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A year nursing in COVID times: working in a time capsule and how to get out



Today I had a meeting with an intensive care nurse, who, like many other nurses in Europe, has been working for a year under COVID19 conditions. The meeting was a short catch-up, a brief “how is life?” conversation. Reflecting upon her story and also many other stories over the past days, with colleagues from Europe, Malta, Croatia, and Belgium, it is apparent that not much has changed from the first wave. Many policy makers think that now, in this third wave, we are better equipped than previously, but this is, on many levels, just not true.

 

Now, one year later, there are many stories of nurses still working full time with heavy extra hours.

“On the surface, the systems vaguely appear to have been improved but there is actually no real improvement. It’s more the case that we have become accustomed to somehow managing a kind of stability amid the same confusing situations.” 

We now see nurses more inclined to leave their jobs and are more assertive in their “No.” when asked to devote more free time to the hospital. It’s also not new or alarming that nurses on sick leave seem to have become the new normal. As a result, we are seeing frequent new personnel coming into our wards, whom we need to show around and guide. This can be troublesome as there is a great lack of understanding of how wards operate, in the sense that each ward is different and has its own character and culture. The medical staff, the surgeons, the anaesthetist, the intensivists and all other staff work very closely and cohesively for at least a year at a time together, and suddenly bringing in new specialist nurses (and student doctors) from other departments (e.g. operation, anaesthesia ) or other hospitals, simply does not work. 

 

In addition, we need to deal with the issue of medication shortage, as this is a problem which constantly flies under the radar. This means that sometimes we receive medication from different countries, with different coloured packaging and/or different ways of preparing and handling. For example, we receive one sedation medication with 5mg per 2 millilitres and the next with 1mg per millilitre.


“Sometimes we even discover, suddenly, that we have been provided with packages only in Chinese language, and then, as you can you imagine, one needs to act very swiftly.”

There is also this urgent outcry that health professionals need to be vaccinated, but to us there is a different reality. I think that most of us are vaccinated by now, but, even so, nurses are often required to stay home because they still have the chance to become a COVID patient. Also, every time someone new enters the ward, we have to check if they are vaccinated, or have had a negative test.

 

In the beginning, we had all this well-deserved applause, but sometimes I think we are living in a strange time-lapse, as if the struggles of last year are exactly the same as today. Last, but not least, some of us nurses do not do this work for money alone, but the overall distribution of the proposed renumeration has some very strange dynamics which are simply unfair. We were promised a bonus of 2000 euro, but at the end it was 2000 for the full ward with a full staff of 40 professionals. I don’t see, in any way, how that logically adds up? What i do see are unrealistic images of pretty and smiling nurses in wards with high level officers, but we know exactly how it is when the cameras are turned off.

This ongoing lack of stability is aeons away from our wish to provide quality of care. We like to think we do provide quality care, but it’s not really clear to us anymore.


“It’s heart breaking to act, when you think you are doing the right thing, but not sure and then you simply have no choice but to say: “we did our best”.”

It’s just not good enough to have to deal this way with patients, when we know that low quality has grave repercussions, not only to us to us, but, above all, to the patients we care for.

 

On the question of how to keep optimistic, I think it is about the participation in initiatives on education and making improvement programs. It is largely also the good connectivity with the nurses from our association that keeps me going.


”I think now one can really understand how nurses have had to find ways to cope and even worse, to understand how most don’t even care about what we endure. However, the bond with the European and even the global specialist nurse’s community is, and has been, very helpful.”

 

The greater challenge is to find ourselves in the #POST_COVID19 phase as quotes in the article: ‘Beware the ‘last mile, first smile’ syndrome when we near the end of the Covid-19 pandemic’. “For many doctors, nurses, and other frontline health care workers, this transition may be challenging in ways that might expose them to profound risk of burnout, anxiety, depression, post-traumatic stress disorder, and even suicide.”

 

Based on conversations with nurses from Europe

Ber Oomen


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