You are called to a rapid response or a code blue and the patient is in isolation for COVID-19. It takes you several minutes to don your personal protective equipment, delaying life-saving interventions by several minutes.

You go in and out of one isolation room after another donning and doffing the PPE and by the end of the shift you are exhausted and wonder if you can keep going.

A patient with COVID-19 is dying due to acute respiratory distress syndrome because there are no ventilators available. Another patient is on a ventilator and declining despite proning the patient and he is not eligible for ECMO. You know this patient will die.

Patients are dying alone because visitors are not allowed, and you are simply too busy with other patients to come and hold their hand and tell them you are there.

During this crisis, we are faced with ethical and moral dilemmas many of us have never encountered before. Perhaps being a nurse in war time is similar; but for those of us who have not served in that capacity, all of this is new and is shaking us to the core. We are a caring profession and our instinct is to run towards adversity not away from it. That’s what we are doing now. But, we have always said we would be there to care for the sick, hold their hand, just be present when they needed us, and above all, never let a patient die alone. It presents a dilemma for us when we can’t be the type of nurse we were just a few short months ago.

The reality is this, we have to protect ourselves first so we can help others. So, just like the announcement says before every flight, put your own mask on before helping others, we have to take the time to put on PPE before we enter a patient’s room if they are in isolation. Taking those few minutes to do the right thing is imperative if we are going to be healthy enough to care for the many patients who need our care. We cannot allow ourselves to be a casualty because of not taking the time to protect ourselves first.


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Facing Moral & Ethical Dilemmas During COVID-19

Caring for so many patients is overwhelming. We need to think about each patient as an individual and give what we can of ourselves for that one patient when we are with them. It is not about what we can’t do, it is about what we can do with the resources we have available. Doing our best for each individual patient is all we can do. 

For front line caregivers, be vigilant in recognizing when your patient is heading for trouble. You have a sixth sense; use it. It is always better to address a situation before it becomes a rapid response or a code blue situation. Performing procedures and interventions in a nonemergency situation is always preferable.

As healthcare professionals, we haven’t seen a test of our healthcare system of this magnitude since the Spanish Flu pandemic of 1918. This is a learning experience for all of us and one that will test us to our very core. We are facing ethical and moral dilemmas, but we carry on because we know we can’t save everyone, but we will save as many as we can. We need to do the best we can for our patients, one patient at a time.

The COVID-19 pandemic is an opportunity for nursing to show what were made of – we are a caring profession that rises above challenges to provide care to those in need. We recognize the need to protect ourselves first so we can provide care to the masses. When we are with our patients, we will focus on one patient at a time and think about what we can do for them – not what we can’t.