In a year set aside to celebrate the achievements of nurses and midwives around the world, never before has their value been more clearly demonstrated. The World Health Organisation has declared 2020 the International Year of the Nurse and Midwife to showcase the brilliant work these hardworking practitioners accomplish around the world in providing professional and compassionate care to the sick, injured and dying. And it has quickly become the most challenging year of their lives.
What would Florence Nightingale do, faced with COVID-19? No doubt, she’d roll up her sleeves and get to work, reminding everyone to wash their hands.
Just like the millions of nurses who have come after her, setting a standard of care that saves lives every single day.
The International Year of the Nurse coincides with the 200th anniversary of the birth of Florence Nightingale, the founder of modern nursing. Well ahead of her time, she pioneered hygiene practices, data analysis and even infographics to better explain statistics, taking what was then considered a lowly job and turning it into a noble vocation even the upper classes felt proud to enter into.
Something Nightingale was noted for was her calm demeanour and her methodical approach to maintaining a clean and calm hospital environment, which is something nursing staff continue to strive for to this day, even under the most stressful of circumstances.
Suzanne Metcalf is the executive director of nursing and midwifery for the Sunshine Coast Hospital and Health Service. She says our nurses and midwives are used to working under stress and are well equipped to face whatever comes our way.
“I believe our nurses and midwives are an incredible team and I’m proud of the work they do in caring for our community,” she says. “They’re resilient.
“They’ve had extensive training and one of the things we pride ourselves on is the ability to remain calm and think clearly under pressure.
“Where the pandemic is different, is that they are balancing the demands of work and home life. Many have the responsibility of looking after elderly parents or schoolchildren, as well as working here in the health service. That can obviously impact them enormously, how to keep them safe and also save the community on the frontline.
“It’s an emotional time for everyone, including our nurses. There is a bit of irony with regards to this being a tough year with COVID-19 – it wasn’t something we were expecting as part of celebrating the Year of the Nurse.”
Some media reports have focused on a lack of PPE (personal protective equipment) for doctors and nurses around the world, however Ms Metcalf says the Sunshine Coast is in no danger of running out. “We have enough PPE to meet the needs of all of our staff,” she says. “Queensland is unique in that we have our own significant stockpile. We have strategies in place regarding the use of PPE to make sure we conserve the amount of stock and it remains available.”
Ms Metcalf says the Sunshine Coast Hospital and Health Service currently employs around 3300 nurses and has around 500 casual nurses who will also be stepping in to meet the increasing demand.
“Across the country, routine procedures are being postponed and outpatient appointments are being changed or cancelled,” she says. “Nurses currently within the Hospital and Health Service are sharing their ability to adapt, taking on new tasks and new skills to support the community. Some are being redeployed. This is part of the planning we’ve undertaken to ensue we have the right number of staff in the right place.”
She says reports of nurses being ‘rushed through’ their study to become registered are false. However, last week Health Minister Greg Hunt announced up to 20,000 nurses would be trained online for high demand and intensive care needs, including fitting ventilators, at a cost to taxpayers of $4.1 million. He also said a further 3000 former nurses had put their hands up to return to the workforce.
Ms Metcalf began her career as a nurse in the UK, following in the footsteps of her grandmother.
“I’ve been nursing for 24 years and it’s a profession with great opportunities,” she says. “You’re not limited to just being a bedside nurse. It is certainly a very rewarding career and we’re in a unique position to look after our community.
“Hopefully we have a great opportunity in 2020 to show the community the excellent work we undertake in nursing and we’ll have an opportunity to shine. We’re here and we’re ready.”
Kate* is a nurse in one of the emergency departments on the Sunshine Coast and says things are strangely quiet at the moment. But the department is bracing itself for what is to come. She says there’s a lot of misinformation circulating and would like people to know the Sunshine Coast is well prepared for COVID-19.
“There’s misinformation that nurses don’t have the proper protective equipment,” she says. “We’ve had no issue with accessing PPEs [personal protective equipment] in my workplace. Right now, the curve is flattening and the message is really getting out there that this is a real thing and the best place to be is at home.
