Risks and Duties in a Global Outbreak: Nursing and the Novel Coronavirus
Nursing is the largest healthcare profession in the world, with over 20 million nurses providing front-line care to patients with COVID-19, a novel coronavirus that emerged in late 2019 and has since caused a global pandemic. COVID-19 is a respiratory infection that can range from mild to severe, and can lead to complications such as pneumonia, organ failure, and death. Nurses play a key role in preventing and responding to COVID-19 outbreaks, as well as educating the public on disease prevention and reducing misinformation. However, nurses also face many risks and challenges in their work, such as exposure to the virus, lack of personal protective equipment (PPE), stress, burnout, stigma, and ethical dilemmas. This paper will discuss the risks and duties of nursing in a global outbreak of COVID-19, and provide some recommendations for improving nursing practice and policy in this context.
One of the main risks that nurses face in a COVID-19 outbreak is exposure to the virus, which can result in infection, illness, or death. According to the World Health Organization (WHO), as of December 2021, more than 10 million health workers have been infected with COVID-19 globally, accounting for about 10% of all cases (WHO, 2021). Nurses are particularly vulnerable to exposure because they have close contact with patients who may be infectious, perform aerosol-generating procedures that can increase viral transmission, and work in settings where infection prevention and control measures may be inadequate or inconsistent (Choi et al., 2020). Moreover, nurses may face shortages of PPE, such as masks, gloves, gowns, and eye protection, which are essential for reducing the risk of exposure. A survey of more than 15,000 nurses from 44 countries conducted by the International Council of Nurses (ICN) in 2020 found that 87% of respondents reported insufficient PPE supply at their workplace (ICN, 2020). The lack of PPE not only puts nurses at risk of infection, but also affects their psychological well-being and professional autonomy.
Another risk that nurses face in a COVID-19 outbreak is stress and burnout, which can have negative consequences for their mental and physical health, as well as their quality of care. Nurses experience high levels of stress and burnout due to various factors, such as long working hours, heavy workload, high patient mortality, fear of infection or infecting others, lack of support or recognition, ethical dilemmas, and violence or harassment (ANA et al., 2021). A study by Liu et al. (2020) found that among 2,143 Chinese nurses who worked during the COVID-19 outbreak in early 2020, 50.4% reported symptoms of depression, 44.6% reported symptoms of anxiety, 34% reported insomnia, and 71.5% reported psychological distress. These findings are consistent with other studies that have shown high levels of psychological distress among nurses during previous outbreaks of SARS and MERS (Maunder et al., 2006; Khalid et al., 2016). Stress and burnout can impair nurses’ cognitive function, emotional regulation, communication skills, and decision-making ability, which can compromise patient safety and outcomes (Hall et al., 2016).
A third risk that nurses face in a COVID-19 outbreak is stigma and discrimination,
which can affect their social and professional relationships. Stigma refers to the negative attitudes and beliefs that people have towards a group or person based on their perceived characteristics or attributes (Link & Phelan, 2001). Discrimination refers to the unfair or unjust treatment or behavior that people experience because of their stigmatized identity or status (Link & Phelan, 2001). Nurses may encounter stigma and discrimination from various sources during a COVID-19 outbreak, such as patients, families, colleagues, employers, or the general public. For example, some people may avoid or reject nurses because they perceive them as potential sources of infection or transmission (Wen et al., 2020). Some people may also blame or criticize nurses for the spread or severity of the outbreak or for the lack of resources or services available (ANA et al., 2021). Stigma and discrimination can undermine nurses’ self-esteem,
confidence,
and motivation,
and create barriers to accessing health care,
social support,
or legal protection
(ANA et al.,
2021).
Despite these risks,
nurses have many duties and responsibilities in a COVID-19 outbreak,
which reflect their professional values,
standards,
and ethics.
Some of these duties include:
– Providing safe,
effective,
and compassionate care to patients with COVID-19,
regardless of their age,
gender,
race,
ethnicity,
religion,
socioeconomic status,
or other characteristics
(ANA,
2015).
