On The Front Lines: The Role of Nurses During a Pandemic
Storybook heroes wear capes. True heroes wear scrubs.
The virus that causes COVID-19 burst onto the world stage unexpectedly, quickly becoming a global pandemic and grinding entire cities, states, and economies to a halt.
The suddenness of the Coronavirus caught many off-guard, but fortunately, the largest trained contingent of healthcare workers around the world were already on the job trying to stem the tide of this terrifying pandemic.
Nurses. They were there for the Spanish Flu, for Polio, for Ebola, and now, they stand between COVID-19 and the rest of the world.
The Role of Nurses in a Pandemic
In “Expanding nursing’s role in responding to global pandemics,” the American Academy of Nursing asserts that nurses are prepared for the leadership roles in policy decisions of health systems and government agencies and can prepare for, identify, respond to, and direct recovery efforts for global pandemics that require an informed, internationally coordinated response.
In other words, nurses are (and have always been) uniquely equipped to deal with the prolonged crisis of a pandemic, and their presence on the front lines is one of our greatest defenses against disease.
How Nurses Fight Coronavirus Daily
Patient Care
While researchers battle viruses like SARS-CoV-2 in laboratories and clinical studies, nurses are facing this threat head on, directly interacting with countless patients who may be carrying the virus. Their role is critical to the entire health care operation and pandemic response—processing, assessing, and triaging patients quickly and efficiently.
Nurses are ideal for this task because of their existing experience working directly with patients. By tapping into that experience and quickly assessing a patient’s condition, the spread of infection can (and often is) drastically limited. Patients who test positive or show symptoms are quickly moved to quarantine, protecting other patients who may not have the disease.
It’s also primarily up to the nursing staff of a hospital to carry out infectious disease prevention—added steps and social distancing techniques designed to prevent Coronavirus from quickly spreading within the hospital setting.
Those symptoms (provided by the CDC) for the Coronavirus include:
- Fever
- Cough
- Shortness of Breath
Note: The CDC warns that symptoms may not appear until 2 to 14 days after Coronavirus exposure.
The number of infected continues to climb, with estimates nearing 470,000 cases and over 21,000 fatalities across 173 countries as of March 25, 2020, and nearly one-third of the entire global population is now on lockdown. The United States is also currently one of the hardest hit countries by number of cases. New York alone, with over 33,000 cases, accounts for approximately 7% of the entire number of cases on the planet.
The highly contagious nature of COVID-19 poses an obvious threat to the 2.86 million registered nurses in America who are fighting the disease, and nurses begin each shift with the knowledge that today may be the day the virus catches up with them. Hospital policy, lack of available tests, and privacy laws prevent the exact number of infected nurses from being known.
In China, an early study found that 29% of the patients in one hospital were medical professionals, and that nurses were at a much higher risk of infection due to the bedside nature of their duties.
One major challenge nurses face is the scarcity of tests and the rigid rules surrounding who can take them.
A 31-year-old ICU nurse in Portland, Oregon (who wished to remain anonymous), said the tests policies are “so strict, that almost no one is allowed to get tested. It’s almost impossible to have all of these criteria, which is why no employees have been tested, and very few patients… but I think that’s across the board for all hospital systems right now.”
Managing Medical Supplies & Equipment
Another role that nurses play during a pandemic is maintaining supplies of medical equipment and protective items such as masks, gloves, and hand sanitizer. These resources can easily become scarce during a crisis, and nurses play a vital role in safeguarding these supplies from theft or hoarding.
For example, Wendy Shaw, a nurse in Washington State, is in charge of protecting and rationing these types of medical supplies. Whenever an item is requested, Shaw immediately responds with a list of pre-written questions to ensure that certain supplies are being used appropriately.
“What are you using it for? What patient? What’s the procedure?” she says. “I have become a ‘jailer’ in a sense of these masks. We now have to learn how to work with less, and how to be good stewards of the resources that we have.”
Enforcing Sanitation
Proper sanitation is one of the most important factors in turning the tide of a pandemic. Viruses such as COVID-19 can remain on surfaces for hours, sometimes longer, making regular and thorough cleaning a life-or-death necessity.
Because nurses work so closely and so regularly with patients, it often falls on them to enforce sanitation rules and procedures.
Working Overtime
During a pandemic, nurses can expect to work longer shifts, especially as the virus spreads and healthcare workers themselves fall ill, leaving gaps in the workforce.
In some countries, such as Canada and the UK, nurses are even being asked to return to work from retirement to help fill the need.
Other nurses, particularly ones whose age puts them at additional risk of COVID-19, have found other ways to help—such as manning the emergency health lines for hospitals and clinics.
