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Authors: Jessica Rainbow, Assistant Professor of Nursing, University of Arizona; Chloe Litzen,
Assistant Professor of Nursing at the University of Portland; and Claire Bethel,
Part-time lecturer in nursing at the University of Arizona.Originally published on dialogue.

Nurses stepped up to respond to the challenges of caring for patients during the pandemic and exceeded 1,150 of us died of COVID-19 With the surge in cases and deaths in the United States, nurses continue to work in a broken system Minimal support and resources Take care of critically ill patients, many of whom will still die.

US Yes Nurse and nurse scientist Study Nurse Welfare During the COVID-19 pandemic.One of our studies requires Shared voice mail for healthcare workers Regarding their experience in providing care during the COVID-19 pandemic, it is ongoing. We found in our research that nurses are struggling, and without the help of the public and healthcare system, they might give up nursing altogether.

To help you understand their experience, here are five key points for our research on nursing during the COVID-19 pandemic.

1. Calling nurses “heroes” is a harmful narrative

The nurses proved that they can do almost anything for the patient, even if risking one’s life. As of the end of December 2020, More than 1.6 million health care workers The world is infected with COVID-19, and nurses are the most affected group in many countries.

for this, The nurse is hailed as a hero. But this may be a dangerous label with negative consequences.Through this heroic narrative, expectations of what nurses should do become unrealistic, such as with Insufficient resources, staffing and safety precautionsAs a result, it becomes normal for nurses to extend working hours or work overtime, regardless of their personal impact.

This may eventually cause nurses to leave the industry due to burnout. A survey of more than 6,000 ICU nurses conducted by the American Association of Intensive Care Nurses found that 66% of respondents are considering leaving care Because of their nursing experience during the pandemic.Similarly, we found 67% of nurses under 30 Are considering leaving their organization in the next two years.

The nurses in our study put the needs of patients and society above themselves. A young nurse described their experience of caring for COVID-19 patients without any safety guidance: “There is a clear tension there…no one knows what happened or what was expected to happen. There is no real agreement yet. If a patient is admitted and you have to take care of a patient, you will feel like you have been thrown into the wolves as an experiment.”

2. Nurses lack sufficient resources or support

Despite working in the hospital, the nurses still take care of the patients Dangerous working environment. Although some healthcare organizations provide Increase the salary of traveling nursesOr contract a temporary nurse to solve the shortage of staff, but the discount did not extend to their full-time employees. Instead, many organizations need to work overtime and do not provide sufficient resources, Such as personal protective equipment or Support staff, For safe patient care. This makes many nurses feel undervalued, underestimated and insecure.

As one nurse in our study explained: “Lack of resources, lack of staffing, failure to solve all our problems, and so on. These are very energy intensive, especially when we should provide patient care and do a good job… ….. All the dramatic things at work, these are of no avail. If anything, it will only make the environment more toxic and unbearable. It certainly will, and at some point, it will start to affect … your mental and physical health, and even your mental health.”

3. Nurses lose trust in medical institutions

The nurse said they were working with Rapidly changing policies and proceduresEven when providing them with information about these changes, many healthcare organizations are not transparent about the reasons behind these changes and expect nurses to let the flow go.

To make matters worse, some healthcare organizations are refueling nurses because they are worried about their safety. For example, a young resident nurse described the frustration of management’s lack of communication: “They just didn’t tell us a lot. Our unit has three managers and seven clinical coordinators. There must be enough people to send emails and provide updates. , But they are not sure. They just chose radio silence, which is really frustrating and makes the whole situation more challenging. When they provide us with information, many of you are overreacting. You don’t need to wear it all the time. N95.”

The safety sacrifices made by nurses for their organizations and patients have had serious mental health consequences.exist A study Of the 472 nurses in California, 79.7% reported anxiety and 19% met the clinical criteria for major depression.

Another nurse in our study had a similar experience: “Our policy changes so fast that anesthetics usually have a different understanding [of the policy], Doctors and residents will have different understandings, and nurses will receive different e-mails within about half an hour. This is very frustrating. The pressure is very, very great. “

4. Nurses experience moral trauma

Nurses have been exposed to a large number of Moral harmThis happens when they witness, continue, or fail to stop something that contradicts their beliefs and expectations.

Not only do nurses see a large number of deaths every day, they are also in a moral dilemma due to resource shortages, such as Oxygen supply, ECMO machine Supports cardiorespiratory function, and Beds and staff. Even more conventional aspects of care, such as basic hygiene, Neglected, Which further contributes to the moral dilemma of nurses.

A nurse in our study described the ethical dilemma they encountered in making life support decisions for patients: “We were told very early…if this person needs a ventilator, they will not get it. Therefore, in To some extent, we determine the status of the code without actually consulting the patient, which is very problematic and unethical for me.”

5. Nurses are frustrated that the public is not taking the epidemic seriously

mask with vaccine Proven to help prevent the spread of COVID-19.However some Americans Still refuse to mask, And, as of November 1, 2021, Only 67% of the population Have received at least one dose of vaccine.

According to CDC data, 92% of COVID-19 cases and hospitalizations and 91% of COVID-19-related deaths belong to the following groups: Incomplete vaccination Between April and July 2021. In contrast, only 8% of COVID-19 cases and 9% of deaths occurred in fully vaccinated individuals.

Regardless of the vaccination status, the nurse will take care of the patient. Unfortunately, the public may not realize that their decision to refuse vaccinations or wear masks has serious consequences not only for nurses, but also for their friends and community members.When the hospital system is overwhelmed by unvaccinated COVID-19 patients, staff or resources to help those in need may be limited Take care of other medical emergencies. This is a frustrating experience for nurses who find that they cannot take care of every patient in need and protect people from COVID-19.

In one of our studies, a nurse recalled that she had to chase an unvaccinated pregnant woman with COVID-19. Although she was at risk of infecting others, she tried to leave the ICU and violated medical advice: “This too early [in the pandemic], We don’t know how far [the virus] Can travel. So I thought, would she infect the staff in the hall? Is anyone down there? You know, she just wants to go home and give this to her newborn. And… her husband looked at me and said, you know, basically Western medicine is not true, it’s not true, I think, well, it’s true. I think you have to give it to your newborn and your five children. “

How to help nurses

As the pandemic continues to overwhelm hospitals and communities across the United States, the impact on nurses needs to be carefully considered.The exhausted and demoralized nurses are Have quit or retired At an alarming speed.

Only time will tell what long-term impact the COVID-19 pandemic will have on the care industry. However, public and health care organizations can now step up to help nurses by increasing access to mental health support and providing adequate resources, safe working conditions, and organizational transparency during periods of great change. Everyone can protect themselves from COVID-19 by wearing masks and vaccinations.