The real frontline warriors

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The COVID-19 period has been very harsh and, till now, the world hasn’t found any concrete solution on how to deal with it successfully, which for us is the prime trial. Even when many countries have arrived with the vaccines, yet there is still a long way to go, since the pandemic hasn’t  ended. As the numbers of confirmed COVID-19 cases accelerate, nurses on the front line of the healthcare response, find themselves making high-stake choices for patients and their own private lives. We know that nurses are the backbone of health care, and often its heart and spirit. This pandemic is testing all of us, but nurses are the front liners, having knowledge, experience, and have taken challenges about working on the forefront in such a dreadful pandemic. Nurses do a lot of overworking, are understaffed, probably heartbroken and fatigued too, but have always shown enough courage when the world has been in dire need of such fighters. The role of nurses is now more important than ever. Nurses are often the last thread of sympathy for patients. They’re the ones who do the screenings, take care of the ill, execute triage procedures, communicate to families, and the ones who attend the dying ones.

Nurses, in every role are compressed. They’re being asked to work in areas of the hospital that aren’t their regular field of strengths. They’re providing tele-health discussions and are being re-deployed, to learn fresh expertise and take new duties as security officers, while taking care of the critically ill patients. They are making triage plans effective and functioning. While we had to distribute our resources in earnest possible ways, nurses are innovating and handling the chaos in the middle of the pandemic. The shift makes the nurses feel like they’re deserting their distinct patients and that they are not competent to provide the amount of care that they used to. The crack between what they can actually do and what they consider they should really do produces a moral distress, and a sense that they are negotiating their integrity. Nurses always have responsibilities to the patients, but this pandemic has enforced so many boundaries. Quick verdicts are essential on how to use apparatus, medications, and resources when there are already in dearth. Nurses always initiate with patients, as their chief primacy in their proficient work, and that never means that nurses have no obligations to their own well-being and to their families. Nurses usually wonder that if they are potentially causing any harm to their loved ones by coming home from work every day and if they are matching the needs of their loved ones with the limitless requirements of patients. The risks are many, and regrettably there are no respectable answers and they are continuing to live in uncertainty, acknowledging the sensitivity of the present times.

As per reports from the studies, the nurses articulated that working with personal protective equipment (PPE) for stretched hours was a main physical and professional challenge, the physical challenge, since they wore airtight and protective gears, and as they perspired, their clothes used to become moist. The central heating system of the hospitals was turned off to lessen the transmission of filthy air, and wet clothes used to become cold at night. Nurses felt anoxia and chest pain, they avoided going to the rest room throughout working hours, skipped mealtime while in their PPE. The professional tasks they faced were standing for long hours, performing tasks in difficult and constant postures, and supervising patients while relocating them, the double duty loads, virtual proficiencies, and they dare to make different modalities in ICU, high risk of musculoskeletal illnesses, gastric hitches etc.

Other professional encounters nurses face are to execute some procedures even though they are competent in it like catherisation, venipuncture, or I/V injection but doing this was challenging because feeling the blood vessels under three layers of gloves was not easy, defensive goggles are shadowy, writing of the nursing notes and  administration of medication made the nurses anxious and irritable. When the patients die after fighting a battle with the virus, the nurses go through emotional agony for the patient and their families, as the body is enveloped in numerous layers of fabric, filled into two bags, which are spewed with antiseptic and it was grim to accept this form of a death.

Nurses go through terrific work-related trauma, exhaustion due to assignment and workloads, and extensive hours of working, due to the severe scarcity of skilled nursing staff. It also affects their personal wellbeing. More than 90% of nurses have musculoskeletal disorder, 61% also experienced neck pain sometimes. Likewise 7% nurses have taken leaves for 4-6 days in an extent of two months to cope with the pain, 88% of nurses work for 8-10 hours a day at a stretch, along with doing overtime at least twice or thrice a month. While 20% of nurses stated performing double-shift duty at least twice a month, 26% of nurses were requested to work on their off-days twice a month. These tasks discussed here are only the tip of the ice berg and there may be many more stories all over the globe where we may find the perfect examples of the nursing dedication. Keeping in sight the losses of the nursing officials, we can arrive at an conclusion that it was the forefront nursing workers who put the best of  their effort in handling the tough situations during the pandemic, but the COVID-19 warrior awards were not given to them.

It’s imperative to call the nurses with dignity and respect as the nomenclature of nursing staff has been changed to nursing officers, senior nursing officers under the order no. Z.28015/41/2014-N on dated 09/09/2016 by Ministry of Health and Family Welfare, Govt. of India. It has been noticed that the nomenclature has been incorporated by all the health institutions across the country in their policy except Jammu & Kashmir. Policy makers of Public and Private Health sector of J&K are requested that they must incorporate this change in all health institutions including nursing advertising posts.

Conclusion: Nurses have the same obligations towards  their own self as to others. Investment in one’s well-being is not optional, it’s a moral mandate. It’s not only post-traumatic stress but this emotion in some people exists that they’re acting in contradiction to their own consciences in some actions during the crisis. The effect of that is major moral distress or injury, which amasses over time. We can’t wait to take measures to overcome that suffering. We must begin now. We want to provide approvals from frontline nursing to notify our health care system’s future replies.