Abstract
The COVID-19 pandemic has raised many ethical concerns for healthcare practitioners. One concern is how much risk the public and other stakeholders expect that nurses, physicians, and other frontline healthcare providers should accept in their day-to-day work life. This chapter discusses risks that nurses and physicians accept when they enter the profession. It examines how the concept of “acceptable risk” has been defined in other contexts, such as by engineers and in human subjects’ research, to help inform a definition for the healthcare field, where a definition of acceptable risk is lacking. When the COVID-19 pandemic introduced deadly risks into the working lives of nurses, many accepted them, and this chapter addresses factors in their decisions to do so and how we can begin to plan for the next pandemic and create safer workplaces for healthcare providers. The nursing profession should accept the challenge of formally defining acceptable risk for its constituents and whether there are some risks that are more acceptable than others, especially during a pandemic.
The dangers of life are infinite, and among them is safety.—Goethe.
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References
Lowrance WF. Of acceptable risk: science and the determination of safety. Los Altos, CA: William Kaufman Inc; 1976.
Industrial Safety & Hygiene News. Most dangerous jobs in the U.S.: The top 20; 2019. https://www.ishn.com/articles/110496-most-dangerous-jobs-in-the-us-the-top-20.
Haug OC. Nursing home and care workers officially the most dangerous job inthe U.S 2020. https://msmagazine.com/2020/08/03/nursing-home-and-care-workers-officially-the-most-dangerous-job-in-the-u-s/.
Landis J. Nursing is one of America’s most dangerous jobs. 2017. https://thedoctorweighsin.com/nursing-is-one-of-americas-most-dangerous-jobs/.
The Joint Commission. Physical and verbal violence against healthcare workers. The Joint Commission. 2019. www.jointcommission.org/sea_issue_59/. Published April 17, 2018. Accessed August 5, 2021.
World Health Organization (WHO). In: Fewtrell L, Bartram J, editors. Water quality: guidelines, standards and health. Assessment of risk and risk management for water-related infectious disease. London, UK: Published by IWA Publishing; 2001.
Health & Safety Executive. The tolerability of risk from nuclear power stations. 1992. https://www.onr.org.uk/documents/tolerability.pdf.
American Nurses Association. Risk and responsibility in providing nursing care position statement. 2015. https://www.nursingworld.org/~4ad4a8/globalassets/docs/ana/riskandresponsibility.pdf.
Wickner P, Hartley T, Salmasian H, Sivashanker K, Rhee C, Fiumara K, Resnick A, Mendu ML. Communication with health care workers regarding health care - associated exposure to coronavirus 2019: a checklist to facilitate disclosure. Jt Comm J Qual Patient Saf. 2020;46:477–48.
National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The Belmont report: ethical principles and guidelines for the protection of human subjects of research. U.S. Department of Health and Human Services; 1979. https://www.hhs.gov/ohrp/regulations-and-policy/belmont-report/read-the-belmont-report/index.html
Ulrich CM, Knafl KA, Ratcliffe SJ, et al. Developing a model of the benefits and burdens of research participation in cancer clinical trials. AJOB Prim Res. 2012;3(2):10–23. https://doi.org/10.1080/21507716.2011.653472.
Electronic Code of Federal Regulations (e-CFR). 45 CFR §46. Electronic Code of Federal Regulations. 2021. https://www.ecfr.gov/cgi-bin/text-idx?m=07&d=19&y=2021&cd=20210803&submit=GO&SID=83cd09e1c0f5c6937cd9d7513160fc3f&node=pt45.1.46&pd=20180719.
Centers for Disease Control and Prevention. Cases & deaths among healthcare personnel. 2021 Accessed August 5, 2021 https://covid.cdc.gov/covid-data-tracker/#health-care-personnel.
The Guardian and Kaiser Health News. Lost on the frontline. 2020. https://www.theguardian.com/us-news/ng-interactive/2020/aug/11/lost-on-the-frontline-covid-19-coronavirus-us-healthcare-workers-deaths-database.
VOA News. At World Health Assembly, WHO Chief pays tribute to lost health care workers. 2021. https://www.voanews.com/covid-19-pandemic/world-health-assembly-who-chief-pays-tribute-lost-health-care-workers.
American Nurses Association (March 20–April 10, 2020) COVID-19 Survey Series. COVID-19 survey results. https://www.nursingworld.org/practice-policy/work-environment/health-safety/disaster-preparedness/coronavirus/what-you-need-to-know/covid-19-survey-results/.
American Nurses Association (July 24–August 14, 2020). Update on nurses and PPE. https://www.nursingworld.org/~4a558d/globalassets/covid19/ana-ppe-survey-one-pager%2D%2D-final.pdf.
American Nurses Association (February 2021) COVID-19 Survey Series. One year impact assessment. https://www.nursingworld.org/practice-policy/work-environment/health-safety/disaster-preparedness/coronavirus/what-you-need-to-know/year-one-covid-19-impact-assessment-survey/.