– Applying evidence-based practices and guidelines to prevent and control COVID-19 infection and transmission,
such as hand hygiene,
respiratory etiquette,
waste management,
and environmental cleaning
(WHO,
2020).
– Educating and empowering patients,
families,
and communities on COVID-19 prevention and management,
such as recognizing the signs and symptoms of the disease,
seeking timely medical attention,
following isolation and quarantine measures,
and adhering to treatment regimens
(ANA et al.,
2021).
– Advocating for the rights and interests of patients with COVID-19,
such as ensuring their privacy,
confidentiality,
consent,
and autonomy in decision-making,
and protecting them from stigma,
discrimination,
or harm
(ANA,
2015).
– Collaborating and communicating with other health professionals and stakeholders to coordinate and integrate COVID-19 care and services across different levels and settings of the health system
(ANA et al.,
2021).
– Engaging in continuous learning and professional development to update and enhance their knowledge and skills on COVID-19 diagnosis,
treatment,
and prevention
(ANA et al.,
2021).
– Participating in research and innovation to generate new evidence and solutions for COVID-19 care and response
(ANA et al.,
2021).
To fulfill these duties effectively and efficiently, nurses need adequate support and resources from various sources, such as governments, employers, professional associations, educational institutions, and society. Some of the recommendations for improving nursing practice and policy in a COVID-19 outbreak include:
– Providing sufficient and appropriate PPE to nurses and ensuring their proper use, maintenance, and disposal
(ANA et al.,
2021).
– Implementing fair and flexible staffing policies and practices that balance the workload and well-being of nurses, such as limiting overtime, rotating shifts, providing breaks, and offering incentives or rewards
(ANA et al.,
2021).
– Establishing supportive work environments that foster teamwork, respect, trust, feedback, recognition, and empowerment among nurses and other health workers
(ANA et al.,
2021).
– Providing accessible and affordable mental health services and programs to nurses, such as counseling, peer support, stress management, resilience training, and self-care strategies
(ANA et al.,
2021).
– Promoting positive public awareness and appreciation of the role and contribution of nurses in COVID-19 care and response, such as through media campaigns, social media platforms, or public events
(ANA et al.,
2021).
– Enhancing the education and training of nurses on COVID-19 related topics, such as through online courses, webinars, podcasts, or simulations
(ANA et al.,
2021).
– Increasing the funding and opportunities for nursing research and innovation on COVID-19 related issues, such as through grants, scholarships, awards, or partnerships
(ANA et al.,
2021).
In conclusion, nursing is a vital profession in a global outbreak of COVID-19, as nurses provide essential care and services to patients with the disease, as well as prevent and respond to its spread. However, nurses also face many risks and challenges in their work, such as exposure to the virus, stress, burnout, stigma, and discrimination. Therefore, nurses need adequate support and resources from various sources to fulfill their duties effectively and efficiently. By improving nursing practice and policy in a COVID-19 outbreak, nurses can not only protect their own health and well-being, but also improve the health outcomes of their patients and communities.
References
American Nurses Association (ANA), American Organization for Nursing Leadership (AONL), & Johnson & Johnson (J&J). (2021). Nurse-led innovation: Advancing health during a pandemic. Retrieved from https://www.nursingworld.org/~4a9c3a/globalassets/practiceandpolicy/innovation/ana-aonl-jnj-nurse-led-innovation-report.pdf
American Nurses Association (ANA). (2015). Code of ethics for nurses with interpretive statements. Retrieved from https://www.nursingworld.org/coe-view-only
Choi KR., Skrine Jeffers K., & Logsdon MC. (2020). Nursing and the novel coronavirus: Risks
and responsibilities in a global outbreak. Journal of Advanced Nursing 76 (7), 1486–1487. https://doi.org/10.1111/jan.14369
Hall LH., Johnson J., Watt I., Tsipa A., & O’Connor DB. (2016). Healthcare staff wellbeing,
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Huang C., Wang Y., Li X., Ren L., Zhao J., Hu Y., Zhang L., Fan G., Xu J., Gu X., Cheng Z., Yu T., Xia J., Wei Y., Wu W., Xie X., Yin W., Li
