As the world emerges from the grip of a pandemic that created so much suffering through lost lives, long-term illnesses and economic devastation, we must pause and reflect on lessons learned to inform the future. Here are a several takeaways I believe should shepherd future plans.
- For any globalization and interconnectedness skeptics, we are a global community. What happens in one corner of the world effects everyone else, locally and globally. Nurses always have been a global force, working across nations. They can lead the planning for disasters.
- We were not ready to deal with the spread of the virus, nor to deal with its devastating effects on patients, families and communities. We did not have enough masks for the public, personal protective equipment (PPE) for health professionals, ventilators in our ICUs for patients or disaster plans in place for implementation. Can we do better in the future? Yes! Only if implementation plans are made, rehearsed, periodically modified and tested.
- In every society, the vulnerable and the marginalized became more vulnerable and more marginalized. Note the higher percentage of illness and death among the elderly, the vaccination rate disparities between the majorities and the minorities, the rate of infection variabilities among different ethnic groups and the inability of the poor and frontline workers to shelter at home and to use distancing in their own communities. We saw how women suffered as caregivers, trying to hold jobs while monitoring their children’s education from home. Women were among those affected the most, and many either gave up their employment or significantly curtailed their careers. Systemic inequities must be addressed continuously.
- We learned that partnerships and collaborations are vital for implementing viable prevention protocols, as well as for research to develop and produce vaccines. Competitive drug companies teamed together, countries collaborated to deal with border and sheltering policies and health care professionals saw the positive outcomes of working in egalitarian teams. Collaborations between countries were vital in the battle to decrease Covid’s spread. Partnerships and collaborations must be developed and fostered in education programs, as well as in health care organizations. Investments in interprofessional education and interdisciplinary research should become the norm.
- We learned about different modes of communication, and that working, teaching and doing research remotely were possible. Zooming became a viable option and part of our lexicon. But again, disparities manifested, as students with limited Wi-Fi access could not connect, profoundly affecting their learning. The elderly, who were not computer literate, could not schedule or get to their health care appointments or vaccination sites. Creative solutions are needed to ensure access equity.
Furthermore, I believe the pandemic amplified many take home messages for nurses:
- It became even more apparent that without the 24-hour care nurses provide, hospitals were not able to admit, care for and heal patients. Beds were closed and ICUs did not admit patients. The pandemic highlighted the severe global shortage of nurses. While the WHO’s 2020 State of the World’s Nursing Report presented compelling data on global shortages and highlighted the need for more nurses with higher education and more nurses in leadership roles, it took a global pandemic to make this data real. Because there was a shortage of nursing care, nurses traveled across the country to help in hospitals that lacked needed staff, ICUs closed beds and patients were sent home prematurely.
- Nurses’ creativity and innovation shined globally in the face of uncertainty about the virus and treatment. Nurses found ways to incorporate families in spite of mandated quarantine and isolation. To support their patients, they used virtual applications to ensure families were connected and able to support their loved ones and able to say goodbyes when patients were near death. Nurses celebrated weddings and birthdays, combining knowledge about social support and meaning of life with evidence about infection control and palliative care, all while providing compassionate care that was much needed in life and death situations.
- Another important lesson was the incredible professional commitment of nurses to their patients. Nurses, physicians and other health care and frontline providers continued to fulfill their professional roles and never faltered in providing care at the expense of their own health and their families’ health. Many opted to stay in hotels, away from home, to protect their families while providing care to their Covid patients. Nurses are stoic, professional and loyal to the principles and values of our profession. They are creative and resilient.
- We learned that when policies are not protective of nurses - when there are compromised staffing levels and a scarcity of PPE to protect them - that nurses’ mental health is profoundly affected. Nurses care about their patients’ physical and psychological safety and health. Therefore, when patients suffered because of the lack of ventilators and the inability of families to visit, patients’ suffering was also nurses’ suffering, leading to mental meltdowns on top of the physical exhaustion they experienced.
- The pandemic triggered educational changes that closed universities and opened up distance learning. This left faculty with quandaries as to how to provide virtual clinical rotations. The different experiences and responses to these major changes and their effect on graduating nurses who can safely transition into employment need to be carefully studied and warrant thoughtful planning for the future. Similarly, future research protocols also may require anticipation of unanticipated disruptions.
The above are just some of the lessons that should inform planning and decision-making in preparing for a future in which other major disruptions may occur.
