After a winter of bleak news and fearful statistics about COVID, recent signs point to long-awaited relief from the pandemic. COVID cases, deaths and hospitalization are all tumbling, the CDC has issued relaxed mask guidelines, and states are lessening or ending mask mandates.
With these developments as a backdrop, nursing may finally be entering a transition, from pandemic to “endemic.” The CDC defines endemic as “the constant presence of an agent or health condition within a given geographic area or population; can also refer to the usual prevalence of an agent or condition.”
Dr. Donna M. Nickitas, dean of the Rutgers School of Nursing–Camden.
So as the country learns to live with COVID as an endemic, what are the ways that nursing should respond?
For one thing, as the profession pivots to working from an endemic stance, nursing should take time to reflect on the experience, says Donna M. Nickitas, PhD, RN, NEA-BC, CNE, FNAP, FAAN, dean of the Rutgers School of Nursing–Camden (NJ). For one thing, “We all understand the importance of what good public health looks like, and how we have to listen and trust the science as well as the evidence,” she notes. “And that wasn’t always clear from the very beginning of the pandemic.”
For another, nurses can appreciate the growth in “how more expert we’ve become on the front line to manage more rapidly, assessing, testing, informing, educating, vaccinating.”
Filling a void
As to the toll the pandemic has taken on the nursing workforce, especially on nurses who have been on the front lines in hospital systems, “they sustained a significant amount of moral injury,” Nickitas says. “They have witnessed death after death and because of that, and what was required of them, they are exhausted, both mentally and emotionally. And many of them are burned out. And that is so heartbreaking, to know that my colleagues now have gone through this experience and have left or are thinking of leaving the profession.”
“When they go, remember they take with them all of that expertise, all of that knowledge, all that wisdom, that not only have they acquired during the pandemic but also they have acquired through their professional life. Those of us who are left behind are going to have to learn to fill that void,” says Nickitas.
For nurses who are leaving, and as we move from pandemic to endemic, one hope is that nurses who choose no longer to work in an acute-care setting “will find other opportunities and consider population health, community health and certainly public health,” says Nickitas. Or work as preceptors or teach as part-time lecturers in university settings “where we can take some of that expert knowledge and apply it to the next generation.”
On a sobering note, a new study from the American Nurses Foundation finds that younger nurses are struggling with the effects of the pandemic. Nearly half of nurses surveyed under age 35, according to a press release, say they have sought professional mental health support since March 2020. What’s more, of the survey respondents under age 25, 69% say they have been suffering from burnout, which is more than double than those older than 25 (30%).
Staffing ratios
Also, in moving to an endemic posture, “we have to do a better job at nurse staffing to recognize and compensate and support those nurses who have in essence given their professional lives to these institutions.”
The evidence is clear, notes Nickitas, “that patients get better care when the numbers are lower. They have less morbidity and less mortality. So let’s listen to the evidence.”
“I wouldn’t always say mandate legislation, but when it doesn’t work, we have to get people’s attention and we’re talking about safety,” says Nickitas. “We’re talking about people’s lives and patient safety is critically important. We’re talking about reducing medical errors and improving patient outcomes. And we know that we can do better when we have the appropriate nurse staffing ratios.”
Supporting education
To help address nursing shortages, government needs to support nursing education, notes Nickitas. “We’re going to need additional funding from the federal government, from the state governments — ensure that there are scholarship monies and research funds available in the pipeline.”
Luckily, she notes, enrollments are up about 5%. In April 2021, the American Association of Colleges of Nursing (AACN), released data that in programs designed to prepare new RNs at the baccalaureate level, enrollment increased by 5.6% with 251,145 students studying in those programs nationwide.
“We have to get ready for the next generation,” says Nickitas. Hospital systems need to regard nursing staff as “valuable assets that cannot be overlooked.”
Now a freelance writer and editor, he served as a Director at Elsevier, where he was instrumental in the development of major online nursing reference and procedure products. Previously, he served as Editorial Director at Nurses.com, one of the first nursing websites, and was Executive Editor at Nursing magazine, a premier large-circulation journal.
Today, he continues to serve nurses and other clinicians by reporting on developments and trends in healthcare with meaning, context, and insight.
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