Ulrich CM, Grady C. Cardiopulmonary resuscitation for Ebola patients: ethical considerations. Nurs Outlook. 2015;63(1):16–8. https://doi.org/10.1016/j.outlook.2014.11.011.
Schnirring L. Second Ebola-infected Dallas nurse triggers air passenger tracing 2014. https://www.cidrap.umn.edu/news-perspective/2014/10/second-ebola-infected-dallas-nurse-triggers-air-passenger-tracing.
Courage KH. How did a Dallas nurse catch Ebola? Scientific American. 2014. https://www.scientificamerican.com/article/how-did-a-dallas-nurse-catch-ebola/.
Grinberg E. Texas nurse who contracted Ebola settles hospital lawsuit. 2016. https://www.cnn.com/2016/10/24/health/nina-pham-ebola-hospital-lawsuit-settled/index.html.
World Health Organization (February 23, 2021) Ebola virus disease: Key facts. https://www.who.int/news-room/fact-sheets/detail/ebola-virus-disease.
Dekker S. Patient safety: a human factors approach. Boca Raton, FL: CRC Press; 2011.
Mahase E, Kmietowicz Z. Covid-19: doctors are told not to perform CPR on patients in cardiac arrest. BMJ. 2020;368:m1282. https://doi.org/10.1136/bmj.m1282pmid:32224494.
Marsden E. Risk acceptability and tolerability. https://risk-engineering.org/static/PDF/slides-risk-acceptability.pdf.
Kirzinger A, Kearney A, Hamel L, Brodie M. (March 2021) KFF/The Washington Post Frontline Health Care Workers. https://files.kff.org/attachment/Frontline%20Health%20Care%20Workers_Full%20Report_FINAL.pdf.
Graham E. Majority of nurses are vaccinated or plan to be vaccinated: poll. Interview by Mika Brezinski, Moring Joe (Producer). 2021. https://www.msnbc.com/morning-joe/watch/majority-of-nurses-are-vaccinated-or-plan-to-be-vaccinated-poll-117446213789.
Mazumdar T. COVID: Global healthcare workers missing out on jabs. 2021. https://www.bbc.com/news/health-57820346.
Ruderman C, Tracy CS, Bensimon CM, et al. On pandemics and the duty to care: whose duty? Who cares? BMC Med Ethics. 2006;7:5.
American Nurses Association. Nurses, ethics and the response to the COVID-19 pandemic. https://www.nursingworld.org/~495c6c/globalassets/practiceandpolicy/work-environment/health%2D%2Dsafety/coronavirus/nurses-ethics-and-the-response-to-the-covid-19-pandemic.pdf.
Taquet M, Geddes JR, Husain M, Luciano S, Harrison PJ. 6-month neurological and psychiatric outcomes in 236,379 survivors of COVID-19: a retrospective cohort study using electronic health records. Lancet Psychiatry. 2021;8:416–27.
Wilhite L. What is the factor of safety? 2018. https://www.onsitesafety.com/safety-articles/what-is-the-factor-of-safety/.
American Nurses Association. Executive summary: American Nurses Association Health Risk Appraisal. 2017. https://www.nursingworld.org/~4aeeeb/globalassets/practiceandpolicy/work-environment/health--safety/ana-healthriskappraisalsummary_2013–2016.pd.
Weingarten E, Trewn P, Desai M, Davis K. From ideal worker to ideal workplace: Using behavioral design to create more equitable companies. 2021. https://timesupfoundation.org/work/equity/from-ideal-worker-to-ideal-workplace/.
Brooks Carthon JM, Hatfield L, Plover C, Dierkes A, Davis L, Hedgeland T, Sanders AM, Visco F, Holland S, Ballinghoff J, Del Guidice M, Aiken LH. Association of nurse engagement and nurse staffing on patient safety. J Nurs Care Qual. 2019;34(1):40–6. https://doi.org/10.1097/NCQ.0000000000000334.
King AT, Gontarz J, Wei H. Employee engagement and absenteeism: a step towards improving patient care. Nurs Forum. 2020;55(3):356–61.
Woods DD, Hollnagel E, Leveson N. Resilience engineering: concepts and precepts. Boca Raton, Florida: CRC Press; 2006.
Fischhoff B, Lichtenstein S, Slovic P, Keeney R, Derby S. Approaches to acceptable risk: A critical guide. Work Performed for U.S. Nuclear Regulatory Commission under NRC Interagency Agreement 40–550-75. U.S. Nuclear Regulatory Commission, Washington D.C.; 1980.
Manuele FA. Acceptable risk: time for SH&E professionals to adopt the concept. Prof Saf. 2010; https://aeasseincludes.assp.org/professionalsafety/pastissues/055/05/F1Manuel_0510.pdf
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Ulrich, C.M. (2022). What Are Acceptable Risks during a Pandemic?. In: Ulrich, C.M., Grady, C. (eds) Nurses and COVID-19: Ethical Considerations in Pandemic Care. Springer, Cham. https://doi.org/10.1007/978-3-030-82113-5_2
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