COVID-19 had a significant and far-reaching impact on the global healthcare sector. Since its emergence in late 2019, the pandemic has fundamentally reshaped how healthcare services are provided around the world. Nursing — as one of the key components of frontline health care delivery — has been significantly impacted by this transition. These changes have included everything from a shift to more remote working practices to dealing with increased rates of stress and burnout due to an increased workload.
The evolution of healthcare demands
Even though we are now on the other side of the pandemic, many of the changes we saw remain. If we cast our eyes back to March 2020, In a matter of months, many hospitals and clinics went from serving patients with chronic illnesses to managing an influx of those ill with the novel virus. Nurses were among the first line of responders in this crisis, providing essential care for all patients regardless of their diagnosis. Many roles and responsibilities were placed on their shoulders. This included things like administering medication, monitoring vital signs, and providing comfort to those suffering from symptoms due to COVID-19 — all while trying not to get infected themselves.
Resources being stretched thing across different departments had an impact, too. Intensive care units (ICUs) were swamped, leading to nurses expanding their duties and taking on additional roles. Techniques like ventilator management and endotracheal intubation procedures were common in the early days of COVID-19, and nurses were heavily involved. Nurses also had to learn how to manage complex cases involving multiple health issues caused by prolonged hospitalization during the pandemic — something which they rarely encountered prior to 2020.
At the pandemic’s peak, the needs in some areas had grown so great that medical professionals without clinical experience or formal training were being recruited into nursing roles. This rapid change in scope forced nurses into new positions and required them to adapt quickly. They were faced with unfamiliar circumstances and had to be ready for whatever was thrown their way.
The reality of burnout
Nurse burnout is not new, but it was ramped up during the pandemic. Burnout is when someone is emotionally, physically, and mentally exhausted, and it can be brought on in many ways. It can lead to feelings of inefficacy, depersonalization, and a lack of accomplishment. Unsurprisingly, burnout became more common among nurses during COVID-19. The combination of long shifts, inadequate staffing levels leading to overwork, and lack of PPE were the main causes. Many nurses — like people from a whole range of different industries — reconsidered their futures. This impacted the nurse shortage, but thankfully many smart people are working on closing the gap.
Although being a nurse throughout COVID-19 was often demanding — coupled with a constant concern of becoming infected themselves — there were still positives. Many nurses experienced a journey of resilience and growth through those very challenging times. They were put under pressure and constantly rose to the occasion — protecting the public in the process. A common anecdote from nurses through this period was that a unique sense of community developed among nursing staff. Due to necessary precautions implemented for infection control, nurses found themselves navigating a new normal, often at a distance from their families. This fostered an even stronger bond among them as they united in their shared commitment to care for others, essentially becoming a family away from home.
Burnout is bad for employees but also for employers. Burnout among healthcare workers can result in decreased morale among colleagues. It can also lead to an overall decrease in quality patient care due to staff fatigue. This could include things like making errors when writing prescriptions or administering medication. It’s important that everyone involved in healthcare organizations — staff and leaders alike — take the threat of burnout seriously and be proactive about it.
Addressing the shortage of nurses
There was already a global shortage of nurses prior to March 2020. The demand for nursing care has been steadily increasing for some time. This was largely due to an aging population and growing healthcare needs in many parts of the world. This was only been compounded by COVID-19, as hospitals saw a sharp increase in patients requiring care.
Healthcare is an industry that has historically faced budget constraints, which is one reason why there was a preexisting shortage of nurses. The problems this caused go beyond just the welfare of the nurses themselves. It resulted in longer wait times at hospitals and compromises in patient safety. It also led to disruption in areas of healthcare deemed less time sensitive. This included things like non-urgent surgery and medical device maintenance.
In response to the increased demand for nurses, healthcare organizations have approached things in different ways. By pursing a Bachelor of Science in Nursing degree or other advanced nursing course at an online university such as Spring Arbor, students can improve their skills and knowledge in mental health care, pediatric care and how to provide treatment to patients with a variety of illnesses.
There are various measures that have been used to try and entice people to become nurses, and some of these are:
- Offering sign-on bonuses and retention bonuses.
- Increasing overall pay rates.
- Offering flexible work schedules.
- Providing tuition reimbursement and loan forgiveness programs.
- Offering mentorship programs.
- Providing career advancement opportunities.
- Offering on-the-job training programs.
- Providing more mental health support for nurses.
There was government involvement with attempts to create agreements to bring in nurses from overseas. Policymakers also increased funding for nursing education and residency programs and offered incentives for nurses to work in underserved areas. All of these policies have had differing amounts of success, but the nursing shortage still persists.
The changing landscape of nursing education
Since the start of the pandemic, nursing education had to rapidly adapt and adjust in order to address the new healthcare needs created. Many changes were implemented within classroom learning and clinical practice. There were even nursing simulation experiences introduced in order to meet safety requirements while still allowing students to continue their education.
