The nurse’s role in crisis situations

SARS-CoV-2, the virus that causes COVID-19, has likely changed the worldview of healthcare, at least for a generation.

The COVID-19 pandemic has propelled the world into challenging and unprecedented times. Nurses are at the frontlines and are facing this pandemic head-on, sometimes without adequate support and resources. There have been reports about the shortage of personal protective equipment (PPE) and workforce shortages, placing both patients and nurses at risk. Sadly, there have even been reports of health professionals committing suicide. COVID-19 has generated feelings of fear, grief and helplessness all around the world, and for many nurses these emotions are pronounced.

Facing uncertainty, and surrounded by death and suffering has led many health professionals to experience moral distress, particularly because of the feeling of being unable to meet the needs of patients and colleagues. This distress has also been fueled by feelings that, in some instances, healthcare systems have not been prepared for the pandemic and that patients and healthcare professionals have been put at an unnecessary risk. However, there are many examples of healthcare systems rising to the challenge and adapting quickly to provide innovative models of care. We need to learn from what has worked well as well as our failures.

These experiences underscore the fact that to be effective nurses, we cannot operate in a bubble or in professional silos. We need to consider our experiences within the context of systems and society. Although you may be an expert in infection control in the hospital, this is not sufficient in containing a pandemic. Pandemics require engaging the whole of society in prevention, containment and mitigation. This is complex, requiring community engagement and collaboration with government organizations as well as non-government organizations and the private sector.

Nurses are widely recognized as the most trusted professional group because of their values, integrity and their role as a voice for the disenfranchised. The COVID-19 pandemic has revealed multiple vulnerabilities, including in prisons, nursing homes, refugee camps and homelessness settings. Not only are these hot spots for the spread of the virus but loci of suffering and distress. And nurses are not immune to this.

At this critical time, it is also important for nurses to engage in self-care. Our codes of ethics do not advocate abrogating personal responsibility for our own health. As nurses, we need to be able to recognise moral distress in our nursing practice and be empowered to address morally complex situations. That way, we can reduce moral distress and burnout.

Providing nursing care in the context of a pandemic is highly stressful and the uncertainty we face can impact on not just your mental health but the ability to provide the best possible care and optimize your safety. Taking steps to manage your stress and physical health is critically important at this time.

Over to you

How have you been managing your stress?

Has your organization implemented any strategies to address moral dilemmas happening at this time?

The See Also section provides you with some resources and views of nurses on dealing with the challenges of the COVID-19 pandemic. Just as Florence Nightingale faced unique challenges in the Crimea, many nurses are entering uncharted waters and being challenged to adapt quickly.