COVID19 PANDEMIC left an indelible mark in our society USA and across the globe, everyone is affected to some degree. The healthcare professionals ,hospitals but nurses and doctors were mostly affected.Nurses work 8hours, 12hours and 16hours shift. You see they are there all the time.
(1)First of all, most hospitals were not prepared for COVID19 PANDEMIC ,so weren’t adequate PPE protection for nurses and doctors. The main suppliers are in China and COVID19 originated from Wuhan China. Rather than chase PPE they (hospitals)prepared themselves to ration the PPE they have and manipulate nurses. The PPE were used mainly in ICU in pretence that there were no COVID19 patients on regular floors.Far from it ,SNF(Skilled nursing Facilities 40% of COVID19 PANDEMIC cases)patients were admitted on regular floors and so many patients that were not diagnosed initially because the doctors were not sure. So they were diagnosed with pneumonia and later changed to COVID19. Or we were told that patients were in” PCR observation”. These patients were placed on a regular floor and regular room. There were no negative pressure room for these patients. The two negative pressure rooms were already in use for COVID19 patients and the ones on PCR observations were not. N95 was given if you have COVID19 patients and should use the mask for a whole day.So the mask that you wore for Mr Xy with COVID19 is the same mask that you will wear for Mr Antony for twelve hours. And most of the masks are less than 50% Protection. It was a nightmare. The nurses were competent but were cowards and lack backbone ( 80% immigrants)”At the heart of unparalleled crisis of COVID19 PANDEMIC healthcare workers (HCWs) face several challenges in reducing the spread of infection, develop suitable short term strategies and formulate long term plans. (Western Journal of Emergency Medicine)
According to NationalNurse – THE VOICE OF NATIONAL NURSES UNITED(Sentinel Event)”We can’t say that they (hospitals)failed to protect public health, because that would imply that they tried. On every level,they disregarded the health and safety of nurses and of patients. They treat us as if we are expendable. But if nurses aren’t protected, patients aren’t protected”.
December 31st 2019 ” Pneumonia of unknown cause in Wuhan,China reported to world Health Organization “.
January 07 2020″Chinese authorities identified a novel Coronavirus as causal agent for pneumonia cases”.
January 8″ NNU begins monitoring novel Coronavirus “.
January 20th 2020″282 confirmed novel Coronavirus cases in four countries”(National Nurse)
January 21st 2020″ First travel- related Coronavirus case in United States of America (Washington State)
January 30th 2020″ Global Nurses United sends letter to WHO demanding it strengthen its guidance on prevention and control of novel Coronavirus”.(National Nurse)
“January 30th 2020 WHO declares novel Coronavirus a global public health emergency “.(National Nurse)
(2)Lack of skills in dealing with COVID19 patients. There was no time to train nurses. Who train who ?. What do they know about COVID19?. Lots of unanswered questions on how to take care of these groups of patients. Research has been going on since the SARS outbreak of 2003,as well as Ebola of 2014 and the anthrax. Is this COVID19 the same as the SARS in the past?.The patients kept coming into the hospitals. The nurses have to be there since families cannot. They witness death upon death every single day. Initially we thought that it affects the lungs as time goes on, we realized that it also affects all the organs of the body including the heart.”Crisis Standard of Care COVID19 PANDEMIC- (American Nurses Association) “American nurses association is adapting Standards of Care under extreme conditions. Guidance for Professionals under disasters or Pandemics. “February 28th NNU warns that U.S.A hospitals are unprepared for COVID19 after one infected patient at UC Davis Medical Center led to the self- quarantine of at least 36RNs and 88 other health care workers “.(National Nurse)
(3)No Opportunity for Prevention of COVID19. Over 260,000 people have died from Coronavirus. Most nurses went into Nursing to help the sick.And the main function of hospitals is to support medicine regimen in the treatment and cure of dysfunction and diseases. Nurses promote health, take care of the sick and are major force in the delivery of healthcare services. Florence Nightingale believed that nurses role should be to follow hospital protocols rather than to be independent in decisions making. While this worked in those days, it is detrimental to nursing because nurses are seen as subordinate to physicians. Even though so many of the experienced nurses are more knowledgeable than the young Physicians. This was frustrating for so many nurses who are looked down upon. No adequate equipment to do their jobs. And when they brought their own supplies they were fired.It is not the policy of hospitals for you to bring your own supplies for Safety Reasons.But since the hospital is not doing it.Some nurses became proactive.I witness one of the nurse cried on Television and I cried with her.Nurses were manipulated for profit. Nobody cares about the mother goose that lay the golden eggs. In the cases on COVID19, what is right and what is wrong?.What is call to duty ?. (American Nurses Association )” Omissions risk unintended consequences with implications for human rights. Thus nurses must engage in discernment, carefully assessing their intentions, reflectively weighing all possibilities and rationales…etc”.