Many universities — both across the United States and throughout the world — moved nursing courses online. This was true for both lecture classes and lab sessions. Some have since moved back to the traditional way of doing things, while others have opted to go with a hybrid model of both. This shift from traditional face-to-face instruction posed a challenge for educators in a number of ways. They had to learn how best to utilize technology and create an effective remote learning experience, and they had to do it quickly. The inability to do hands-on work with patients in acute care settings was especially challenging.
The pandemic also caused fluctuations in enrollment numbers. It was a time of change, with many people reconsidering what was important to them and what their future looked like. This posed a financial burden on many nursing programs nationwide. It also decreased graduation rates due to delayed program completion times resulting from canceled internships or reduced course loads per semester. Despite these challenges, many schools found creative ways to make it work — everything from to virtual labs that allowed student access.
Policy changes and their impact
Governments and health systems implemented a wide range of policy changes in order to respond to the need for increased care. These policies included increasing nurse-patient ratios and suspending some regulations related to licensure and scope of practice. They also expanded telehealth services and sought to bring on more nurses from outside sources like travel nursing agencies. Although many policies were wound back as we came out the other side of the pandemic, many are still with us.
These policy changes had a significant impact on nursing practice. The increased nurse-patient ratios provided much-needed support during times when hospitals were overflowing with patients. This also allowed for greater continuity of care as fewer nurses were needed per patient. The relaxation or elimination of certain regulations allowed nurses to use their skillset beyond what they may be traditionally trained in. This helped to alleviate staffing shortages in different areas. Telehealth services provided easy access for patients who felt uncomfortable seeking physical care, and they also allowed for remote follow-ups from clinicians.
While policy changes have brought about some significant benefits, it’s important to acknowledge the challenges they’ve introduced. Nurses — who had already demonstrated remarkable resilience in their roles before the pandemic — faced an even higher demand on their strength and stamina. These demands included extended working hours and decreased opportunities for rest. But with these challenges also comes the opportunity for better understanding and potential solutions. We are now more aware than ever of the strains on our nursing workforce, paving the way for positive future policy adjustments and interventions.
The role of technology in nursing practice
We have touched on telehealth several times throughout this article, but that’s not the only place where technology has changed. COVID-19 accelerated the use of technology in many areas of healthcare, and nurses have been at the forefront. In addition to telehealth, healthcare organizations have started implementing AI-assisted decision-making tools and just generally using more advanced systems in their IT processes.
One other example is remote patient monitoring systems. These tools allow hospitals and facilities to track vital signs remotely without needing additional staff members present all the time. Nurses are also increasingly using digital health apps that allow them to access patient records quickly from any location with internet access.
Seeing how successful these technologies were during the pandemic should give us confidence about their continued use going forward. This is especially true given they can ease some of the burdens on nursing personnel. We never know when there will be another challenge to deal with — or even the next pandemic — but digital technology will surely play an increasingly important role.
Preparing for the future
As we have mentioned again and again, the COVID-19 pandemic brought about significant changes, many of which are still with us today. These changes were very much felt throughout the nursing industry. The lessons learned during this unprecedented time highlighted long-standing issues that need to be addressed to build resilience for future crises.
The pandemic reiterated just how important nurses are and that they are at the forefront of patient care. Their role is crucial in managing any crisis effectively. It’s for this reason that the nursing shortage must be solved. This problem is also twofold. It’s not just about bringing in new nurses but also ensuring existing nurses are looked after. The long working hours, the high caseloads, and general mental and physical fatigue are all reasons that nurses may look at different careers. Addressing these issues will require hospitals and healthcare facilities to prioritize employee well-being.
As we alluded to in the last section, technology was proven invaluable during the crisis. Many areas of healthcare and society generally were able to function in light of strict lockdowns through the use of creative technological solutions. Healthcare providers should continue to invest more resources into technology solutions that can help them be flexible in times of need.
Policymakers must also lead the charge. They need to take steps towards overhauling nursing education so that graduates are better prepared with the skill sets relevant beyond traditional hospital settings. Teaching them to prioritize their own well-being while still being great at their job should also be part of this overhaul.
Nursing leaders must advocate for policy changes aimed at addressing these systemic issues. This could include workplace safety concerns like lack of PPE availability — which was a huge problem during COVID-19 — or exacerbated stress levels amongst staff. This could also include things like reimbursement rates from insurance companies. Some of the more extreme lockdown mandates led to smaller practices struggling to keep the lights on, and this should be considered before the next major global crisis. The COVID-19 pandemic presented unique challenges for nurses and healthcare workers worldwide. Nurses shouldered a major burden of the crisis, going above and beyond in their roles to provide effective care for patients. In response to these demands, nurses adapted quickly. They retrained in new clinical skills and found alternative ways to mentor students and maintain staff morale. This demonstrates remarkable resilience and adaptability in the face of unprecedented difficulty. It is clear that society will fall apart without nurses the next time we face a pandemic. It’s for this reason that it is critical for us to continue to support them going forward.