OPINION | Covid-19: Nurses deliver care with compassion, grit and courage

Nurses and midwives play a vital role in providing healthcare services, and constitute more than 50% of the healthcare workforce in many countries. They are often the frontline healthcare professionals, and first point of care in their communities who devote their lives to caring for patients throughout the continuum of life. Nurses and midwives are teachers, advocates, caregivers, advisors, critical thinkers, problem solvers, innovators, and researchers. 

In addition, nursing is an art and a science, underpinned by a strong foundation of care and compassion. Nurses are often the ones who are at the patients’ bedside 24/7, transforming lives, and who deliver care from the birthing process, to either recovery or peaceful death of a patient. Nurses and midwives remain the core of the healthcare system and healthcare workforce; they are essential in maintaining continuous patient care and establishing a seamless working relationship across the multi-and interdisciplinary teams, with the aim of delivering integrated care. 

Nurses and midwives can transform the ways health actions are organized, decisions, policies and research are implemented and how health care is delivered. They are referred to as the backbone of primary healthcare systems and healthcare establishments and are essential to achieve Universal Health Coverage (UHC). However, as indicated by the World Health Organisation (WHO), globally nine million more nurses and midwives are needed if UHC is to be achieved by 2030.

The WHO designated 2020 as the “International Year of the Nurse and Midwife” to mark the bicentenary of the birth of the founder of modern nursing, Florence Nightingale and to recognize the critical contribution nursing makes to global health. Furthermore, it is a call for nations of the world to unite in celebration of the contributions that the nursing and midwifery profession make to health and the global population. This year is significant for the WHO in the context of nursing and midwifery strengthening for UHC, a time to celebrate the work of nurses and midwives internationally and highlighting the challenging conditions nurse often face in advocating for the profession (WHO, 2020). Thus, it is fitting that this is also the focus of World Health Day (7 April) celebrations for 2020.

In lieu of the WHO’s announcement, many nursing schools and organisations globally started celebrating the profession. However, the nursing world has quickly shifted attention from the WHO’s proclamation of the “International Year of the Nurse and Midwife” to the COVID-19 pandemic. 

In December 2019, a newly identified coronavirus, known as COVID-19, emerged in Wuhan, China causing illness in humans. Multiple clusters of COVID-19 have since been reported across the globe, including the African continent. The United States Department of Health and Human Services declared the virus to be a nationwide health emergency following the WHO’s declaration of a public health emergency of international concern on January 30, 2020. Currently, South Africa is experiencing a lockdown in an attempt to “flatten the curve” and reduce the spread of the virus. On January 21, 2020, China announced for the first time that healthcare workers have been infected, and the count has ever since increased in various countries across the globe. 

Every day the media highlights the conditions that nurses and other healthcare providers are facing and how staff shortages and limited resources may impact the healthcare system’s ability to save lives. Each nurse working with these patients is potentially putting their own health at risk, and many nurses, as reported in so many countries, are contracting the virus despite their best efforts to keep themselves safe. Access to personal protective equipment is limited in many healthcare establishments, testing remains inadequate, and the likelihood of shortages ranging from masks, ventilators and hospital beds has left many healthcare workers, including nurses, with moral distress, burnout, emotional distress and feeling isolated and helpless. 

However, it is during this period of the pandemic that nurses in all healthcare establishments has shown absolute resilience, care, passion, dedication and commitment. The nurse’s pledge for service to humanity has become in so many instances the order of the day. Practising the noble tradition of the nursing profession, with conscience, dignity and respect, and having the total health of patient entrusted to their care became the first consideration and intensified for so many nurses during this vulnerable and uncertain time in our healthcare landscape. 

During this pandemic, nurses continue to deliver care with compassion, amidst their own fears and ability to deal with the implications of COVID-19. In the time of social distancing, nurses are still providing the human connection patients need to help them heal, as they navigate illness and the pandemic. The lessons of Florence Nightingale nursing practiced during the Crimean War are still being applied today, even more so during the COVID-19 pandemic, namely basic hand washing and hand hygiene practices, maintaining standards of cleanliness, recording, interpreting and learning from data and health trends, to name but a few. In 1870, Florence stated that it will take 150 years for the world to see the kind of nursing that was envisioned. Perhaps, with the convergence of these two events, it is a time to highlight the role of the nurse and the nursing profession that is so critical and needed. 

I believe that as we navigate our way through the COVID-19 pandemic, the WHO mandate to declare 2020 as the “The International Year of Nurse” has become more profound. Nurses across the globe should indeed be honoured, appreciated and gratitude be shown for the work they do. Their compassion, grit, courage, noble qualities and deep sense of commitment to render care to those entrusted to their care and to rise above their own circumstances, vulnerabilities, fear and uncertainties should be acknowledge and celebrated throughout and beyond the proclamation of the WHO. Nurses are ultimately a vital link in the healthcare profession, and in providing healthcare delivery. 

*Prof Portia Jordan is the Executive Head of the Department of Nursing and Midwifery in the Faculty of Medicine and Health Sciences at Stellenbosch University.

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