Cast Into the Shadows: COVID-19’s Power Over Non-COVID Cases

As a pediatric ICU nurse in a hospital that has not experienced an overwhelming surge of COVID-19 patients, it has taken me some time to register the ways this pandemic has affected my perspective and practice.

Non-COVID diagnoses left in the shadows.

Photo by Unjay Markiewicz/ Unsplash

I recently took care of two young patients, each with acute and unexpected conditions. One was under post-operative care after a brain tumor had been removed the day before. The other had been newly diagnosed with acute lymphoblastic leukemia. What stood out to me as I interacted with their families was that these were some of the only people I would interact with in this period who did not have COVID foregrounded in their mental and emotional space. This feeling was followed by the sobering realization that this was only because they found themselves dealing with something just as insidious, if not more so.

In both cases, the families observed confusing symptoms in their children and had to wrestle with whether or not to go to the ED in the midst of a pandemic. Only when the symptoms became so severe and concerning did these families decide they could no longer avoid the ED. Now facing an inpatient hospital […]

2020-06-02T09:32:44-04:00June 2nd, 2020|family experience, infectious diseases, Nursing, nursing stories, patient engagement, Public health|1 Comment
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Time Matters, Priorities Change: A Nurse and Cancer Survivor on Living with the Pandemic

Everything is different, and the same.

Michael Himbeault/Wikimedia Commons

It’s going to be a while before things get to normal, if they ever do. It’s more like the future will become the normal.

The only thing in my experience I can liken it to is my cancer survivorship: you start living your life again, but everything is different. Priorities change. Your sense of safety never fully returns, yet because of this you become more purposeful in living: time matters. It’s as though you go on living, but learn a new way to do it.

There’s actually a sense of freedom accompanying the realization that nothing/no one lasts forever.

Finding a middle ground.

After I completed treatment, I watched the Jeff Bridges film Fearless (1993). His character is a survivor of a horrendous airliner crash, and he develops a sense of invincibility as a way of coping. I understood his character really well. You either hide in fear, or you go forward as if you are invincible. Eventually, you discover a middle ground. […]

2020-05-27T10:26:29-04:00May 27th, 2020|infectious diseases, Nursing, patient experience, Public health, wellness|0 Comments
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COVID-19: It’s Not Only About Hospital-Based Nurses

‘We all just went charging towards this monster…’

We’ve all seen the photos of nurses in PPE providing care to patients who are obviously very ill with COVID-19. These nurses have justifiably received recognition and accolades for their commitment to duty under the most challenging circumstances and often at great personal risk.

I recently spoke with Megan Brunson, the president of the American Association of Critical-Care Nurses (AACN), who is also a supervisor in the cardiovascular ICU at Medical City Dallas Hospital.

Brunson described her own experiences, but also what she was hearing from her colleagues as they all “just went charging towards this monster called COVID.” She also talked about how the organization was rapidly developing resources, not only for clinical care but to help nurses deal with emotional stress. One initiative is partnering with DearWorld.org to create a collection of portraits and stories from nurses caring for patients with COVID-19.

Disrupting work in many settings.

But it behooves us to realize that this pandemic has not caused stress and critical challenges just for acute care nurses; nurses in many settings have been challenged and have had their work disrupted.

In the last two weeks, I spoke with nurses and nursing leaders of several organizations to learn about how the coronavirus pandemic has changed their work. […]

2020-05-15T17:09:36-04:00May 15th, 2020|COVID-19, infectious diseases, Nursing, nursing roles|0 Comments
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Addressing Clinician Mental Health and Suicide Risk During the Pandemic

Pandemics are known to cause panic disorder, anxiety, depression, sleep disturbances, and posttraumatic stress. Depression can lead to suicide if not treated, yet is a treatable disease. We have seen nurses die by suicide during this pandemic in Italy.

Past experience suggests that health care workers exposed to the stress of the pandemic will need help long after the pandemic is under control.

I am serving as co-chair of the Strength Through Resilience task force of the American Nurses Association, whose focus was originally to collate resources to reduce suicide among nurses. We quickly shifted gears when the pandemic hit to collate resources to optimize resiliency and mental health among nurses in relation to the projected impact of the pandemic. Curiously, these resources are virtually identical. The ANA has posted initial resources as part of their Healthy Nurse, Healthy Nation campaign and is and building more resources as quickly as possible.

Nurses already at higher suicide risk.

The added stress of the pandemic is particularly problematic because of evidence that emerged before the pandemic that nurses were at higher risk of suicide than the general public. If leaders at health care organizations have not already started proactively screening […]

2020-05-12T16:27:31-04:00May 12th, 2020|COVID-19, mental illness, Nursing, Public health|0 Comments
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A Safety Paradox: Stay-at-Home Policies and Domestic Violence Risks

What happens when the very measures put in place to keep us safe and healthy instead place us at risk for harm? For women in abusive relationships, the stay-at-home strategy for controlling the spread of COVID-19 can do just that.

A perfect storm of risk factors for escalating violence.

High stress levels, loss of a sense of control, unemployment, increased time together—all are known to increase the frequency and intensity of intimate partner violence (IPV). A study of IPV rates before and after Hurricane Katrina found a 98% increase in physical IPV and a 35% increase in psychological IPV against women after the hurricane, with stressors as one of the strongest predictors for increased violence. IPV rates are known to rise with unemployment rates; a study of IPV during the economic recession of 2007-2008 found that a rapid rise in unemployment led to increased violence and controlling behaviors. And multiple studies have found that IPV incidents occur at much higher rates on weekends and during the summer—times when couples spend more time together. With Covid-19, people are suddenly unemployed and experiencing stress due to economic hardship, fear of illness, and uncertainty about the future. And couples are now spending all their time […]

2020-05-04T12:27:03-04:00May 4th, 2020|Nursing, Public health, women's health|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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