The current COVID19 pandemic has spread all over the world and increases each day in exponential numbers. Flattening the curve and stopping the spread is demanding extraordinary measures. Quarantines, stay-at-home orders and social distancing are showing some promise, but 100% compliance is a challenge. These are very stressful times. 

Nurses, doctors and all healthcare workers on the frontlines are potentially being 100% exposed. With the shortages of PPE, (masks of any type, gloves and gowns) it makes this even more of an issue. This is a huge concern and is causing nurses to think about refusing to go to work without the proper protection. That’s going to open other issues of patient and job abandonment and beyond. So how can nurses take care of themselves as well as prevent the spread to their families?

Infection Control

Infection control is not new to nurses. But there is a lot of public misinformation and lay people are overwhelmed. It’s our job as nurses to educate. Handwashing is always the first and best defense! No shortcuts! And teach your patients, any allowed visitors, as well as your own family members to wash their hands appropriately and when to wash. Hand sanitizer disappeared off shelves in record time and now people are making their own, but those supplies are limited, and price gouging is making it difficult. Soap and warm to hot water isn’t always readily available, but where it is it should be used. Gloves are also at a premium now and rumored relaxed CDC rules are encouraging washing them and reusing. Hand sanitizer isn’t a good idea because it can degrade the vinyl or latex and create even more cross contamination nightmares!

Believe it or not, prior to the AIDS/HIV outbreak in the 1980’s nurses rarely used gloves. It was even discouraged to use gloves when cleaning up messes from the likes of stool, sputum and emesis! The philosophy was not to insult or embarrass patients who couldn’t help these accidents. Ostomy nurses were very strong in the belief that wearing gloves would further affect and discourage new ostomy patients already dealing with self-image issues. Handwashing was perhaps even more important. When the assumption that everyone was possibly infected with AIDS took over, the use of gloves exploded. Now we find ourselves in very new and different territory. Nurses are resourceful and inventive, but they need protection. 

Other infection control methods we need to enforce include not touching your face, and if you do, wash it as well as your hands. Cough or sneeze into your elbow, or at the very least a tissue and not in the direction of anyone else. Dispose of tissues immediately in an appropriate bedside receptacle. 

Social distancing was implemented with the expectation of staying 6 feet away from another person. But when providing patient care, this is impossible. Protecting our co-workers, by staying 6 feet away is a good practice when possible. At home it’s a good idea, but again not always possible. 

Social isolation and self-quarantine or stay-at-home orders have been implemented across the country and are rapidly expanding, but compliance is not what it needs to be yet. Many of these orders coming from state and local officials do represent misdemeanors and some have threatened law enforcement, but the reality of this is challenged by more important uses of law enforcement. To flatten the curve, compliance needs to improve. The longer it’s ignored; the longer it’s going to take! Lives will be sacrificed. 

The coronavirus has been found to attach to hair, skin and clothing and this represents an issue for anyone who has to venture out of their home. For nurses, it’s imperative to make arrangements to have a safe place in your home to remove clothes and clothing and head straight to the washing machine and then to the shower before having any contact with family. Changing out of scrubs or uniforms before leaving work lessens the contamination of your car or home but walking from changing rooms to the exit door is still within the contamination zone. Please consider this. Make sure to shower and wash your hair when you first get home. Launder clothing in as hot a temperature as possible for the fabrics. 

Cleaning surfaces such as doorknobs, handrails, counters, car doors, steering wheels and other controls, and any place your shoes contact needs to be done with antiviral cleaners. A 10% bleach solution is one of the best options, but you have to consider surfaces and what bleach can do to them. Lysol and Clorox make wipes that are more friendly to surfaces, but again these are hard to find. And handwashing frequently!

If someone in your home is ill with any virus or bacteria, contact your employer to discuss the need to stay home. If you are ill, stay home! Check to see what rules have been implemented about time frames of self-quarantine. It’s recommended 14 days, but 72 hours without fever and no fever medications along with no cough might be more realistic with healthcare workers who are in dire need. 

Strengthen your immune system

One factor in the susceptibility to the virus appears to be increased in those with lowered immunity from cancer and heart disease along with chronic inflammatory diseases such as RA, lupus, inflammatory bowel disease, multiple sclerosis, metabolic diseases such as diabetes, and many others. Anyone of any age with lowered immunity is recommended to stay at home during this crisis. Healthcare workers with these diseases should take extra precaution. This again emphasizes the need for sufficient PPE and perhaps reassignment away from the most active exposure. 

The immune system can be strengthened by appropriate nutrition, adequate sleep, reduced stress levels, and exercise. With dining out options reduced by the closure of restaurants and bars, more people are cooking and eating more meals at home. Many of those business remaining open for take-out and delivery only have geared their products to offer healthier well-balanced family meals. Nurses must pack healthy snacks and plan for adequate hydration as well as ensure they take a meal break not only to eat, but to destress. If only for a very short period. When at home, nurses need to replenish and relax as much as possible. These are very different times and changes in routines and responsibilities need to be considered to ensure the health and well-being of all.

Vitamins, supplements, essential oils, herbs and other supportive products can also play an important part in strengthening the immune system and reducing stress. They should be things you’ve already discussed with your physician. Vitamin C and zinc play an important role in protecting the body from viruses and strengthening the immune response. Recommended doses should be followed. Overdoing can be counterproductive and harmful. 

Adequate sleep is essential to replenishing the soul as well as the body. If a temporary sleeping aid is needed, it’s probably time to discuss with your physician – most likely that will be over the phone or through a telemedicine doctor at this time. There are many OTC options, but sensitivities to ingredients need to be considered. 

Nurses are the backbone of the healthcare system and will be the heroes of this coronavirus pandemic crisis. But nurses can also be the worst patients and now is the time to implement self-care to stay well and protect their loved ones.