Author(s): Jayasudha A
COVID -19 has presented nurses with unprecedented challenges professionally, socially and psychologically. This article gives a brief overview of the experience of a Nurse Midwife during this period. Because of COVID -19 pandemic, health care professionals and health care system worldwide were working under challenging conditions. In fighting COVID - 19 Nurses held a greater responsibility in providing needed specialized patient care, optimizing resource management, providing psychological support, adequate training for nurses and formulating high quality protocols to tackle the crisis situation.
A novel Coronavirus (COVID -19) was first reported from Wuhan, China on 31st December 2019.The official names for COVID-19 and SARS-CoV-2 was issued by the WHO on 11th February 2020. Nurses had critical role and responsibilities during the COVID - 19 pandemic. They were at the frontline of patient care in hospitals and actively involved in evaluating and monitoringthe clients in the community. Nurses had to ensure that all patients acquire personalized, high - quality services irrespective of their infectious condition. A global pandemic needs strong nursing staff engagement in clinical management, awareness and exchange of knowledge and public safety.
To be a Nurse and Midwife means to be of service no matter the circumstances. Have you ever wondered what it feels like to be a Nurse and Midwife during the COVID-19 pandemic? “The COVID-19 warrior explains ......”
Tessy, mother of two, the nursing superintendent, a counselor and most importantly a dedicated Nurse Midwife. She began her carrier 24 years ago. She is in charge of the hospital and also involved in delivering direct patient care during COVID-19 pandemic. At the beginning of the first wave from late march 2020, there was a deep fear of unknown. Health workers were confronting a novel virus without protective equipment and no known treatment or preventive vaccination.
The pandemic gave Tessy an additional responsibility of leading the hospital with strict following of IPC related standard operating procedures while delivering essential health services. She constantly kept chanting the mantra to her staff and patients “Clean Hands; Save Lives”. Which in turn saved many lives!! “Hand hygiene is very important in preventing the spread of infections in the hospital and learned that how to respond to the disease with significant wider challenges”- Tessy added.
The training programs she attended gave her an opportunity to train her staff as well on the new knowledge she had acquired. She also made recommendations to the management, added additional handwashing facilities in the ward and made it compulsory for her to ensure patients are regularly washing their hands in all the wards. Conducted practical lessons on the correct hand hygiene technique. Tessy continues to encourage her staff to share information on the best IPC measures with patients as they provide essential health services.
Every time I left the house, I was worried. I had the feeling that the virus is everywhere, and I am constantly on watch. When I touch a door knob, I am anxious because of fear that I can carry the virus from one place to another. Since the outbreak of COVID-19 there has been a worldwide shortage of facemask particularly the N95. They filter about 85% of particles smaller than 300mm. Due to shortage, many health care workers had to wear the same N95 mask repeatedly, even though they are intended for a single use.
“I also learned that you cannot wear the same mask the whole day. It actually increases the chances of infecting yourself” - Tessy explains. I consider myself lucky that there was sufficient stock in my Unit.
Views: Dilemmas in the Second Wave Vaccines became available from 16th January 2021 in India. Hesitancy towards vaccine emerged for a number of reasons. The misinformation from whatsapp group and social media was extreme. Fears were also held by health care workers who were one of the first groups where vaccination was mandated. By the time the second wave from mid-2021, when deaths and more serious illness were experienced, the demand for vaccination increased dramatically. This was the challenging time for Tessy to train the staff on vaccination, tackle the negative effects of strict lockdowns like staffs unable to report duty on time, hospital supplies unable to reach the destination, disruption of the economy, boredom young children unable to attend school.
“Health workers faced immense pressure and protecting their mental health is crucial”. As one of Tessy’s staff expressed ...
“...Our workload has increased at these stressful times caused by the pandemic; my life and my family’s life have been affected ... it’s not easy to work with all this protective gear on ... Such things as fogging of my face shield interfered with my job ... I was exhausted, both physically and emotionally...” Echoing of cries, panicking for oxygen, unavailability of beds lead to occupational burnout, anxiety, stress and depression in the health care services. COVID-19 pandemic initiated an upheaval in society and has been the cause of considerable stress during this period. It has undoubtedly altered the routine of life and caused unanticipated changes resulting in severe psychological responses and mental health crisis.
High levels of psychological stress have been documented among nurses as well as the patients during this disease outbreak. Therefore, mental health initiatives are needed to support them during this unprecedented health crisis of a pandemic. To bring a significant change in their stress level Tessy planned the duty roster according to the personnel’s condition, counseling sessions for staffs, patients and their care givers. She conducted workshops to inform the nurses about the pathophysiology of COVID-19.
She coordinated with the management to show appreciation and gave awards for the COVID warriors. All these efforts led them to self - transform and making them braver to face critical conditions and more empowered in managing difficult times.
The third wave of COVID-19 had plateaued in India and the number of cases started after August and October 2021 when 3, 47,254 infections were reported. As time pass by the health workers across the hospital felt more prepared. There was better protective equipment available as well as testing facilities, and there was more acceptance of vaccination. The systems were developed to test, trace and contain the disease.
To conclude she says all the health workers worked incredibly hard during the pandemic. They had to follow a set of complex measures of testing, masking, distancing and so on. Many lessons have been learned about how to respond to a pandemic, live with the virus and also to prepare the health system to face any inevitable pandemic in future.
Tessy’s advice to her fellow friends - “In every crisis, doubt or confusion, take the right path - the path of compassion, courage, commitment, understanding and love”
View PDF