As I write this, we are in the midst of the COVID-19 healthcare crisis. As individuals, we are worried about our own health and survival; as family members, we are anxious about the health of our loved ones. But as nurses, we are concerned about the health of humanity. "Nurse" is who we are full time, whether in the role of individual or family member. The nurse in us supersedes the other roles in our lives because we bring nursing into how we think, plan, and react. Since before Florence Nightingale, nurses-however defined-have answered the call and cared for humanity despite the risk to themselves. Although others think what we are experiencing is new, nurses know that this is not new. Historically, we have not received the publicity or recognition physicians or others have received during times of crisis, but we have been there regardless. One positive aspect of the crisis is that nurses are finally receiving attention for how vital we are to the healthcare system. We are worth what we are paid, and then some. Today, nurses are dying because they are doing their jobs. This is a tragic example of the art and science of nursing coming together. Some nurses are providing high-technology care, whereas others are holding the hands of dying patients and consoling families.
We know it is likely there will be relapses and that this disease is likely to revisit us every year with its colleague-influenza. Once we have a vaccine, we hope the incidence will be minimal or eliminated. However, just as with the flu and other illnesses for which there are vaccines, there will always be people who ignore our warnings and choose not to vaccinate themselves or their families. In time, the directives to wash your hands frequently and cover your mouth when you sneeze or cough-good advice during the best of times-will be forgotten. Nurses are not likely to lose the part of our job that requires us to be expert healthcare educators.
As rehabilitation nurses, we restore. We promote maximal self-care. We strive to increase the patient's independence and self-care agency. Once the acute nature of COVID-19 is over, rehabilitation nurses will need to model how we help patients and families manage the aftermath. We do not yet know if there will be any long-term physical effects of the disease. We do know there is likely to be grief, despair, confusion, and significant impact on older adults and those with comorbid conditions. How will young people think of their own health care after this crisis? Will they feel more vulnerable and less invincible? Will families decide not to send family members to long-term care facilities, including rehabilitation hospitals, because of fear of a contagious disease? If so, what kind of additional support will they need in the home? There may be exponential growth in the services needed in community settings. How will this crisis change how we deliver care? How will it change how we educate students? We are teaching online to comply with social distancing orders. Will students, our professional organizations, and ultimately politicians decide online learning is cheaper and easier to deliver and decide on-ground education is not worth paying for? Will the clinical agencies that provide invaluable direct patient care experiences for our students decide it's too much of a risk to have students on site?
Although today we are making our voices heard as we beg for more personal protective equipment to protect nurses and other healthcare providers, after the crisis, we need to continue to ensure nursing voices are heard loud and clear. We should harness this momentum as we advocate for our patients, students, healthcare policy, and our profession.
Stay well,
Leslie Neal-Boylan, PhD, APRN, CRRN, FAAN
Solomont School of Nursing
University of Massachusetts Lowell
Lowell, MA
E-mail: [email protected]