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

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 […]

COVID-19: On and On

A note from AJN’s editor-in-chief Shawn Kennedy.

Published: March 30. As I write this, the United States has over 140,000 COVID-19 cases and over 2,400 deaths, and we’re told those numbers have yet to peak. The US Navy hospital ship Comfort is on it’s way to New York City, bringing its 1,000 beds to be used as a supplemental hospital. Its sister ship Mercy is on its way to Los Angeles. Bedside nurses and CNOs alike talk about the “war zone” that their hospitals have become. And they’re exhausted: many ICU nurses are working five days of 12-hour shifts as they await help from nurses who are getting crash courses in ventilator management.

Perspectives for and by nurses, from many angles.

Our goals during this pandemic are to serve as a reliable and up-to-date source of information and advocacy for those on the front line, to bear witness and give nurses and other health workers a voice during these uncertain times.

We’ve been using this blog to bring you evidence-based information about the COVID-19 pandemic, mostly via posts by our clinical editor Betsy Todd, whose expertise is in public health and infectious disease. She has done a yeoman’s job, researching the latest information and ensuring what we publish on PPE and COVID-19 is in in accord with the most current state of knowledge at the time—even contacting study researchers to verify facts […]

Moral Courage in a Pandemic: a 14th Century Physician and Health Care Workers Today

What does it mean to be human? What values should we live by? How should we respond to those in need during a time of crisis? What would I do?

A physician during the Black Death.

Guy de Chauliac

As a hospice social worker who loves the humanities, I find that historical figures often come to mind when there’s a parallel with things that are happening with patients and their families. Amidst the COVID-19 pandemic, I’ve been thinking a lot about a 14th century French physician named Guy de Chauliac.

Although little known today, in his time he was one of Europe’s most respected medical practitioners. In fact, his text Chirurgia Magna was a standard part of medical education for 200 years.

I came across de Chauliac’s story years ago while researching the ‘Black Death,’ the plague that decimated Europe in the 1340s, killing up to a third of its population.

Those who have read Giovanni Boccaccio’s contemporary account of this plague in his work Decameron are often left with a cynical impression that, as Boccaccio puts […]

Deserted: Note from a Young ICU Nurse as COVID-19 Pandemic Intensifies in U.S.

The following note came to us from a young ICU nurse in New York State. Based on other accounts we are hearing, her working conditions and the risks they put her and her colleagues in may be far from unusual at the current moment. 

Coworkers and I are feeling a vast array of emotions and one of the worst ones we feel is deserted—we hear very little from hospital administrators (except when management comes to sign out our daily masks to us).

Our earliest confirmed COVID case was not isolated or swabbed for COVID until the day he died (at which point countless staff had been exposed). Several of us nurses requested that the patient be tested earlier in his admission, but mostly due to lack of preparedness and testing protocols on the hospital’s part, the patient was not tested until the fifth day of his admission.

Meanwhile, hospital administrators had sent us text messages telling us that we were not allowed to use any masks in patient rooms unless the patient was officially ordered for isolation precautions, in anticipation of PPE shortages. So, despite our suspicions that the patient had COVID, we were not able to protect ourselves. Hospital staff like me who worked closely with the patient were not informed that he had become an official suspected case until after test results came back, resulting in widespread exposures to staff and their families. The overwhelmed occupational health department gave very little guidance […]

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