Moving Forward from the First Wave of COVID-19

Kathy Quan RN BSN PHN

Kathy Quan RN BSN PHN

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It’s 2020, the Year of the Nurse and Midwife. The 200th anniversary of the birth of Florence Nightingale was celebrated recently on May 12. Some are saying the legacy of Flo has become crystal clear as nurses fight against the silent killer, COVID-19. During the Crimean War, Nightingale’s work to save lives lead to the modern-day improvements in infection control. Her determination to set standards for sanitation and distancing of wounded and infirmed soldier’s beds rings true in today’s fights to save lives from the Coronavirus. To say that Flo would be amazed and honored by the level of care nurses provide today would be an understatement.

Nurses are the backbone of the health care industry and comprise major portions of the workforce in many countries throughout the world. In the US today, there are almost 4 million nurses including RNs, LP/VNs, Advanced Practice RNs and Midwives along with many more who are no longer active. Nurses outnumber physicians 3:1 and have taken centerstage in the COVID-19 world and have been honored by the public in many ways such as fly overs from military jets, concerts televised from entertainer’s homes to honor nurses, doctors, first responders and other health care workers. Just prior to the known outbreak in the U.S., the Gallop poll named nurses the most ethical and trusted profession for the 18th consecutive year. Nurses have certainly proven themselves worthy of this in recent months. 

Facing Unknowns in a Future Wave

As the COVID-19 curve flattens and people venture back to work, there’s still a lot left unknown about the future. Some areas of the world have seen sudden spikes in cases as they have opened up, and yet many tout the need to develop a herd immunity in order to be able to survive any future wave(s) of the pandemic. If the pattern follows the 1918 pandemic, the second and possible third wave can be even worse and more deadly. 

Some of the most important factors nurses will have to deal with facing a future wave of the pandemic include the ongoing fight for adequate PPE, hand sanitizer, sufficient ventilators, and staff. This will be compounded by a strong-willed public fighting the continued need for masks and social distancing. Dealing with a lay public that presents a lack of education and a constant supply of misinformation will present even more challenges. The politics that have invaded the pandemic and divided people aren’t going away. The financial repercussions of the pandemic are yet fully unknown. Unemployment has reached record levels and probably is not completely accurate. How reopening the country will aide or further harm the economy is also unknown and will have to be navigated one step at a time.

Honors and Discrimination Together?

Nurses have received acknowledgement and thanks from a grateful public for their care and assistance to themselves as well as loved ones. In far too many cases, nurses were the only physical contact with the dying patients, and this is not likely to change. Social distancing has succeeded in reducing the spread of the COVID-19. There will also be a double edge to this in private lives. Misinformation is making many parents of young children leery of their children having any association or contact with children of nurses and other health care workers who could carry the virus home. Although social distancing has limited contact for weeks now, as the country opens up, there is a growing chatter on social media about this matter. Another job for nurses will be to dispel rumors in order for their own children to be able to return to some figure of normalcy.  Nurses have been confronted in grocery stores for wearing scrubs and possibly contaminating the store. How do you honor a hero in one moment and discriminate against them and their families in the next? 

Burnout and Self Care

Perhaps the most important factor for nurses is that self-care is not optional. Nursing has always been the most physically and emotionally challenging profession and it’s never going to change. It can be managed with significant self-care, and that has to be escalated when the situation demands it. There will be a lot of PTSD to deal with for years to come. There has been so much death, near death and damage to healthy bodies. Taking time to honor yourself is the single most important thing to do every day. It can be combined with a hot shower, or a relaxing meal and perhaps a glass of wine or favorite foods. Indulge in a few moments alone, some mediation and reflections, some goal and intention setting.  It can take the form of a FaceTime or Zoom or Teams meeting with family or friends who are also hunkered down in their home missing friends and family. The point is it is not optional. Burnout is real and it’s been escalated exponentially by the events of the past 3 plus months. Whether you work the front lines or are part of the behind-the-scenes support system these have been the worst days of our careers. It is imperative to be kind to ourselves and to take time to be important so that we can continue to make a difference. Continuing education courses for nurses can be quite useful in understanding anxiety, PTSD and burnout.

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