At this very moment, families either have or will soon receive the phone call they dread. They have been told or will be told that (name your loved one) is about to be discharged from the hospital to make beds available for the inevitable surge of patients with coronavirus. Their loved ones are still sick—just not sick enough. What are they going to do about the still present need for managing pain, anxiety, confusion, and other difficult symptoms, administering complicated treatments, newly prescribed medications with potentially problematic drug interactions, carefully planned increases in activity, and nutritional needs that may be delivered through tube feedings or special intravenous lines?
They will turn to nurses in their communities. We are rightly concerned about the availability—and the safety—of nurses and other health care professionals in our hospitals. But we cannot forget that patients will continue to need nurses to continue their recovery or die peacefully at home. And, during this crisis, it may not be their or their families' choice.
Research from our Centers at the University of Pennsylvania School of Nursing provide convincing evidence that nurses can and do meet these needs. Data from the New Courtland Center for Transitions and Health convincingly show that nurses' care in home does more than stabilize patients' conditions. Advanced practice nurse‐led interdisciplinary teams, in fact, show better health outcomes than traditional care with lower health care costs. This care, now recognized as the Transitional Care Model, is better care for those at home who must navigate the complex and often fragmented healthcare services available to them.
Similarly, research from Penn's Center for Health Outcomes and Policy Research has long provided definitive evidence that care from well‐educated nurses in supportive work environments with safe workloads saves patients' lives, promotes recovery, and facilitates peaceful death at the end of life. These studies also showed chronic nurse understaffing in hospitals and nursing homes along with nurse exhaustion and burnout before coronavirus thus leaving nurses in a depleted state before the fight of their lives.
Faculty affiliated with our Center for Global Women's Health have long recognized women's strength in protecting their families and their vulnerability to the upheavals that accompany wars and pandemics. They now comb their data on women and infectious diseases, domestic violence, pregnancy outcomes, and breast feeding to lend evidence to our ongoing work with women and their families.
And that from our Barbara Bates Center for the Study of the History of Nursing offers innovative examples of nurse‐led care that have significant policy implications for today's coronavirus crisis. We cite, for example, New York City's “Home Hospital” developed in the early twentieth century to fight the risks to other family members when one became ill with highly infectious tuberculosis. Whole families moved into a specially designated apartment building where a well‐trained public health nurse not only cared for the individual with tuberculosis, but also oversaw strict measures to prevent the spread of TB to others. In addition, this nurse also saw that children continued to receive their education, nutritious meals were available to all, and rooftops—with their fresh air ‐ became the center of the building's social life.
We know that nursing practice is saving lives in this pandemic. Nursing research also plays a critical role. We support the move in universities to concentrate research on innovations directly related to the coronavirus crisis. But so much of nursing's research is coronavirus research. We applaud the search for reliable epidemiological data, effective treatments and vaccines. We, though, must articulate nursing research's fundamental frame. We focus on the lived experiences of clinicians, patients, families, and communities. How, for example, can we best understand the experiences of nurses practicing in under‐resourced hospitals and nursing homes? How are individuals sheltering at home, managing diets that affect their congestive heart failure? And are there lessons from the past that can lead us forward.
Our message: nursing research is coronavirus research.
KEYWORDS
community health, coronavirus, nurses, nursing research, public health, transitional care