Nurses spend more time with patients than most other types of providers and have unique insight into patient care and the the healthcare system.

Building Back Better: Constructive Nursing Regulation

As governor of the first COVID-19 epicenter in the country, Andrew Cuomo challenged New Yorkers to think about how the state could “build back better” after the crisis. As registered nurses with experience in health law and policy, we have recommendations for transforming the boards of nursing. The manner in which nurses are regulated must be reformed, not just in New York, but throughout the country. It must begin by understanding the dangerous environments in which nurses are working.

Staffing, safety issues affect both nurses and patients.

In May, for example, Governor Cuomo reported that 12.2% of health care workers in New York city had been diagnosed with COVID-19. Nationwide, more than 164 nurses have died, often because they lacked adequate personal protective equipment. But COVID-19 is not the only dangerous situation. Long-term and psychiatric care facilities, as well as hospitals, are often dangerously understaffed, exposing nurses to violence. Nurses and other workers have been attacked and sometimes killed because they lack necessary resources and protections. Workplace violence is a growing threat which has not been adequately addressed by health care managers and administrators. Danger to patients occurs when nurses are expected to accept assignments outside of their areas of expertise. Nurses cannot care […]

Every Frontline has a Backline: What Nursing Can Learn from Rugby

Photo credit: KJ Feury

Have you ever had a day at work that could only be fixed by an ice cream from your favorite creamery or by a hug from your best friend? Every shift during the height of the COVID-19 pandemic felt like this.

Unfortunately, because I work as an RN in a pediatric ICU at a large hospital in northern New Jersey, social restrictions that coincide with COVID-19 forestalled my usual comfort measures. After the start of the COVID-19 pandemic and during my reassignment in the COVID-19 ICU, I could no longer truly “leave” work. Work came home and walked with me throughout my day.

Dozens of IV pumps lining hallways, countless boxes of gowns, gloves, masks, and rubber shoes scattering the unit; ventilator alarms sounding; coworkers with surgical caps and masks, only identifiable by their eyes. The once medical–surgical unit transformed into a critical care unit equipped to care for COVID-19 patients.

After donning and doffing personal protective equipment (PPE), giving medication, adjusting ventilators, and updating families, you leave your 12+ hour shift wondering if you did your best. In the chaos of an unfamiliar unit, caring for patients with an unfamiliar virus, did I do everything to create the best outcome for my […]

A Message from Frontline Nurses: Let’s Keep the Real Enemy in Sight

The recent protests against stay-at-home restrictions across the country are painful to watch for nurses most affected by the pandemic, those caring for COVID-19 patients. Four RNs working in hospitals in New York City who are graduate students at the Lienhard School of Nursing at Pace University decided to work together with one of their professors to share their thoughts on behalf of nurses on the front lines.

There are refrigerator trucks filled with bodies outside our hospitals. Many of us have to pass by them when we go into work, knowing that among those bodies are the patients we cared for yesterday and when we leave 12 hours later, some of the patients we cared for today will join them. Even harder to handle is the knowledge that among those bodies may be a colleague or friend, fellow nurses who caught COVID-19 while caring for others. It is heartbreaking and terrifying because we know that we too could end up in a body bag shelved in a refrigerator truck.

So, it is no wonder that the sight of people protesting protective measures generates such strong emotions for us—anger, fear, sadness. Anger that in choosing to ignore restrictions, or insisting on the right to risk their own health, they […]

Two Poems by an ED Nurse

Mask

         -from Latin, masca (specter, nightmare)

My borrowed face,

incorporeal,                blue—

I give you        only

my eyes.

First Sunday on the Ward, Pandemic

Deft swallows nest inside the thorny crown of a stone Christ.

I whisper Our Father . . .                   

twice

over the scrub sink.

 

-Editor’s note: These two spare poems were sent to us recently by Stacy Nigliazzo, an ED nurse and poet whose work has been featured in JAMA and the Bellevue Literary Review, as well as in AJN’s Art of Nursing column. We don’t usually publish poems on this blog, but make an exception here because they seemed to us urgent and yet timeless. Publishing them implies no affiliation of AJN with any particular religion. At the same time, it’s only natural that faiths and practices of every sort are likely to be a source of strength and meaning during this time for nurses around the world. 

2020-04-10T13:39:42-04:00April 10th, 2020|Nursing, nursing perspective|2 Comments

Preserving Integrity and Staying Power as a Nurse in a Pandemic

We are in unprecedented times—uncertainty and fear are ever present and nurses are being called to serve others in ways that challenge our appraisal of benefit to our patients and risk to our families’ health and well-being. Many of us are experiencing varying degrees of moral distress and moral outrage arising from the gaps between what we ought to be doing and what we are actually doing under these adverse conditions. It can feel as if it is impossible to do ‘the right thing.’

What can we do to remain whole in the midst of the COVID-19 crisis? How can we accept what seems unacceptable?

Instead of using precious energy in unproductive ways, we can focus on the things that are within our control for meeting the demands of the situation with integrity.

Recognize your moral distress.

It’s easy to get swept away with fear. When fear takes over, we can become paralyzed—unable to think clearly or to act in accordance with our values. One way to confront our fear is to recognize and name the source of the angst.

What is causing your distress? Notice tension anywhere in your body. Accept whatever it is you find. What are the conflicting obligations you are confronting? Try to name the conflict.

You may realize that your core value in the current situation is to not cause harm to your patients. You may say to yourself, […]

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