How do you replenish and nourish your spirit in these unheard-of times when extreme stress is the norm?
At one hospital network located in the pandemic’s epicenter, you could nourish the spirit by accessing a brief podcast or video, or spending a few moments in a quiet room. At another hospital, you might search for meaning by consulting with a spiritual director.
“The COVID-19 crisis represents a real departure in terms of the emotional and spiritual stress on frontline personnel, especially nurses,” says Reverend David Cotton, Regional Director of Spiritual Care Services at Hackensack Meridian Health, a multihospital system serving New Jersey. Just as the system provides PPE, Reverend Cotton notes, health care providers’ emotional and spiritual needs must be cared for – “PPE for their spirit,” he says.
Hackensack’s new Spiritual Care Program provides guidance and support in areas such as grief; fear; hope; faith and inner peace; and meditation, gratitude, and purpose. Health care providers can access various resources including brief videos and podcasts hosted by clergy; inspirational writing; an email to make prayer requests; and a quiet room in each hospital. Professionals who are involved with the program include hospital chaplains, community clergy, and members of integrative and behavioral health teams.
Addressing Grief and Fear
Videos and podcasts on fear and grief, says Rev. Cotton, are among the most highly used resources by frontline staff. “Grief because they’re dealing with a whole new level of grief in the traditional sense, but also grief in the sense of loss. We’ve lost our rhythm of life. They’ve lost the way they usually do business as a nurse for 10 years or 20 years or two years. Nursing is different these days.” And fear because, for one thing, nurses may fear that they will take the virus home to their families.
Also popular are quiet rooms in each hospital, which have low lighting and soft music. “Those quiet, meditative prayer spaces are a great stress reducer and reliever,” he says. Visitors to the spaces can read scripture, pick up a religious article, or write a prayer request on a note, which chaplains will then pray over.
At Bridgeport Hospital, Bridgeport, Connecticut, a hospital of Yale New Haven Health, nurses can access a program to help them deepen their spiritual sense through the Murphy Center for Ignatian Spirituality of Fairfield University. They can take advantage of four free therapy sessions from the hospital, but then can access a spiritual director from the Murphy Center, available at no charge, according to Marcy Haley, Assistant Director at Murphy Center. No prior religious experience or background is needed. This program may extend to other hospitals that have a relationship with the Murphy Center, notes Haley.
In addition, the Center is working with Fairfield University’s Egan School of Nursing and Health Studies to develop a class on spirituality and palliative care, as well as offering pastoral support for all undergraduate and graduate nursing students, many of whom are working on the front lines.
Trauma, says Haley, has “a way of humbling all of us, and how we put those pieces back together is a spiritual journey as much as it is a physical and emotional journey.”
Millions of nurses care for the world’s patients, and millions more will be needed. This is one of the takeaways from “State of the World’s Nursing 2020,” a new report developed by the World Health Organization in partnership with the International Council of Nurses (ICN) and the Nursing Now campaign.
More than ever, the world must have nurses “working to the full extent of their education and training,” states the report’s executive summary. This report “confirms that investment in the nursing profession is a benefit to society, not a cost,” says ICN President Annette Kennedy in a press release.
Some 191 countries provided data for the 144-page report,
which provides a detailed look at the profession globally. The report sounds positive
notes, while also calling for significant improvements in some areas.
On the plus side:
Some 86% of countries have a body responsible
for regulating nursing.
Of 115 responding countries, 82 (71%) have a
national nursing leadership position to provide input into nursing and health
From 2013 to 2018, the total number of nurses
increased by some 4.7 million. The global nursing workforce is 27.9 million
nurses, of which 19.3 million (69%) are classified as “professional nurses” as
opposed to “associate professional nurses” or unclassified. As the largest
occupational group in the health sector, nursing accounts for about 59% of the
However, notable needs exist:
Despite the growth in the number of nurses, more
are needed. The report notes a global shortage of nurses of 5.9 million in
2018, which is a decrease from a shortage of 6.6 million in 2016. The vast
majority of that shortage is concentrated in low- and lower middle income
To address the shortage by 2030 in all countries,
total nurse graduates would need to increase by 8% per year on average, along
with an improved capacity to employ and retain these graduates. Without this
increase, there will be a shortage of 5.7 million nurses, primarily in Africa,
Southeast Asia, and the eastern Mediterranean.
In some regions, an aging nursing workforce poses
a threat. One out of six of the world’s nurses are expected to retire in the
next 10 years, according to a press release. “Substantially older age
structures” exist in the American and European regions.
Although nursing is 90% female, few leadership
positions in health are held by nurses or women.
Only 78 countries report having advanced
practice roles for nurses.
Of 157 responding countries, 97% report that the
minimum duration for nursing education is a three-year program.
One nurse out of eight practices in a country
other than the one where they were born or trained.
Actions to Take
To equip the world with the nursing workforce it needs, WHO
and its partners provide a series of recommendations, including the following:
increase funding to educate and employ more nurses;
monitor nurse mobility and migration and manage it responsibly and ethically;
educate and train nurses in the scientific, technological, and sociological skills they need to drive progress in primary health care;
establish leadership positions including a government chief nurse;
ensure that nurses in primary health care teams work to their full potential;
improve working conditions including through safe staffing levels, fair salaries, and respecting rights to occupational health and safety;
“The world needs millions more nurses, and we are calling on
governments to do the right thing, invest in this wonderful profession and
watch their populations benefit from the amazing work that only nurses can do,”
Kennedy is quoted as saying.
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