“I want to do what I can, offer what I can,” says 74-year old nurse Marie-Rhein Seguin, who volunteered to answer health line phones in Quebec. “In any case, I can’t travel.”
The United States has also begun similar programs, calling for nurses and medical staff to return from retirement to help.
In Italy, one of the hardest hit countries, nurses have begun sharing post-shift selfies as a way of demonstrating the seriousness of their tasks. For example, nurses like Alessia Bonari recently posted an Instagram selfie, displaying the dark circles and bruising on her face from wearing protective gear for multiple shifts at a time.
Spreading Knowledge & Awareness
Nurses must teach others everything they practice, from symptom awareness and sanitation to disease prevention.
As the frontline of healthcare, nurses bear the additional responsibility of educating their patients and the general public on how to stay healthy and prevent the virus from spreading.
While information on things like proper handwashing, social distancing, and sanitation can be found from many sources, nurses have a more powerful voice than most.
For nearly two decades, nurses have been voted as the most trusted profession in the United States. So, while people may doubt the news, politicians, or what they read on the internet, they’re much more likely to listen to and heed the advice (and direction) from nurses.
The Dangers Nurses Face During A Pandemic
Infection
By being on the frontline of a virus outbreak, nurses and other healthcare workers assume the risk of contracting the disease. When caring for sick patients, they can be exposed to the virus even when following all safety guidelines and procedures.
While newer policies and upgraded equipment have lessened the risk to nurses in recent years, nurses must still exercise caution—for their sake and for the sake of their friends and family with whom they have regular contact.
Burnout
Longer shifts and higher stress levels are likely to occur during a pandemic, which can result in burnout for many nurses.
When fighting against disease, managing stress and avoiding burnout must be a top priority. Therefore, nurses must take all the necessary precaution to protect themselves both physically and psychologically.
Here are a few ways nurses can avoid burnout in the midst of the COVID-19 pandemic:
- Mindfulness – Be aware of what you’re thinking and what you’re feeling, and when your body (or mind) is telling you that you need a break.
- Take Real Breaks – If you have a moment to rest, make sure you rest! Avoid the temptation to scroll through disease updates on social media or filling up the free space with other chores or responsibilities. Do something to let you body and mind completely relax… the disease will still be there when you get back.
- Get Away – You can’t (or shouldn’t) leave on vacation during a pandemic, but you can go home and rest. If you’re feeling overwhelmed or exhausted, forcing yourself to stay at work puts you and your patients in danger.
- Practice Deep-Breathing Techniques – Take five to ten deep breaths between patients to ground yourself.
- Eat Right – How you fuel your body plays a big part in your overall spirit, energy, and mindset. Avoid the junk food temptation and try to eat healthy whenever possible.
- Drink Lots of Water – Water is essential for many things, and preventing burnout and exhaustion is one of them. There are many additional benefits to staying hydrated as well, so drink up.
Our Nurses, Our Heroes
Despite the struggles, frustrations, and risks associated with their jobs, nurses around the world have remained strong and steadfast in the face of overwhelming odds.
These heroes duck in and out of hospitals by the hour, many of whose stories may never be told but will forever be appreciated by those who received their help.
Heroes such as ICU nurse Elizabeth Douglas of New York City, a mother of two who’s been working 13-hour days, five days a week, at the epicenter of the viral crisis despite overcrowding in the hospital and a lack of protective gear.
“It’s rough,” she admits. “I know there’s a risk of me being infected, I’m with positive patients everyday… but I do it because I’m a nurse and that’s what I do.”
WATCH: Dutch citizens applaud their country’s healthcare workers from quarantine.
Others, like nurse Molly DeSiegler in Fargo, North Dakota, volunteered to walk into the threat simply because she knew people needed help.
“To the public and to our staff, this whole situation can seem overwhelming and scary. It’s unknown. This is a different type of COVID that we don’t know a ton about yet. But these are still patients. They’re still a loved one to someone else. They need to be cared for,” DeSpiegler said.
“If I was the sister or mother, I would hope that there would be a nurse that wants to be there, providing exceptional and safe care.”
Perhaps the heroism is best captured by Doris Grinspun, head of the Registered Nurse Association of Ontario, whose call for volunteers was answered by over 3,300 nurses.
“Our nursing tribe,” she says, “this is the way we are.”
A Final Message
There are so many stories and examples of nurses who have saved the lines of countless individuals and it would be impossible to fit them all into a single article.
All we can do is try our best to express our sincerest heartfelt gratitude to these brave men and women who (without hesitation) answer the call every single day.
To all the nurses that are out there caring for the sick and injured during these difficult circumstances, and who are probably too busy to see read this article, we have one message.
We see you. We honor you. And we salute you. Thank you for being our heroes.
