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During Coronavirus Pandemic, Nurses Need Leaders Who Advocate for Them


Since the first days of the coronavirus outbreak -- which quickly became the coronavirus pandemic -- news and information have come in faster than we can digest them.

Whether you're a staff nurse or nurse leader, all of us are worried about what we're hearing and what all of it means.

What we know

According to the World Health Organization the novel coronavirus (COVID-19), named for the crown-like spikes that protrude from its surface, causes a range of respiratory illnesses -- from the common cold to pneumonia.

The WHO's role is and always has been to protect the public -- but patient safety is a responsibility shared by all of us in healthcare. We're accountable for protecting patients from harm by making decisions that are scientifically sound, evidence-based and made in our patients' best interests.

COVID-19 is a large issue worldwide, and it has made us face things we've never faced. It calls for vigilance and every form of personal and group protection anywhere people gather. Hospital ERs filled with scared patients and worried families are at or above capacity; masks and ventilators are being ordered and manufactured in higher numbers than ever; food and cleaning supplies are disappearing from store shelves; children and their parents are being affected by school closings; social events, family celebrations, and religious services are being canceled; and thousands of companies are closing and sending employees home to work remotely. And state governments have begun to act. In New York, for example, the governor speaks almost daily on contingency plans for more ventilators for ICU patients, additional ICU beds and additional staff.

Nurses need to have answers for patients

Nurses always have been there for their patients, and the coronavirus pandemic is no exception. But we can't give patients what they need if we're not knowledgeable about what's going on. We see on TV and social media that everyone has lots of questions, and we're going to need some answers for them. "How does the virus spread and who is in most danger of contracting it or succumbing to it? What supplies should I keep in my house? Must I stay quarantined? Can I get tested for the virus?" Many of these answers are available for healthcare providers on the Centers for Disease Control and Prevention website, and they are frequently updated.

Leaders need to have answers for nurses

Leaders will get even more questions. While dealing with staff directives and providing needed manpower and supplies, leaders also must help staff understand their new roles and responsibilities. They must ensure nurses have a workplace with all the resources they need, which also comply with safety measures. Leaders need to keep staff informed and calm fears about the coronavirus pandemic by addressing questions promptly and assuring staff they'll have everything they need to do their jobs. The current shortage of N95 respirators is a good example.

If I still worked as a CNO I'd communicate to staff the guidelines we've received from the CDC and talk with them about strategies and options to deal with shortages, as outlined in the Checklist for Healthcare Facilities: Strategies for Optimizing the Supply of N95 Respirators during the COVID-19 Response.

Ensure staff understands inventory flow and supply chain, regular vs. surge utilization rates, and that management is in communication with state and local public health partners on the issue and the steps needed to optimize the supply of other PPE for staff at the same time. I'd also discuss the importance of proper equipment usage and maintenance. This includes fit, use and circumstances for reuse, as well as proper disposal. And I'd let staff know how to best make our supply meet the needs of our census. Staff needs to understand how surge capacity during the coronavirus pandemic could impact how they prioritize PPE usage to conserve inventory and how being able to move from regular to crisis patient capacity could impact the plan. Leaders need to remember how decisions to implement different measures in changing patient capacities must be made in concert with the appropriate federal, state and local agencies involved in the emergency plan. Above all, the staff needs to feel someone in command has their backs, and nurse leaders are the ones they will look to for assurances that they'll be safe as they care for patients.

The whole game plan should be reviewed regularly, and staff should have time to express their concerns, give their input, and discuss what they think is working and not working.

All for one, one for all According to reports, COVID-19 isn't going away anytime soon, so through it all we need to remember the basics at work and at home: handwashing; our use of PPE; following hospital policies and procedures; attending infection control updates; cancelling unnecessary travel and events; staying home and being evaluated at the first signs of symptoms; listening to the experts; caring for our elderly; working within community guidelines. It's important -- now more than ever -- to put politics and opinions aside during this national emergency. Healthcare and government leaders at the federal, state and local levels are doing their best to lessen the impact of the coronavirus pandemic on everyone. We're in the midst of an unprecedented health emergency, and others will be looking to us for information and guidance. During the past few weeks many have said: "We're all in this together," and to that I add, "Together is the only way we'll all get out of it."

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