True Heroes of COVID-19 Battle – Our Nightingales

Sir,

“The best defense against any outbreak is a strong health system and a robust healthcare system that relies on its frontline health-care workers.” The pandemic due to a novel Coronavirus has thrown a great challenge in the Indian health-care sector and the country's economy. Based on data from 73 countries, India's response to this pandemic is one of the most stringent in the world. India has scored a perfect 100 on the “Oxford COVID-19 Government Response Tracker (OxCGRT)” that aims to track and compare government responses to the coronavirus outbreak rigorously and consistently worldwide.[1]

As millions of patients are fighting this battle of COVID-19 pandemic with no targeted treatment, it reminds us of the famous quote by Florence Nightingales– “And what nursing has to do in either case, is to put the patient in the best condition for nature to act upon him.”[2] This stands true today as well. Our frontline health-care nursing staff provide the best support, round the clock service, apt to be termed as present-day superheroes. They form the backbone of the healthcare system around the world. India is one of the countries which is currently fighting one of its toughest battles ever. With a population of 135 crores, as the number of COVID-19 cases increase each hour, the medical personnel, including nurses who are on the front lines of healthcare response are making high-stake sacrifices that involve an increased risk of infection, risking their own lives and fighting the social stigma. Interviews with our nursing staff have revealed various issues related to their personal and private life. These mainly include the fear of contracting the disease and transmitting it to their family members, social stigma, job insecurities, having pay cuts leading to financial distress, and experiencing psychological issues such as stress, depression, anxiety, and fear. Its been hard for them to fight a prolonged battle against a deadly virus challenging them with prolonged duty hours with protective gear that restrict access to food, water, and basic sanitation. Due to the fear of transmitting the disease to their family members, most of the nursing staff involved in the care of COVID-19 patients have shifted to solitary accommodations and have given up going homes.[3] This has affected their personal duties, in turn, impacting their family life, leading to the anxiety of being away from their families. Apart from having a psychological impact on frontline warriors, this pandemic has exposed the vulnerabilities of health-care infrastructure and is expected to cause economic recession unparalleled in history. The health-care industry has suffered huge operational and revenue losses since the onset of the COVID pandemic. This has further raised financial distress in nursing staff due to pay cuts and worries related to job insecurity.

As the lockdown continues, the levels of anxiety, depression, distress, and reduced sleep quality with frontline nurses have been constantly increasing. A recent survey conducted by nursing times with data of 3500 nurses provides a glance of the current state of nurse's mental health. About 33% of nurses described their overall mental health and well-being as “bad” or “very bad,” 87% of respondents rated themselves as either “a lot” or “a little” more stressed at work than usual, whereas 90% said they were “a lot” or “a little” more anxious than before the outbreak.[4] Concerns about contracting the virus, the health of family and friends, and lack of sufficient supplies of personal protective equipment were the most common reasons respondents cited for being more stressed or anxious. The results are not surprising, and it provides a challenge and opportunity for the psychiatric association and health-care sector to increase such studies and take immediate actions to control the damage as the impact of COVID-19 on mental health will persist for many more weeks or months.[5] We believe in need of a holistic approach to support our frontline nursing staff. A multipronged module which should include; best possible testing and safety equipment, well-planned working shifts with adequate breaks, adequate food and accommodation facilities, recreational activities, and psychological counseling. Every institution should work with nursing associations and local and state administrative authorities to ensure job security, financial support and to ensure social securities and, if required, with legal enforcements against defaulters causing distress to health-care workers.

It should be our mandate to strengthen our nursing staff on all fronts because they still believe in Florence Nightingales words– ”Rather, ten times, die in the surf, heralding the way to a new world, than stand idly on the shore” and are putting their best efforts to save the humanity at this crucial juncture which is witnessing a paradigm of change in the evolution of the human race.