Right now, a year into the pandemic, the suppressed tension from the continual trauma of COVID is now showing visible cracks to nurses’ souls; the emotional, physical, and psychological well-being of nurses. The letters of support from the community have faded behind the display case. Free snacks to lift our spirits in the rare moments we can remove our masks are no longer found. Nurses knew it would not last long, but we savored every moment it lasted. Instead of acknowledging our kryptonite the word “hero” was erased and replaced with fear and suspicion.
When, in moments of frustration and weakness, nurses said, “I did not sign up for this,” the world callously replied with, “It is your job.”
Yes, the job is to help sick people. Patients can die and some seasons of nursing are more challenging than others. But we became nurses to give patients a fighting chance at life. We did not sign up to watch morgues overflow and, even in the best of healthcare circumstances, we cannot survive this job alone.
Nursing has never been about segregating yourself from loved ones and support systems… but COVID was. Healthcare workers sent their children away for protection to live with non-medical family members. They could not hold them or kiss them good night for months on end. Healthcare workers quarantined in hotels isolated from family because they lived with people who were at high-risk. FaceTime and Zoom became the only mode of human interaction with their loved ones.
Nurses are strong, determined, and independent people, but even the strongest nurses will break without critical emotional, spiritual, and physical support.
Since the profession of nursing’s inception under Florence Nightingale, quality of environment has been a key ingredient in the positive outcomes. Her theory of increasing light, cleanliness, and airflow led to the survival of more soldiers as it decreased infection and depression. When you work in a toxic environment, patients will suffer unnecessarily. By giving nurses the leeway and resources to care it allows both patients and nurses to thrive. In order to do that, we have to ensure nurses are being cared for as well.
Quality of the environment is not only key for patients, but for nurses as well. The Self-Care Deficit Theory says if nurses do not have their basic needs met, including the need for support, they cannot effectively care for themselves let alone their patients. Nurses continually pour themselves into their patients regardless of how empty their own cup is. They sacrifice their own personal needs at the altar of patient safety. Negative workplace habits of self-sacrifice bleed into their personal lives. Self-care is almost non-existent. Our families get our leftover emotional energy (if there is any). Resilience decreases as we stretch ourselves further and further with poor coping skills adopted from the generations of “It’s the job- get over it” mentality ingrained in the culture of the nursing profession.
Interpersonal relationships on the job greatly affect the quality of the work environment. The theory of Interpersonal Relationships emphasizes that strong relationships based on mutual trust and respect are needed in order for nurses to provide effective care. This was primarily created for the nurse-patient relationship, but the concept also applies to relationships between nurses and leadership. The health and safety of our patients is the highest priority. We place a higher priority on our patients well being than we do our own.
So when decisions are made by leadership that interfere with our ability to provide quality care, let alone basic care, the result is a deep moral wound and erosion of trust.
Now we are a year in. The world has prematurely written a conclusion to the darkest season nurses have faced in generations. The world has grown weary of running the marathon alongside its healthcare workers. The vaccine seems to make a pretty bow on top of a finished story. Yes, the vaccine brings hope that the marathon is almost complete and it renews strength to keep combing back to work. However, nurses do not have the luxury to close the COVID chapter just yet. Even when the population is vaccinated and the pandemic is over, it will only mark the beginning of recovery.
We have been continuously over-extended— even more so than pre-COVID. Patient ratios were obliterated. We have seen more death in this short season than many nurses have seen over their entire career. The invisible psychological wounds sustained during this pandemic will have consequences on the future of nursing. It will take time for the wounds to turn into scars. Even then, scars remain. They may fade over time, but they will always be there. Scars can also be painful reminders and are at risk of reopening if they do not heal properly.
The dull echoes of “Heroes,” “We are all in this together,” and applause now resonate as the distant memories of people who abandoned nurses when their endurance faded. The impact of COVID has strained nurses’ trust in the community, leadership, and their facility’s ability to meet nurses’ needs for a safe environment where they can give their patients the quality care they deserve. Even with the vaccine, nurses know there is still a long way to go— not just the true end of the pandemic, but healing from the complex trauma nurses have endured during the pandemic as well as rebuilding the confidence that nurses have in our own healthcare system and nursing leadership.
Recovering from the marathon will be just as difficult.
For my non-healthcare workers:
If you love a healthcare worker, be patient with them. Bouncing back from trauma takes a lot of time and effort. Find ways to support them. If your friend ran a marathon, you would give them water and a chair to sit in. Sometimes providing respite can be allowing them to talk or vent about the worst parts of their experience. Support can also come in the form of distraction. Allow them the opportunity to take their mind off of the stress of work, to laugh, and re-experience life outside of scrubs.
To my healthcare workers:
But do not be discouraged. I know you are tired, but you have proved to have more endurance than the rest of the world. The majority of the world only cared for Superman even though he and Clark Kent are one and the same. I have not only seen your struggles, but I have experienced them firsthand. Your Clark Kent— your daily perseverance, willingness to come back everyday, mental health, quality of life, and who you are outside of scrubs— is more valuable than the fleeting worldly recognition of your Superman.
