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Behind the masks, nurses are worried but determined

Europeans have taken to applauding the efforts of health care workers on their balconies every night during the COVID-19 pandemic. The worryingly high death-rate among health workers speaks for itself about their heroism in the face of this unprecedented pandemic.

Incidentally, 2020 is the International Year of the Nurse and Midwife. It would in any circumstances been well-merited, but rarely have health care professionals been more essential than now when nurses, like all health care workers, are on the front line in the war against COVID-19. UNRIC talked to nurses across Western-Europe to find out how they are coping.

André Sobral works in the Intensive Care Unit in Santa Maria’s Hospital, the biggest hospital in Portugal. “Basically, I’m constantly in the Intensive Care Room, in the red zone, where we must follow a strict protocol. I’m monitoring up to 2 or 3 patients at a time, monitoring medication, ventilation and complying all medical guidance.”

Kathleen is a nurse at the Sint-Augustinus Hospital in Antwerp, Belgium where 100 patients are being treated for COVID-19 at the moment, but it is expected to rise considerably.

“On the one hand, there is a restless atmosphere in the hospital, but on the other hand, we all share the feeling that we are going for it together. I don’t want to be a hero at all, I’d rather be safe at home, but being part of a well organised and supportive team that tries to ensure everything runs smoothly, gives me reassurance,” the Belgian nurse said in an interview with UNRIC.

“We are all feeling stressed and we are trying to stand by our colleagues and patients. We are fearful, especially regarding a possible lack of medical material,” Ms. Dioni a Greek nurse told UNRIC.

Lack of face masks and even more seriously ventilators are among the issues virtually all health workers worry about. “However, we are optimist that we will make it, and this makes us even stronger,” adds Dioni.

Behind the protective masks – where they are available – are worried people, who like all of us, have to bear in mind that their very presence in the company of others may be dangerous.

Medical staff in Iceland preparing for COVID-19 patients
© Landspitali/TH.Thorkelsson

 

The elderly

COVID-19 hits the elderly harder than younger people. Many of them rely on the visits of carers, nurses and others to their homes, but at the same time, their visits can put their health in jeopardy.

Mireille Delon, a nurse in Montpellier in the south of France visits 10-15 patients a day, aged between 70-100 years, and in many cases is the only person they meet due to the virus. She and her colleagues are constantly worried about infecting these vulnerable people.

“Every time I leave the house, I am worried sick,” Delon told UNRIC. “I have the feeling that the virus is everywhere, and I am constantly on watch; when I open a door when I push a button in an elevator when I touch a doorknob. I am anxious because of fear that I carry the virus from one house to the other.”

She considers herself lucky that there is sufficient stock of face masks in her office. She makes sure to clean thoroughly all surfaces she touches in her car when she gets into it.

But in some places, the number of people caring for the elderly, with or without a face mask, may decrease quite suddenly. In Germany, up to 300,000 households are dependent on the help of foreign caregivers, predominantly from Eastern Europe.  It is expected that most of them will leave the country to return to their home countries. An estimated 100.000 – 200.000 elderly will be left without support by Easter.

Medical staff on the front line of COVID-19
© Landspitali/TH.Thorkelsson

 

How to cope with stress

Emergency nurses are of course the ones on the forefront but all nurses, no matter what their speciality is, are touched by the pandemic. Hannah is a British nurse working in sexual health but has been redeployed. “For a lot of nurses and health care workers their lives are being completely turned upside down so we can all join the front line and fight the virus,” she told UNRIC.

But how can nurses and other health workers cope with such stress?

Dr. Hans Kluge the WHO Regional director in Europe told a briefing on Mental Health and COVID-19 last week that he stuck to the methods that had served him well in the past when under pressure;  simple relaxation techniques, like breathing exercises, muscle relaxation, and mindfulness meditation. “I also try and acknowledge upsetting thoughts when they occur and discuss them with people around me. They are likely to have them too and we may be better able to find solutions collectively. Try to stay positive.”

Dr. Aiysha Malik, technical officer in WHO´s Department of Mental Health gave some advice at the WHO briefing last week. “Health workers face immense pressure right now and the protection of health worker´s mental health is crucial.”

She said it was important to rotate staff from high risk to low risk on a regular basis and mix highly experienced staff with less experienced. Good communications were imperative, and everyone should be able to approach people to talk about how they feel and how they are doing.

Last but not least, she emphasized that rest was extremely important. But rest is, unfortunately, a luxury that most health workers cannot allow themselves at the height of the pandemic.

Vigdís Árnadóttir, a highly experienced Icelandic nurse, says that in some hospitals in the hardest-hit countries nurses and health-care workers are getting 2 to 4 hours sleep. “Is it possible that this has contributed to the high death-rate? Have these people been so exhausted that their immune systems have suffered to such an extent that they have died from the virus?”

Even before the COVID-19 outbreak, it was known that hospitals in many countries were suffering from years of budget cuts. In Germany, for instance, there are not enough medical staff, including nurses, due to low salaries.

As in many other countries, people have been applauding to demonstrate their respect for medical staff. But in Germany, this has not necessarily been well-received. Nurses do not want to be “Heroes, just for one day” to paraphrase David Bowie’s famous song.

In a Facebook post that has gone viral in Germany, a nurse said that people’s applause, while meant well, does not change her salary or the fact that she is exposing herself to the illness. Nurses are suddenly called heroes, though their work has always been meaningful and saved lives, not just during the COVID-19 crisis.

The COVID-19 virus is unfortunately not going away anytime soon. In the words of Dr. Malik from WHO, “This is a marathon, not a sprint.”

 

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