“Right now, it’s really quiet in the emergency department where I work. People are managing their symptoms at home, there’s less road trauma, people aren’t driving as much and we’re not seeing as many sporting injuries.”
Kate became a nurse 30 years ago and says what’s happening now is unlike anything she has ever seen before. However, she believes the respect now being bestowed upon medical staff across the world for selflessly putting themselves on the frontlines is a long time coming, particularly for nurses, who have often been underpaid and undervalued and seen almost like hospital waitresses.
“We’ve still got a long way to go before nursing is seen in the eyes of most people as a profession,” she says. “We often get ‘oh, you’re just the nurse’. But it’s up to my assessment whether you get seen by the doctor in 10 minutes or two hours. You’re triaged according to how a nurse assesses your symptoms.
“I feel we need to impress upon the public that nurses are highly studied professionals. We’re not handmaidens to doctors anymore; we’re professionals in our own right and practitioners in our own right.
“That’s an important thing the public needs to be aware of. We’re not heroes; we’re going to work because it’s our job.”
Kate says nurses work very much in a team with doctors and allied health professionals and the hierarchy that once existed is changing.
“I never feel like I’m less than my colleagues that are doctors. I’m consulted, I’m part of the team. They’ll ask, ‘what do you think? Let’s nut this out, what could be happening here?’ I think emergency departments are more like that because they have to be.
“I love the fact that I can make a difference in someone’s life,” she adds. “People come to us, especially in emergency departments, and it’s often the worst day of their life. They’ve had a heart attack or we’ve told them they’ve got a condition that means they’re not going to live. We have to have difficult conversations with people and that’s an honour. I love that we get to be there for people and make a difference to how this hard stuff is experienced.
“And now we have coronavirus, which is definitely scary. You don’t know if someone who has been brought in after a car accident is positive for the virus, or if they’ve had contact with someone from a cruise ship.
“We’re going to get inundated and it’s only a matter of time. People are going to get sick and be off work and their places need to be filled. The sheer workload is going to be much higher. But we are prepared and we are supported.”
*Name changed to protect privacy.
At a glance
Nurses and midwives account for nearly 50 per cent of the health workforce around the world.
Of the 43.5 million health workers around the world, 20.7 million are nurses and midwives.
Nurses play a critical role in health promotion, disease prevention and delivery of primary and community care, as well as care in emergency settings.
Globally, 70 per cent of the health and social workforce are women compared with 41 per cent in all employment sectors. Nursing and midwifery occupations represent a significant share of the female workforce.
A new World Health Organisation report, The State of the World’s Nursing 2020, recommends all countries increase funding to educate and employ more nurses, establish more nursing leadership positions and improve working conditions and salaries.
A first-hand account
Ashleigh Woods will never forget the first time she had to help a doctor insert an endotracheal tube into a patient’s lungs so they could breathe.
“It’s pretty intense. We got through it… I stepped outside and just burst into tears because I was so overwhelmed,’’ she says.
“You have to concentrate the whole time and you’re in the zone and you block all of your feelings, and then you walk out and go ‘oh my God that was so intense’. That’s why debriefing is so important.”
The 25-year-old Southern Cross University graduate, who is now a registered nurse and midwife, is accredited in advanced life support and works in an airway role in an emergency department resuscitation room. She is also now one of the many nurses and medical staff braving the frontline of the COVID-19 pandemic.
As there is no current cure for the virus itself, patients are treated for individual symptoms. The majority of people with COVID-19 will have mild symptoms and will recover without needing hospital care.
Unfortunately, though, some patients will be significantly unwell and will need to be cared for in an intensive care unit.
“Not all nurses can work in critical care or in ICU,” Ms Woods says.
“I can ventilate someone as an emergency nurse but not in the long term. I don’t have that training.”
“We’re all on the spot now. You just become flexible, you adapt and do what you need to do and overcome it.”