(4)Stress and depression: Nurses have families just like any other person. They were worried about infecting their children, families grandparents with COVID19. And at the same time they watched patients died in their hands every day. Sometimes you have two, three,four patients died in your hands. So many nurses became anxious about going to work, afraid of the unknown. This cannot be normal for anyone. So many suffered from PTSD .They were there when patients were restless took out the nonrebreather mask and she(nurse) put it back ,fighting for their lives before they take their last breathe. Tube feeding, restraint, Foley catheter placement, tracheostomy suctioning,percussion, postural drainage, woundcare,hold hands of the dying. It’s overwhelming. They ( nurses)come back the next day and do it all over again. “”American nurses association directs the NIH’s National Institute of Mental Health to support research on the mental consequences of COVID19 including the impact on healthcare providers”” “(Legislative/Regulatory/ Advocacy branch.
How do you as a nurse handle ethical issues, economy, culture, demographic and public policy?.All these are difficult to contextualize at this critical moment. Normal circumstances nurses in clinical practice resolve ethical issues.
(5) Poverty and immigration: So many of the nurses are immigrants w jvmho came from poor countries like Philippine for example. They are more in number and are afraid to speak up so that they don’t lose their jobs.While the American citizens are willing to challenge the hospitals for better conditions. These immigrants will accept anything making it difficult for the hospital to accept responsibilities and do the right thing. USA have spent 6trillion with COVID19 according to reports and more spending is still needed to salvage the situations. 33 millions of people are currently unemployed .Stimulus package was paid in the past and there is need for more stimulus money, Federal revenues, the CARE Act.(affordable insurance- Obamacare)
(6)Hospitals in dilemma: Due to COVID19 PANDEMIC most of the hospitals money making departments are nonfunctional. For example there are no minor surgeries that give the hospital money. Operating rooms closed and intervention Radiology services closed.So hospitals are not making money either.
(7)Lack of Support: Nurses work day and night without better support. They are the professionals, caregivers, mothers, babysitters everything. They are the shoulders to cry on.But they have no shoulders to lean on. So many people later became supporters of nurses.Some people have no sympathy for nurses. Their remarks were “they signed up for it”.Or they make good money.Nobody will see DEATH and sign up for it.No they didn’t sign up for it.
(8)Unfair Compensation : The frontline nurses should be well compensated not just ICU nurses all the nurses should be compensated.Did the Federal government turned their back on what is going on?. They probably didn’t turn their back but are not doing enough. This is crazy, this is unimaginable. Never expected to see anything like this in my lifetime.
(9)Retention: To retain there must be some satisfaction in the job.But there was no job satisfaction. So many nurses are in anguish. No PPE,no management support, no better compensation, rather manipulation and relegation to the background. How satisfied are you when so many of your colleagues lost their lives to COVID19?.There is no satisfaction here but pain and misery. So many nurses who can afford it left in pursuit of something else ,some change their addresses to heaven. Some experience nurses retired before the age of retirement.
(9)Education: Retention and educational classes to improve competence so that nurses can handle complex issues.Nurses never stop learning new ways of improving the lives of others. Competency in your field enhance better decision making, critical thinking and critical judgment. Hospitals weren’t ready or prepared to take care and educate their workers on COVID19. You cannot give what you don’t have. It is important to support and promote nurses so that they can take care of the public. “On Feburary 11th 2020 more education to the public and WHO(World Health Organization)names novel Coronavirus,COVID19.March 27th 20202 trillion stimulus bill enacted, but doesn’t protect healthcare workers.And by April 2nd 2020 more than 1million cases worldwide, more than 53,000deaths.(National Nurse)And today December 1st 2020 total cases worldwide 63.5millions, and total deaths worldwide 1.47million. But in USA total cases 13,973,785,and total deaths 275,108.
(10)Organizational Survival: In terms of organizational survival lies good management challenges in retaining the old (Experience Nurses)to help with the new.If there is no competent staff how do you (hospital)become competitive with other hospitals around?. There are patients survey which evaluate hospitals. Great competition requires patient satisfaction, understanding of your customers, groups and the entire hospital system. If the restaurant doesn’t have good foods and good services will you return?.If a hawker doesn’t satisfy you do look for her again?.There are so many hospitals around. If the patients were not attended to because of lack of staff or incompetent staff will they return?.If hospitals only receive COVID19 patients without insurance will they survive.? This lead to the hospital unable to survive. And the result will be the termination of positions such as the unit Secretaries, reduce number staff in the laboratory, radiology, terminate per diem workers. “NNU sends letter to CDC to strengthen it guidance on prevention and control of COVID19 “.
Everyone is exhausted from the restrictions, but there is hope on the way the vaccines.Do not let your guardrails down. Hoping that we can help the frontline workers to continue to serve us at this unprecedented time.
Philomena N. Okeke thanks.