So far, 2020 has been a difficult year. The swiftly moving new coronavirus seemed to break out in the United States overnight-jumping from a few cases on the West Coast in January to over 1.9 million cases and more than 110,000 deaths as I write this in early June.
In much of the country, we seem to have moved past the worst of the merciless surge of critically ill patients that overwhelmed our hospitals and staff. Communities have started reopening businesses and parks and are allowing small gatherings as long as proper precautions are taken. But as we've witnessed from various media outlets, there are still too many instances of large crowds and people in close proximity without masks. Those of us who believe in science can only shake our heads at this reckless behavior and hope that these people don't spread the disease to others or end up in our EDs and ICUs. I'm not sure we can handle another surge of cases so quickly.
Health care workers and those in supporting services need a break. Nurses, physicians, aides, respiratory therapists, EMTs-all those who have been providing care to patients with COVID-19 in hospitals, in nursing homes, and at home-need a respite from trudging from room to room or house to house, donning and doffing gowns and masks and gloves, and witnessing death after death with no time to process it all. They need what the military call "R&R" (rest and recuperation)-time away from the front line to recharge. And part of that recharging is processing the trauma and acknowledging the losses, grief, and emotions that accompany such an experience.
Each month in AJN, we publish a one-page column called Art of Nursing, which features poetry, flash fiction, or visual art. Along with our narrative writing column, Reflections, it serves to address the emotional, human side of nursing and health care. Authors needn't be nurses-last month we showcased an Ohio artist's watercolor depicting nurses in masks. This month, in light of the many worthy and poignant submissions we've received related to the pandemic, we are devoting two pages to the column. One page shows a sketch from the 16-year-old daughter of an ICU nurse who was moved by her mother's admission that she cried all the way home from a shift; the other page contains poems from a physician and a nurse, each grappling with their emotions related to the virus. And this month's Best of the Blog talks about self-care in pandemic times.
I've heard from nurses who say they are emotionally and physically exhausted, and that working during this time was far beyond anything they ever thought they'd experience. Most said the fear of contracting the disease and spreading it to family was ever present and made them anxious and often sleepless; many isolated themselves from friends and family; and the hardest part of care, they said, was feeling like they were unable to help so many people. One nurse told me that on her unit, the staff agreed that no one should die alone. They made sure someone was there for each patient at the end, helping to make virtual connections with family using phones and tablets. This represents the best of nursing.
Many organizations are stepping in to address the need for nurses to "take a moment" to address their own needs. For example, the American Nurses Association has the Well-Being Initiative, the Emergency Nurses Association has Nurses Together, and the American Association of Critical-Care Nurses offers guidance to mitigate moral distress.
AJN's blog includes several articles about self-care and dealing with stress during the pandemic (https://ajnoffthecharts.com/ajns-covid-19-posts-regularly-updated), and we're collaborating with the Johns Hopkins School of Nursing on the Frontline Nurses WikiWisdom Forum (https://nurses.wikiwisdomforum.com), a moderated site where nurses can share experiences and collect suggestions from those at the point of care that, hopefully, will help us be better prepared for our next national disaster. AJN will work with Wiki moderators to publish and disseminate a summary report. We hope you will add your voices-they need to be heard.