Doctoral defence: Gerli Mõts "Ethical issues in nursing before and during the COVID-19 pandemic: a multi-method study"

On March 13th Gerli Mõts will defend her thesis "Ethical issues in nursing before and during the COVID-19 pandemic: a multi-method study".

Supervisors:
Visiting professor Mari Katariina Kangasniemi, University of Tartu and University of Turku
Professor Ruth Kalda, University of Tartu

Opponent:
Professor Sanna Salanterä, University of Turku (Finland)

Summary:
Ethical issues are a significant concern in nursing, which burden nurses emotionally and mentally, endanger the quality and safety of care. Patients have the right to safe, high-quality, and ethical care, and nursing, as an autonomous value-based practice, primarily focuses on the needs and preferences of patients. Working in close and long-term contact with patients and collaborating with various stakeholders in a rapidly evolving, efficiency-oriented environment, nurses cannot always follow the values of nursing, leading to ethical issues. Ethical issues and their causes, as well as the meaning and managing these issues are influenced by various contextual, demographical and socio-cultural aspects. Estonia, due to its history of Soviet occupation, differs in many ways from other European countries, including those we are part of today. The healthcare context was also significantly influenced by the recent COVID-19 pandemic, which created new ethical issues and amplified existing ones. Understanding ethical issues and their contextual aspects is crucial for identifying deficiencies and shortcomings in clinical practice to improve the quality and safety of healthcare services in both regular and crisis conditions, as well as the environment in which nurses work. This study describes ethical issues in nursing before and during the COVID-19 pandemic for nurses working in different contexts. The results show that in Estonia, ethical issues in nursing are caused by violations of patient rights, the ambiguity of nurses' professional roles and autonomy, as well as non-supportive professional relationships. Ethical issues are also fostered by unregulated and excessive workloads, socio-cultural influences, and nurses' preparedness for crises. Ethical issues in nursing should be addressed as a phenomenon that affects quality and patient safety. There is a need for joint efforts of nurses, healthcare organisations, nursing associations and policymakers to clarify nurses' professional roles and autonomy, regulate workloads and create a collaborative organisational culture. Preparing for crises, especially from an ethical perspective, also requires attention. The contribution of educational institutions is important so that nurses have a solid, value-based foundation to rely on and flexibly apply in various situations.