key: cord-0996076-hlcdi7p0 authors: Poole, Ellen L. title: The Power of Nursing Presence in a Global Pandemic date: 2021-10-20 journal: J Perianesth Nurs DOI: 10.1016/j.jopan.2021.06.102 sha: e171bf941ec77c2e4534641252d056fc77a60f6d doc_id: 996076 cord_uid: hlcdi7p0 nan The Power of Nursing Presence in a Global Pandemic During this global pandemic, we as nurses have been present, not only for the patients cared for, but in a variety of ways across multiple layers of our society. Nursing presence 1 is a core concept of nursing that has been demonstrated in various facets during the Year of the Nurse and Nurse Midwife 2020-2021. Presence encompasses being present, connecting with the individual, and providing compassionate care. In the next few paragraphs, I'd like to highlight the nursing presence beyond direct patient care throughout this global pandemic. From the earliest stages and throughout the pandemic, nursing leaders had multiple complex decisions to make and implement. These decisions included: use of personal protective equipment with a broken supply chain; designating Coronavirus disease (COVID) units versus non-COVID units; training and cross training personnel; and restructuring visitation policies along with fluctuating budget lines. Their presence provided safe care for all within a constantly changing environment of healthcare policies regarding PPE, social distancing, and ever-changing treatment options for patients while protecting employees. Despite the personal protective equipment (PPE), particularly mask, concerns, nurses were present for the patients and their families. Sheltering in place and quarantine measures in hospitals and long-term care facilities brought innovative ways to keep families connected. How can one forget the many pictures of our elders viewing family members through windows and glass doors? Though hidden under PPE, nurses continued to provide the needed human connection, with large picture IDs on their PPE so patients knew their care givers. Or even more, the use of videocalls to connect families throughout their hospitalizations and particularly during last minutes in the critical care units. When families were allowed outside the rooms, nurses and other personnel made a human chain from the patient to the windows, so a sense of touch and presence were evident. Through cross training, nurses were present for each other as they supported each other through the many hours, days, and months of the multiple surges. Self-care strategies were emphasized for all as the physical and emotional strain became evident. The provision of social support, particularly mental health support, became crucial as nurses had the dual concerns of personal health (not becoming ill with COVID-19 themselves) in addition to the emotional strain and moral distress seen and felt. An increase in Help lines and even Mental Health check in apps were developed to provide the needed support. 2, 3 Nursing organizations throughout the country offered educational offerings to all nurses, not just their own members. The American Nurses' Association (ANA) 4 developed a series of COVID-19 webinars emphasizing PPE, the physiology and treatment of the disease, moral distress, self-care strategies, and the healthcare disparities. Nursing specialties such as the American Society of Perianesthesia Nurses (ASPAN) 5 developed toolkits on how to care for the those with COVID-19. Within nursing education, the National League of Nursing 6 shared teaching tools with nurse educators as everyone switched to a virtual environment for teaching. There was a national call encouraging retired nurses and doctors to assist as they could. 7 Nursing schools 8 offered free courses to update bedside skills for critical care areas and how to become data trackers. Additionally, the National Council of State Boards of Nursing 9 modified the NCLEX -RN exam to accommodate social distancing and other public health protocols while maintaining the licensure standards needed to credential our nursing workforce. Our nurse educators transitioned to a virtual environment within a weekend. For our prelicensure faculty, synchronous teaching continued, but by webinars and virtual clinical experiences. For residential schools, students did not return to their schools in the spring of 2020, whereas commuter schools had students who either stayed in town by themselves or returned to their hometowns. Graduate faculty had students who worked in the various clinical areas, but many lost clinical preceptors for their advanced practice clinical hours. Prelicensure faculty were present for their students as they worried about their clinical competency upon graduation, and dealt with new terms of contingency or emergency protocols where PPE preceded any nursing care given. Many nursing students are also the ancillary care personnel in our facilities, and had to deal with becoming ill with COVID-19, as did many of our nursing colleagues. Many were also in social isolation during the riots following the death of George Floyd. Other students lived in areas that dealt with forest fires during the summer and fall, choosing to attend virtual classes as they simultaneously waited for evacuation orders for their own personal safety. Nursing presence was felt by our own families as we decided what was needed to protect ourselves and our individual families, while providing calm explanations during uncertain times. Nurses on the COVID units took extra precautions of separating themselves from their immediate families either in their homes or elsewhere. For those with children, changes ranged from baby sitting to homeschooling, other nurses worried about aging parents, or even themselves if they were our more senior nurses or had some of the risk factors. As vaccines became a real possibility, nurses were present to support the vaccination process by educating their families and community. Many nurses became vaccinators, working diligently to assist with vaccinating their community members. Some of the initial vaccination sites were open around the clock, so essential workers and our most vulnerable could become vaccinated quickly. [10] [11] [12] Presently, we have 56.4% of the United States citizens fully vaccinated. 13 Masking and social distancing mandates differ per region in response to current surges of the Delta variant of COVID-19. Our acute care and long-term facilities are cautiously allowing family visitation. Within nursing programs, nurses continue to be present as we transition back to classrooms, offering clinical experiences for prelicensure students and preceptors for our graduate students. Did you see yourself mentioned in several scenarios above? Were you at the bedside in our COVID units, or cross trained to provide support? What about you, your family, and community, how were you present? Perhaps you were also a student or maybe a faculty member, or an administrator needing to make some of the difficult decisions. Our nursing presence is and was at the center of this pandemic. It is the Year of the Nurse 2020-2021! A critical hermeneutic analysis of presence in nursing practice Well-Being Initiative: Resources for Individuals ANA Well-being initiative ANA's COVID-19 Video Education Series ASPAN COVID-19 toolkit for the perianesthesia nurse 2021 revised Retired doctors and nurses don scrubs again in coronavirus fight retired medical workers are heeding calls for help amid the coronavirus outbreak. By Kaiser Health News Learning launch course to help nurses prepare for COVID-19 care COVID-19 impact to NCLEX candidates Accessed CDC Guide to Vaccinating Workers Office of Governor Doug Ducey. State, partners opening 24/7 COVID-19 vaccination site at state farm stadium. News Release Douglas county residents attend COVID-19 vaccination clinic at creighton Available at COVID-19 vaccine rates over time