Responding to COVID-19: Establishing a nursing system that is appropriate for the new post-epidemic era

Summary

Hospitals that admit patients with COVID-19 face the challenge of not only dealing with these patients but also balancing normal medical care and hospital management to cope with the challenges posed by the new post-epidemic era. Over the past two years of responding to COVID-19 as a front-line clinical nurse, my colleagues and I have fully appreciated the need to establish a nursing system that is appropriate for the new post-epidemic era. The following four aspects should be emphasized: i) the continuation of thorough infection control measures; ii) exploring new approaches to training for new recruits; iii) ensuring nursing workforce and improving the nursing capacity to cope with patients critically ill with COVID-19; and iv) teamwork and team care to provide nurses with timely psychological assistance.

More than two years have passed since this Hospital - the Center Hospital of the National Center for Global Health and Medicine - began admitting patients with COVID-19 in January 2020. As a nurse manager, my colleagues and I have dealt with many things during this period that we experienced for the first time, including caring for patients in moderate to severe condition, setting up PCR testing sites, PCR testing for returnees on charter flights to Japan from Hubei, China (1), and dispatching medical personnel to the cruise ship Diamond Princess docked in Yokohama, Japan (Figure 1). Moreover, hospitals that admit patients with COVID-19 face the challenge of not only dealing with these patients but also balancing normal medical care and hospital management to cope with the challenges posed by the new post-epidemic era.

Figure 1.

Challenges with nursing at our hospital since admitting COVID-19 patients. (A) caring for patients in moderate to severe condition; (B) setting up PCR testing sites; (C) a charter flight to Japan from Hubei, China; (D) the cruise ship Diamond Princess docked in Yokohama, Japan.

In terms of clinical practice, nursing system that is appropriate for the new post-epidemic era needs to be established. The following four aspects should be emphasized in that system.

First, given that the Nursing department is the department with the largest number of employees in a hospital, the continuation of thorough infection control measures is a key factor in preventing infection clusters among hospital employees (2). Infection control for nursing staff including the wear of protective clothing in the correct manner, hand washing and hand disinfection, and avoiding contact during breaks to maintain social distancing should be thoroughly implemented.

Second, the impact of the epidemic has reduced the number of patients admitted for other diseases and reduced opportunities for new nurses to receive clinical practice, so devising new approaches to training for new recruits will have a significant impact on the continuity of the nursing system. Training needs to include subjects such as infection prevention, nursing practice, and providing daily living and mental health support for new employees who feel burdened with work and life during the current COVID-19 epidemic.

Third, because of the high need for medical and nursing care in wards admitting patients with COVID-19, there is a need to ensure the nursing workforce on these wards and to improve the nursing capacity to cope with patients critically ill with COVID-19 (3). The coordinated management of caregivers is essential as the number of infected patients increases and decreases.

Forth, timely psychological assistance for nurses should be promoted. Due to the many unknowns regarding the virus, nurses are learning how to care for critically ill patients while developing anxiety and various difficulties that they have never experienced before (4-7), including increased fatigue from the increasing number of critically ill patients, challenges in handling critically ill patients, and coping with the anger and grief of patients and their families. In these situations, teamwork and team care are especially important.

In conclusion, over the past two years of responding to COVID-19 as a front-line clinical nurse, my colleagues and I have witnessed the considerably ability of nursing staff to cope with the situation, but nurses have also been placed under enormous stress that they would not be subjected to under normal circumstances. We are proud to play our part in the fight against the COVID-19 epidemic, and we call for the establishment of a nursing system that is appropriate for the new post-epidemic era to better respond to COVID-19 and unknown emerging infectious diseases in the future.

Funding: None.

Conflict of Interest

The author has no conflicts of interest to disclose.