DISASTER RESPONSE REPORT RELEASED
As Weeks noted in "Disaster Nursing: Taking Your Faith to the Field" (p. 236-242), the nursing workforce is inadequately prepared for disasters. The effects and demands of the COVID-19 pandemic have illuminated this insufficiency.
A group of 13 nurses and scholars are addressing this grave situation. "Recommendations for Improving National Nurse Preparedness for Pandemic Response: Early Lessons from COVID-19" was released on June 10, 2020, from the Center for Health Security at Johns Hopkins Bloomberg School of Public Health and confronts the situation with data and specific recommendations.
The report cites a COVID-19 survey by the American Nurses Association in 2020 in which 32,000 nurses responded. Results showed that 87% of respondent nurses acknowledged fear of going to work, a third of nurses had cared for an infectious patient without adequate personal protective equipment (PPE), and just 11% of nurses believed they were well prepared to care for a COVID-19 patient. More than half of the nurses who responded stated an urgent need for more education.
The report addresses multiple factors that influence the nursing workforce and the need for development and training, describing gaps and both short- and long-term steps "to improve the readiness, safety, and support of the national nursing workforce for COVID-19 and future pandemics" (Veenema et al., 2020, p. 3).
The recommendation framework is categorized into three levels: national, systems/organizations, and individuals. Specific recommendations include the funding of a National Center for Disaster Nursing and Public Health Emergency Response that would promote training, career development, and networking opportunities for all levels of the nursing workforce. Schools of nursing are called on to develop and implement "robust metrics" to evaluate nurses' preparedness in academia and throughout nurses' lifelong learning (Veenema et al., 2020, p. 4). To assist schools and universities in improved preparation, the American Association of Colleges of Nursing is called on to revise their Essentials curriculum tool kit.
Funding of research for pandemic planning, including training of nurse scientists, is strongly recommended, and better funding of public health is urgently needed. The report notes that a 2017 accounting showed that just 2.5% of all health spending was for public health.
Individual nurses in every part of the workforce would benefit from the framework in relation to staff development in the workplace, access to adequate PPE, instruction in nursing schools, clinical competence, and addressing physical, mental, and emotional wellness and personal preparedness.
Veenema T. G., Meyer D., Bell S. A., Couig M. P., Friese C. R., Lavin R., Stanley J., Martin E., Montague M., Toner E., Schoch-Spana M., Cicero A., Inglesby T. (2020). Recommendations for improving national nurse preparedness for pandemic response: Early lessons from COVID-19. https://www.centerforhealthsecurity.org/our-work/publications/recommendations-fo[Context Link]
POSTTRAUMATIC STRESS DISORDER AFFECTS NURSES
In 1945, when Dorothy Still served as a nurse in the United States Navy, she met with a Navy psychiatrist to discuss disturbing symptoms she was experiencing. As one of 12 Navy nurses held prisoner for 3 years during World War II, she and the other nurses provided care to diseased, starving, and destitute civilian inmates in a makeshift infirmary at a POW camp. After being freed, she cried easily and was unable to stop her tears (Danner, 1995). Today, experts recognize that Still most likely suffered from posttraumatic stress disorder (PTSD). Mental health experts recognize that PTSD can affect nurses, both military and civilian.
Posttraumatic stress disorder is a psychiatric disorder that can occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, rape or other violent personal assault. The condition has been known by many names, such as "shell shock" during the years of World War I and "combat fatigue" after World War II. But PTSD does not just happen to combat veterans; it can occur in any person of any ethnicity, nationality, or culture, and at any age. Approximately 3.5% of U.S. adults are affected by PTSD, and an estimated 1 in 11 people will be diagnosed with PTSD in their lifetime. Women are twice as likely as men to have PTSD (American Psychiatric Association, 2020). Mealer and colleagues' study of resilience in nurses determined that "resilience can be learned by adopting positive coping skills, engaging the support of others, optimism, humor, and cognitive restructuring" (Mealer et al., 2017, p. 185).
Posttraumatic stress disorder is a reality for nurses and other healthcare professionals. For information on assisting those with PTSD, see: https://www.helpguide.org/articles/ptsd-trauma/helping-someone-with-ptsd.htm
American Psychiatric Association. (2020). What is posttraumatic stress disorder?https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd[Context Link]
Danner D. S. (1995). What a way to spend a war: Navy nurse POWs in the Philippines. Naval Institute Press. [Context Link]
Mealer M., Jones J., Meek P. (2017). Factors affecting resilience and development of posttraumatic stress disorder in critical care nurses. American Journal of Critical Care, 26(3), 184-192. https://doi.org/10.4037/ajcc2017798[Context Link]
CELIAC DISEASE'S FAMILY CONNECTION
Recent findings indicate that most celiac disease patients are asymptomatic or have nonclassic presentations, observed Nellikkal and colleagues after studying the prevalence of first-degree relatives among celiac sufferers (Nellikkal et al., 2019). This confirms the need for a low screening threshold for celiac disease, the researchers added.
The study team has sought to improve detection rates of celiac disease in undiagnosed people because diagnosis and treatment may prevent long-term complications such as nutritional deficiencies, development of new autoimmune conditions, and small bowel cancer known to happen in undiagnosed celiac disease patients.
The Celiac Disease Foundation states that an estimated 1 in 100 people globally has celiac disease; up to 2.5 million Americans have the hereditary condition and don't know it. Individuals with a first-degree relative-a parent, child, or sibling-have a 1 in 10 risk for developing the autoimmune condition (Celiac Disease Foundation, 2020).
As a result of the study, researchers and healthcare providers recommend that first-degree relatives of a person with celiac disease be tested for the condition.
Celiac Disease Foundation. (2020). What is celiac disease?https://celiac.org/about-celiac-disease/what-is-celiac-disease/[Context Link]
Nellikkal S. S., Hafed Y., Larson J. J., Murray J. A., Absah I. (2019). High prevalence of celiac disease among screened first-degree relatives. Mayo Clinic Proceedings, 94(9), 1807-1813. https://doi.org/10.1016/j.mayocp.2019.03.027[Context Link]
PERCEIVING BEAUTY IN INTERRUPTIONS
Author and theologian Timothy Willard studied beauty in the works of C. S. Lewis for his PhD. He advocates for pursuing beauty, as it points us to its creator, God.
Sometimes beauty comes to us unexpectedly in the quiet corners of the day. The interruption of pouring rain outside your window. Watching a chipmunk scale your blueberry bush, stealing away with the blue treasure. Hearing a song that used to be one of your favorites, from a different time, a different place. Overhearing your daughter discover the moon while the sun still shines.
The unexpected. The interruptions.
And there, in the quiet of your day, God finds you. There he wraps you in his whispers: "Blessed are you...blessed are you."
You, the blessed one. You, the happy one.
Be on the lookout for unexpected beauty. Be aware of the interruptions accompanied by beauty. It's here we find the joy of birds. It's here we find that God is not only aware of us, but actively wooing us. For the interruptions are mere signposts-beautiful placards of joy pointed directly at the One who loves us.
"For you make him most blessed forever; you make him glad with the joy of your presence" (Psalm 21:6, ESV).
Lord, Jesus, may your beauty come to me in the moment I need it most. Your compassions are new every morning. Bless me with your interruptions.
Willard, T. (2014). Longing for more: Daily reflections on finding God in the rhythms of life. Baker Publishing Group.
PulseBeats compiled by Karen Schmidt and Cathy Walker.