Conceptual analysis
Professional autonomy is defined as having the authority to make decisions and the freedom to act in accordance with one’s professional knowledge base. During pandemics such as the current Covid-19, nurses while providing primary care to the patients are involved in various duties that demand they make an independent, interdependent and accountable decision that benefits the patients while promoting their health and well-being. Nurses are bound to observe professional codes and standards in their roles where they are accountable to their decisions hence a loss of professional autonomy. The principle of professional autonomy involves various complexities during pandemics where nurses might need to refuse unsafe work. Nurses are in the front line in the battle against Covid-19 and are at risk of contracting the disease hence they experience fear, isolation and death both to them and their families (Yeo et al., 2010).
Nurses are faced with complex situations to choose between personal integrity and professional integrity especially during emergencies and pandemics such as Covid-19. Personal integrity would make a nurse stay at home than to bring the Covid-19 to the family and loved ones from the workplace because they are not assured of protection from contracting the disease. However, they would not have upheld their professional integrity and potentially placing their patients at risk (Canadian Nurses Association, 2017).
In nursing practice, justice focuses on equitable scarce resource allocation and equitable access to care. When a nurse chooses to stay at home concerning the potential risks of Covid-19 to the family indicate a lack of justice to patients. Patients expect to receive equitable access to care and so the nurses should be available to render care to them. However, the lack of efficient protection of nurses by the organization from the pandemic would be unjust ((Canadian Nurses Association, 2008).
Nurses are accountable for their daily ethical decisions. Covid-19 is a global emergency and nurses being front lines are engaged in challenging decision making. Due to the high transmission rate of Covid-19, nurses are the potential in spreading the disease. When a nurse chooses to stay at home because he/she has dependents to protect from Covid-19 has to speak up about their fears with the organization. Overcoming the fear of refusing to work for the sake of the family through expressing the danger he/she is likely to face if he or she contracts the disease (Yeo et al., 2010).
Normative analysis
During emergencies and pandemics, nurses will provide care regardless of the working conditions and risks to themselves as per the nursing professionalism codes and standards. Covid-19 has raised serious concerns about nurses’ duties as patient care providers and commitment to professional standards amidst the health risks to themselves. Nurses should, therefore, be protected from pandemic infection through the use of personal protective equipment and given the freedom to act on their rights like refusing to work when necessary (Morley et al., 2020). Nurses might refuse to go to work during this time of Covid-19 in fear of their safety and their families in case of unsafe work. However, refusing to work is intertwined with professional accountability and so nurses might be forced to work under problematic conditions to ensure patient safety (Bearwood & Kainer2013). Employers should, therefore, be obligated to mitigate risk by adhering to every reasonable precaution to ensure the safety of nurses in their practice.
Despite the cost implications from personal protective equipment, employers should supply nurses with personal protective equipment (PPE) like masks and gowns. In cases where the nurses have dependents at homes such as old people and young children, they should be provided with PPEs that they can use at home and thus protect their families in case they exposed to Covid-19. Nurses should be prioritized for care during this Covid-19 to realize practical and valuable benefits through the availability of key staff in providing care to the patients. This consideration will allay fear, prevent attrition and boost the morale of the nurses (The Hastings Center, 2020). They should, therefore, be rewarded through remunerations and allowances to boost their morale. Nurses have families who depend on them and for those with persons under the vulnerable group, the government or employers should support them by providing home care.
Conclusion
The decisions that nurses face as front lines health care providers in the battle against Covid-19 are complex and uncertain. Nurses should deliver optimal primary care in line with clinical professionalism and accountability while ensuring they promote their safety and well-being. Providing care to Covid-19 patients demands various decision making from nurses and at different times which is a difficult task. Nurses should, therefore, be involved in policymaking processes concerning Covid-19 and they should be given priority access to care.