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, […]

The U.S. Still Can’t Manage COVID-19 Testing: Why Is This Such a Big Deal?

By Betsy Todd, MPH, RN, nurse epidemiologist and AJN clinical editor. Published April 20.

How is it that we in the U.S. make up 4% of the world’s population but account for more than 31% of global COVID-19 cases? Because at the start of the pandemic we weren’t prepared to test quickly and widely—and incredibly, after three months’ time, we still aren’t.

Coincidentally, both the U.S. and South Korea saw their first cases of COVID-19 on January 20. Two weeks later, South Korean scientists had perfected a diagnostic test for the virus, and infected people began to be identified and isolated.

Meanwhile, in the U.S. a series of problems and poor decisions held back test development. In early March, as the number of cases of COVID-19 exploded in parts of the country, Health and Human Services Secretary Alex Azar promised that by March 14, labs would be running four million tests per week. As of April 20, the total number of SARS-CoV-2 tests performed in the U.S. since the pandemic began was only 3.8 million, according to covidtracker.com. Our testing capacity is frighteningly low. Estimates of an adequate […]

Practicing the ABCDEs of Self-Care in Pandemic Times

While talk of the surge in COVID-19 cases continues, what has been less audible in the national discourse is the surge in mental health distress that will be with us long after the pandemic is gone. Many of us who have enjoyed relative psychological well-being are feeling inundated with near-pathological levels of anxiety, uncertainty, anticipatory grief, and real or secondary trauma.

Here are ABCDEs of self-care to keep yourself and loved ones emotionally—and physically—well.

ABCDEs of Self-Care

About

Stay informed as you need to regarding the pandemic, but then promptly pull yourself away and unplug. Initiate what we call a “sensory diet” to limit anxiety-provoking exposure to TV and radio news, social media, print materials, etc., beyond what you must know for yourself, your family, and/or your job. Fearful news can be addictive. Don’t overindulge!

Body

Many people, when asked how they can best care for themselves to stay well, say something on the order of “handwashing, masks, social distancing….” Sure, all that! But we also need to respect the healthy things our mother tried to teach us. How about exercise and fresh air (even if it’s just a three-minute brisk walk around the block), adequate sleep and decent nutrition? Honoring our bodies now will help us stay healthy and […]

Far from Home, a Flight Nurse Cares for One of COVID-19’s ‘Peripheral Victims’

‘Deemed stable to fly home.’

Our fixed-wing air ambulance was recently dispatched to Spain to bring 87-year-old John and his wife of 62 years, Rose, home to the US. They’d traveled to Spain for their annual vacation before “COVID-19” or “coronavirus” were household terms, but John had fallen early on in the trip and broken a hip. He’d spent four weeks in a local hospital and had his injured hip surgically repaired, and then was deemed “stable to fly home” by a doctor. And so he’d been transported back to his hotel two days prior to our arrival. The crew deposited him in the bed, bid farewell to his wife, and left.

Spain’s deserted beaches seen from author’s hotel room, March 2020

And now John was dying. He lay on the twin bed in his hotel room. His eyes were closed. His breathing was rapid and shallow. My partner and I stood, stunned into momentary silence. We had come straight to his hotel from the airport, and his condition was far worse than we had anticipated.

We’d left our equipment in the aircraft, as John’s transport was planned for the following morning to allow time for our pilots to rest. John’s respiratory rate was 60 with frequent pauses, his pulse weak, heart rate about 95 and irregular. He wouldn’t open his eyes or respond to us verbally, but he fought us when we tried to move him. He was covered in feces.

No room at […]

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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