. Nurses have experienced ethical challenges during COVID-19. Nurses' preparation for the future pandemic is pivotal to minimizing the ethical challenges.

The study aims to discuss the ethical challenges faced by nurses during the pandemic and to provide recommendations for readiness for future pandemics. A scoping review was performed on three search engines, Google Scholar, Science Direct, and PubMed to identify the publications between 2019 and 2024. Bronfenbrenner's ecological model and Lichtenthal's PEEK model were applied to categorize the ethical challenges and the readiness factors respectively.

Twenty-nine articles were eligible from the initial search strategy of 3764 studies. The study findings on ethical challenges were categorized according to the five levels of Bronfenbrenner's ecological model. Intrapersonal level: anxiety, willingness, isolation, and moral distress. Interpersonal level; nurse-patient and nurse-client relationships. Institutional level; staff shortage, limited facilities, and inequality. Community level; increased mortality and overcrowding. Policy level; visitation policies, privacy, and infection control. Findings on readiness were categorized according to the PEEK model of Lichtenthal, physical readiness; adequate resources and staff, and nutritional and immunity support. Emotional readiness; coordinating with loved ones, and ethics consultation subsided under. Experience readiness; assessment of hospitals and readiness for mass disaster. Knowledge readiness; implement training programs and prepare guidelines.

To prepare the nurses for future pandemics, health ministries, and hospital administrations are recommended to enhance facilities and equipment, provide emotional support by providing consultation sessions, enhance calamity plans to activate in a mass disaster, and initiate training programs.