What will nursing look like after COVID-19?

[Lightning Rose]

Many people are asking when will life return to the way it was before COVID-19.

Spoiler alert: It won’t.

After World War II, people wanted to forget the hardships of the past decade and tried to go back to the way things were, or believed should be, only to find the world and themselves forever changed. History has a tendency to repeat itself. Life post-COVID will change lots of things, especially nursing.

The Final Straw

Nursing has always had problems, from chronic short-staffing to disagreeable patients and family members to management fussing over petty details, just to name a few. For many nurses, COVID is the final straw. This pandemic is burning both ends of the candle too quickly for too many bedside nurses, having to enter a COVID patient’s room without proper equipment and even becoming sick with COVID themselves. As of writing, eight of my co-workers are sick with COVID, those who are not on a ventilator are likely asking themselves some very tough questions:

• Did I accidentally give COVID to my loved ones?
• Will I make it through this pandemic intact?
• Why did I become a nurse in the first place?
• Will I stay at the bedside when this is over?

To Stay or Not to Stay at the Bedside

Even if they aren’t sick, many nurses are beginning to seriously question whether or not they will remain at the bedside. I predict an exodus of bedside nurses, at least 20% if not more, during and after COVID. The treats and notes from the public are appreciated, as are the compliments from administration, but for many, it is too little, too late.

But that doesn’t mean nobody will be left to care at the bedside. A lot of brand new nurses, particularly those who have lost their jobs due to COVID, will enter the workforce. They will have been told nursing provides guaranteed employment and a decent salary and is a promising career in general. They may have been warned of the incredible difficulties, or they may have not. A lot will just be glad to have a job and not worry about losing their homes or their children going hungry. Whatever their knowledge, whatever their reasons, it is up to the experienced nurses to guide the next generation.

Better Equipped

Those at the bedside after COVID will be better equipped. Masks, gowns, gloves, and Clorox wipes will be better stocked in case another pandemic occurs. Post-9/11, airport security heightened and has remained this way, the same will be for hospitals. They will be a lot pickier about who comes in, likely still taking temperatures and limiting visitors (this can be a good thing!). Administration will learn from the post-COVID exodus of nurses and will do more to make nurses’ jobs easier, such as setting clear boundaries for unacceptable behavior from patients (of sound mind) and family members. I believe they will make more of an effort to staff their nurses fairly, but it is a budgeting issue and hospitals technically are a business, this will require quite a lot of work. Maybe administration and the public will be more appreciative of what those on the front lines do, how we put our own health and well-being on the line for the sake of others.

Greater Variety of Job Opportunities

Nursing will have more variety of job opportunities. Burned-out nurses will be (and most likely already are) looking for opportunities away from the bedside, even creating them. They are making face masks, building businesses for nurse products on Etsy, blogging about nursing, and writing articles. As nurses, we wear many hats. We are not only healers, but we are also teachers, counselors to patients and family members, mentors to nurses learning the ropes, innovators (how many times has a piece of equipment went missing or malfunctioned and you had to be creative with what you had?) and leaders.

We are Strong

We are strong. We are adaptive. We are resilient. We are capable of so much more than we think. Borrowing from the Marine Corps mantra: we improvise, we adapt, and we overcome.

Things cannot go back to the way they were, and judging from the past difficulties, we shouldn’t want them to. The best we can do is move forward. There are better times ahead. The best is yet to come.

Whether you’ve been on the front lines for three months or forty years, thank you. Whether you’re a student, a newbie, or you’ve been around the block more than a few times, thank you.

You are a hero in real life.

[scribblz, BSN, CNA, LPN]

I like your optimism ? I certainly hope the best is yet to come! 

[Lynker, LPN]

I love this article, as a new nurse and student. I agree with Scribblz, the optimism is so important in times like these!

[ICU/EMTP, BSN, EMT-P]

It’s going to look just like it did before and during the Covid; shortstaffed, lack of equipment, terrible administration and organization, and no real plans for future calamities. Hey, you’re all heroes, but we’re cutting your hours because we lost tons of money on this deal! Sorry. ?

[zoidberg, BSN, RN]

I’m planning my bedside exit. If 3:1 is now acceptable in the ICU... I’m out. You’re delusional  if you don’t think admin hasn’t noticed  just how “productive” we can be and just how little staff we can run with. 

[GettingThatRN]

On 9/1/2020 at 8:33 AM, Lightning Rose said:

Many people are asking when will life return to the way it was before COVID-19.

Spoiler alert: It won’t.

After World War II, people wanted to forget the hardships of the past decade and tried to go back to the way things were, or believed should be, only to find the world and themselves forever changed. History has a tendency to repeat itself. Life post-COVID will change lots of things, especially nursing.

The Final Straw

Nursing has always had problems, from chronic short-staffing to disagreeable patients and family members to management fussing over petty details, just to name a few. For many nurses, COVID is the final straw. This pandemic is burning both ends of the candle too quickly for too many bedside nurses, having to enter a COVID patient’s room without proper equipment and even becoming sick with COVID themselves. As of writing, eight of my co-workers are sick with COVID, those who are not on a ventilator are likely asking themselves some very tough questions:

• Did I accidentally give COVID to my loved ones?
• Will I make it through this pandemic intact?
• Why did I become a nurse in the first place?
• Will I stay at the bedside when this is over?

