محمدرضا فیروزکوهی - Department of Medical Surgical Nursing, School of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, Iran.
عبدالغنی عبدالهی محمد - Department of Medical Surgical Nursing, School of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, Iran.
عزیز شهرکی واحد - Department of Medical Surgical Nursing, School of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, Iran.

Dear Editor romoting the principles of professional practice is an approach to build trust among individuals concerning the medical profes sion. Individuals’ trust in nurses plays a cru cial role in patient care; thus, is of signifi cant importance. The main cornerstone in nursing care is the existence of nurses with professional ethics. Due to the epidemic of Coronavirus Disease ۲۰۱۹ (COVID-۱۹), numerous patients have been hospital ized in the Intensive Care Unit (ICU) and some have expired in Iran and around the world. COVID-۱۹ high lighted various difficult ethical issues encountered by healthcare providers in caring for patients and families. Nurses, as frontline healthcare workers, spend most of their time with patients; therefore, it is essential to ad dress the ethical concerns they face [۱]. Attention to safety in nurses In the fight against COVID-۱۹, ensuring the safety of nurses and other forefront healthcare workers is an important ethical concern. Nurses have to work under conditions that pose fundamental and uncertain risks to their health. Although nurses often voluntarily care for patients in high-risk situations, deficiencies and inappro priate conditions (e.g. the lack of protective facilities), prolonged presence in the wards to compensate for staff shortages, and patient care threaten their health; accord ingly, such conditions jeopardize more effective patient care. Due to these limitations, nurses cannot provide ef fective care and experience moral distress, psychological distress, and Post-Traumatic Stress Disorder (PTSD) [۲]. Providing healthcare resources for patients COVID-۱۹-induced conditions have necessitated more serious (and ethical) attention to the prioritization of care and resources in different care units. Making the right decision about the patient is among the ethical as pects that nurses encounter in special wards; it imposes a great moral burden on the healthcare staff. Nurses must provide care, justice, transparency, and protection in a way that does not incur legal and conscientious re sponsibilities. Patients with COVID-۱۹ are admitted to hospital wards with different care needs. They require adequate medical care, beds, ventilators and oxygen therapy, medicine, and so on. When nurses are unable to provide effective care due to a large number of hospital ized patients and the lack of facilities, they face moral contradictions. Even in the UK, due to a large number of patients, the situation changed; normally, in the ICU, the ratio of nurses to patients was ۱: ۱, i.e., altered to ۱: ۶. Consequently, it affected care and caused ethical

Moral distress, Nursing, COVID ۱۹, Patients, کووید ۱۹, پرستاری, پریشانی اخلاقی, بیماران