key: cord-0761513-a67sr4y3
authors: Clifford, Theresa
title: Practice Corner COVID-19: What We Have Learned So Far
date: 2020-04-27
journal: J Perianesth Nurs
DOI: 10.1016/j.jopan.2020.04.008
sha: 549840cb38aa906ba656a7ae82ad81b8c062ae2c
doc_id: 761513
cord_uid: a67sr4y3

nan

Theresa Clifford MSN RN CPAN CAPA FASPAN As our chief of anesthesia has been saying for the past few weeks, it is not business as usual. A new common household word, COVID-19 has come bringing lessons we did not even know we needed. There is still much to be learned regarding the pathogenesis of this virus, the pathway it has chosen in our communities, the widely variable course of illness, the best practices for treating the afflicted, and the potential for prevention by transmission barriers as well as pharmacotherapeutic vaccines. As overwhelming as the lack of knowledge may feel, the fear and lack of preparation of the world and our country has brought is even more overwhelming.

The purpose of this column, as a reflection of all the work that has been generated in response to this pandemic, is to discuss how perianesthesia nurses can incorporate steps towards a future global, national, or local crisis. Many of us have dusted off the emergency response plans from our institutions only to find ourselves still struggling with how to employ rapid responses in a thoughtful, competent, and holistic way. According to the American Nurses Association, during times of disaster nurses "have a commitment to help care for and protect their patients while also protecting their own right to self-preservation and self-care." 1

There are several key areas that should be considered when preparing for a crisis like the COVID-19 outbreak. The first involves your annual competencies and review of policies and procedures. This would be a great time to take out your facility's emergency response plan and review it, practice it, study it. Many of these plans include the activation of an incident command center which will serve as the focal point for allocation of staff and resources when needed. According to the World Health Organization, this command center often includes relevant representation from services within the organization that will have an impact on services. 2 These include but are not limited to executive leadership, marketing and communications, security, patient care services, human resources, pharmacy, and infection control.

As has been discovered during the COVID-19 pandemic, many perianesthesia nurses have found themselves without adequate resources in both supplies as well as the provision of care.

The standards of care since the first few days of this event have changed continually, at times, adding to the confusion and sense of urgency surrounding us. 3 The supply chain obviously has not been able to meet the worldwide clinical needs of patients who have become critically ill from this illness. In addition, the lack of personal protective equipment has drawn the attention of the entire world in terms of not being able to meet the worldwide safety needs of healthcare workers at the frontlines. While social media has served as a source of information and direction for many people during this time, the perianesthesia nurse must make responsible policies regarding sick employees. Be aware of the symptoms that are warnings to stay at home, and know the process for determining when it is best to return to work.

When a disaster or pandemic strikes, nurses and other healthcare workers are often frontline defense. If this pandemic of 2020 has offered lessons, strategies for advanced preparation has been number one. Consider ways to create flexibility in the perianesthesia workplace as well as within the perianesthesia workforce. The units will likely be expanded to provide care for patients rarely seen in the perianesthesia environment. And perianesthesia nurses will likely be deployed to provide care to patients they have never cared for before.

There are a wide variety of digital and virtual options today for providing real-time training. In the future, ensure that emergency preparedness and planning are included in ongoing reviews.

During catastrophic events, whether local, national, or global, perianesthesia nurses have and will continue to be resourceful and strong. As Amy Dooley, 2019-2020 ASPAN President posted "Don't just stand back and worry. You can take charge of your unfamiliarity with certain patient populations by forging ahead and seeking opportunities." 6 

Who will be there? Ethics, the law, and a nurse's duty to respond in a disaster

World Health Organization. Hospital emergency response checklist

Crisis standard of care: COVID0-19 pandemic

Strategies for Optimizing the Supply of Facemasks

Joint Commission statement on use of face masks brought from home

Message from President Amy Dooley. American Society of PeriAnesthesia Nurses -ASPAN Facebook