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MY PREVIOUS DISCUSSION with PROFESSOR:
Many of the challenges these nurses reported facing while talking to them mirror those that they faced before the pandemic, such as balancing family, work, and school and time management. Limited resources, longer shifts, disruptions to sleep and to work-life balance, and occupational hazards associated with exposure to COVID-19 have contributed to physical and mental fatigue, stress and anxiety, and burnout, (Adams, 2020). Similar to most hospitals in the COVID-19–affected areas, the Houston Methodist Hospital (HMH) system has experienced an overwhelming impact of this pandemic on personnel.
While the majority of surgical nurses reported being well-aware of what they needed to do to stay safe during the pandemic, many still struggled with concerns over mental and physical health. While the physical effects of COVID-19 have been documented extensively, nurses actually reported relatively greater concern over their physical health. The rapid spread of the COVID-19 pandemic revealed an overall lack of preparedness and insufficient training as well as limited supplies of PPE for ICU staff, including anesthesiologists, intensivists, pulmonologists, nurses, respiratory therapists, and other front-line providers in most affected areas.
March 2020, from the onset of the COVID-19 outbreak, it was apparent that testing for the virus, detecting its distribution through widespread surveillance, and subsequent contact tracing were major public health gaps. Most hospitals, including HMH, lacked the capacity to test significant portions of our patient population for novel infectious threats. This removed a highly effective infection control tool from our arsenal. Unfortunately, such unpreparedness, potentially resulting in poor patient outcomes, had a significant psychological burden on personnel.
The COVID-19 pandemic has revealed several issues related to current processes and established practices. Most importantly, the lack of established policies for pandemic triage, equipment ordering, and emergency management has led to systemwide inefficiencies and has increased the burden on health care workers. While business is booming in health care, all indicators point to a likely sustained overall economic downturn. This undoubtedly contributes to health care workers’ stress and anxiety. It is well documented that such uncertainty about future occupational stability (job security) is associated with a deterioration in mental well-being, (Pollard, 2001).
Several traits of resilient performance and improvisation have been observed at HMH. The incident command team was rapidly assembled; leadership–employee communication was constant and responsive; and human resources (HR) adapted policies to employee needs. To long-standing employees, these adaptations were not surprising, because our leadership and teams have literally weathered storms before, including in recent history, Hurricane Ike and Hurricane Harvey. Hurricanes are not pandemics, but their local effects are similar in terms of financial and emotional strains on employees, as well as sudden geographical isolation of both employees and patients.
As the hospital is not doing any elective procedures, which has freed up staff to help out elsewhere in the hospital. For those in designated COVID-19 units, the hospital has also increased its training, with a great deal of effort being around proper use of PPE. Houston Methodist has also adapted its pay to offer paid time off for staff missing work for exposure to the coronavirus, provided complimentary meals—from the hospital and community organizations—and maintains daily briefings with employees to keep them informed. Additionally, patients can access virtual urgent care online, which enables patients experiencing COVID-19 symptoms or wanting to avoid catching germs to connect with a virtual urgent care provider 24/7, according to Houston Methodist’s website.
References:
Adams JG, Walls RM. Supporting the health care workforce during the COVID-19 global epidemic. JAMA. 2020 March 12.
Pollard TM. Changes in mental well-being, blood pressure and total cholesterol levels during workplace reorganization: the impact of uncertainty. Work Stress. 2001; 15:14–28.
PROFESSOR: It sounds like your hospital is a wonderful place to work. The employee well-being does seem to be important to the facility and that is not the case in every facility. How is it going working toward your objectives? Do you anticipate any barriers to meeting your objectives?
MY RESPONSE:
Thank you for reading my post. I agree that the hospital that I am working with right now values the employee. I am anticipating barriers to meeting my objectives. With this pandemic, I know that this practicum is conducted in environments where constant changes and challenges are required, and dynamic interactions with various types of occupations, both professional and nonprofessional, exist (Lancaster et al., 2015).
During this pandemic, I know that everyone is now nauseated with the news and constant changes. I know that they feel like they are just obliged to answer and talk to me as I am their current Manager. I feel stressed and helpless because there seems to be nothing they can do about it (Anthony and Yastik, 2011).
I may revise the title of my project. I have “The Impact of the COVID‐19 Pandemic on chosen Surgical Nurses of HMH and their Practices”. Since COVID-19 is a new pandemic, though a lot of reading and research is starting to come out – I intend to do a literature review on how these nurses, not just Surgical nurses, respond to a pandemic. I am thinking of classifying the impact of COVID-19 to Nurses – may it be physically or psychologically, etc.
Another barrier is that I am on the frontlines of the pandemic response as a practicing Nurse Manager. A lot of my staff depend on me on the update or any changes with the hospital policy. I have a Nurse Director who is my preceptor that is on the frontline as well. We recently were visited by the DNV surveyors, and undoubtedly we prepared each unit we handle. We are also preparing for the MAGNET 5th Re-designation of the hospital. I feel that there are too many things on my plate right now. With the homeschooling of my two kids, ages 18 and 7, I needed to guide them as well.
As a student, I always tell myself that I know that I could learn through the lived experience of being a registered nurse and a graduate student during this worldwide pandemic. I appreciate you, Dr. Tara, for being considerate and understanding.
References:
M. Anthony, J. Yastik. Nursing students’ experiences with incivility in clinical education J. Nurs. Educ., 50 (3) (2011), pp. 140-144, 10.3928/01484834-20110131-04
G. Lancaster, S. Kolakowsky-Hayner, J. Kovacich, N. Greer-Williams. Interdisciplinary communication and collaboration among physicians, nurses, and unlicensed assistive personnel
J. Nurs. Scholarsh., 47 (3) (2015), pp. 275-284, 10.1111/jnu.12130
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