Another Viewpoint: What happens to nursing, health care after COVID-19?

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As a nurse, I can’t help but wonder how the fallout from the coronavirus crisis might affect the nursing profession as a whole.

I foresee the post-COVID-19 setting having one of two primary trajectories: an exacerbation of our current nursing-crisis shortage, or a great influx into nursing. Sadly, I fear the former: that COVID-19 may result in another crisis – a nursing shortage the likes of which this country has never seen.

“Who in their right mind would want to become a nurse after this?” seems a reasonable question to ask. Yet it is important to understand that there is no cookie-cutter version of “nursing” – no one-size-fits-all nurse that you can remove from one setting and conveniently drop into another while expecting the same outcome. All nurses have knowledge of infection prevention, but not all nurses are comfortable placing an IV.

The media could be doing a better job specifying the various skill sets needed from nurses, so nurses could feel more confident in volunteering, rather than being placed into a setting simply to have another body on the front lines. I understand that nuances like these are difficult to “message” during a crisis; this point may simply be anticipatory guidance for future management of such crises (which will inevitably occur in the future).

It is imperative for nursing schools and health-care organizations to anticipate the ripple-effects from COVID-19. One could ensure that emergency room and intensive-care unit nurses are appropriately compensated for putting their lives on the line every day, thus providing incentives for retention as well as recruitment.

Just as a tire is essential to the operation of a vehicle and specific to the type of vehicle it carries, so is nursing specific to the area of medicine being practiced. Medicine has become specialized and nursing has followed suit. Just as there are different quality tires, likewise there are varying levels of nursing experience, from novice to expert. This development takes years and years. Not all nurses are equal – not every nursing student should or will become an ER or ICU nurse – and that’s OK. This speaks to the great multiplicity the nursing profession offers and is precisely why the profession is a great one.

We cannot have a ripple-effect of this crisis be the abject fear of joining the nursing (or any health-care) profession. At the same time, we cannot have a continuation of the broken system that makes unreasonable “top-down” demands of nurses, including “we need you to break all the rules of your training, and enter the most death-defying situation of your career with insufficient support and PPE.” Unthinkable and unsustainable top-down demands are what landed us in this nursing shortage.

No matter how many “thank-you pizza parties” get thrown after this, no matter how much the media calls nurses “heroes” during or after this, those of us who know will expect much, much more on the other side. One positive ripple effect from COVID-19 should be the complete re-evaluation of health-care delivery.

Lynne Nichols has lived in and around Portland for 30 years. She started her career as a surgical technologist at Maine Medical Center in 2003, and is now a nurse practitioner and registered nurse first assistant in the total joint arthroplasty program at Mid Coast Medical Group Orthopedics in Brunswick.

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