To Stay or Not to Stay at the Bedside

Even if they aren’t sick, many nurses are beginning to seriously question whether or not they will remain at the bedside. I predict an exodus of bedside nurses, at least 20% if not more, during and after COVID. The treats and notes from the public are appreciated, as are the compliments from administration, but for many, it is too little, too late.

But that doesn’t mean nobody will be left to care at the bedside. A lot of brand new nurses, particularly those who have lost their jobs due to COVID, will enter the workforce. They will have been told nursing provides guaranteed employment and a decent salary and is a promising career in general. They may have been warned of the incredible difficulties, or they may have not. A lot will just be glad to have a job and not worry about losing their homes or their children going hungry. Whatever their knowledge, whatever their reasons, it is up to the experienced nurses to guide the next generation.

Better Equipped

Those at the bedside after COVID will be better equipped. Masks, gowns, gloves, and Clorox wipes will be better stocked in case another pandemic occurs. Post-9/11, airport security heightened and has remained this way, the same will be for hospitals. They will be a lot pickier about who comes in, likely still taking temperatures and limiting visitors (this can be a good thing!). Administration will learn from the post-COVID exodus of nurses and will do more to make nurses’ jobs easier, such as setting clear boundaries for unacceptable behavior from patients (of sound mind) and family members. I believe they will make more of an effort to staff their nurses fairly, but it is a budgeting issue and hospitals technically are a business, this will require quite a lot of work. Maybe administration and the public will be more appreciative of what those on the front lines do, how we put our own health and well-being on the line for the sake of others.

Greater Variety of Job Opportunities

Nursing will have more variety of job opportunities. Burned-out nurses will be (and most likely already are) looking for opportunities away from the bedside, even creating them. They are making face masks, building businesses for nurse products on Etsy, blogging about nursing, and writing articles. As nurses, we wear many hats. We are not only healers, but we are also teachers, counselors to patients and family members, mentors to nurses learning the ropes, innovators (how many times has a piece of equipment went missing or malfunctioned and you had to be creative with what you had?) and leaders.

We are Strong

We are strong. We are adaptive. We are resilient. We are capable of so much more than we think. Borrowing from the Marine Corps mantra: we improvise, we adapt, and we overcome.

Things cannot go back to the way they were, and judging from the past difficulties, we shouldn’t want them to. The best we can do is move forward. There are better times ahead. The best is yet to come.

Whether you’ve been on the front lines for three months or forty years, thank you. Whether you’re a student, a newbie, or you’ve been around the block more than a few times, thank you.

You are a hero in real life.

Great read! Thank you. 

[159Nursesrule, ADN, BSN, CNA, EMT-B]

There has been a mass exodus where I work (inpatient Med-Surg-Tele) all the PRN's were furloughed, full time and part-time hours reduced but they were paid 70% of their shift and could take PTO for the rest. PRN's only heard from management 3 times during furlough one of the times to tell us not to do any online training that it was considered working and we would not be paid for it.  

Float you to other sections/hospitals with no unit orientations.

Rather than showing that you have resigned they put you as a PRN employee, if you do not show up to work in 3 months they terminate you.

Nurse to patient ratio changed from 5-1 to 6-1, we were working on getting it to 4-1.  To be fair they have increased the tech support, but often send them home or pull for another section. High acuity patients, some are total care. 

Then the surge happened and they wanted all hands on deck, threatening, demanding people work OT etc.  You get one mask to wear all shift.  Only use PPE(gown, gloves) for confirmed isolations, C-diff, VRE, MSRA(wound only).  Doctor's show up in full PPE for rounding and admissions.

Rapid COVID tests for surgery patients suppose to wear N95 mask but have to be approved/issued from house supervisor first. Being told to screen the patient and if they have no symptoms or no contact with those who may be exposed perform test without PPE.

Now surge is winding down and back to before surge, so until elective surgeries pick up again PRN's hours cut out/canceled, full time and part-time placed on call or canceled but can use PTO.

Until the public starts to really appreciate what Nurses do and demand safe nurse to patient ratio's the business will stay the same.  Name of the game is to make money.  Hollywood needs to change how they depict nurses.  We are not there to have affairs, make mistakes, murder patients,  break the law - we are there to care for your loved ones.  Never have I seen a Resident or staff doctor constantly at the bedside performing procedures like Hollywood depicts.

If you get Covid-19 paid for two weeks Covid pay 72 hours after that short term disability. Oh wait if you are PRN no benefits so no pay, or short term disability insurance.

Demanding that you complete on-line and in- person training on your own time or they will take you off the schedule.

The company still posted profits in all quarters of the year, has refused to let employees sell stock. 

Need A/I advancements vitals signs, cardiac and breath sounds which integrate into the medical record.  Increase equipment availbitly, every room should have a set of equipment for that room. 

Education of Nursing students has shifted to virtual, on-line to include clinicals.  As Covid-19 numbers decreased need to get these students back into the facilities for hands on training.  Training needs to shift to reality not the perfect NCLEX world. 

Home health and Telemedicine will become the new norm.  A shift to house calls maybe returning.  NP and PA's will be the driving force for these visits.

Nursing will continue no matter what, now is the time to stand up and fight for our rights and our patients rights.  We need the support and voice of our national and state organizations to facilitate change. 

Thank you to all fellow nurses young and seasoned for your tenacity, wisdom, and innovative ideas you do make a difference.