Nurses are More Than Heroes: Saving Nurses in a Collective Health Crisis

The past 18 months has forced Canadians to navigate a health crisis unlike any most have seen in their lifetime. COVID-19 has challenged people around the world to change the way they live their lives to curb the spread of a deadly virus. Canadians were challenged to work together, and they did. In the fight against COVID-19 many gaps in the healthcare and social welfare system we illuminated. The more than 50 000 nurses in BC are front and centre in this fight. Erosion of nurse jobs is not a new phenomenon. For decades public trust and value of nurses has been high, while funding cuts risk safe workplaces, adequate training, and support for competent practice within nurses' full scope.  

A year ago, amidst lockdowns, and bombardment of new information about illness and death rates, the public was unsure and afraid of what the future would hold. 

The collective health of the nation was in flux, and a collective voice stood together banging pots and making noise when healthcare workers were leaving their shifts out of gratitude. 440 000 of these healthcare workers are nurses: Registered Nurses, Registered Psychiatric Nurses and Licensed Practical Nurses. But nurses need more than banging pots. Nurses need the public to listen to their recommendations, research, and reports about healthcare issues. In the continuous scroll of social media there is public support for what nurses do, while at the same time ambiguous understanding of what nurses do. It is heartwarming to know that public perception is of nurses as the metaphorical heart of the healthcare system, but nurses are also the head, the arms, the legs and the backbone of the system. The COVID-19 crisis highlights the lack of understanding the public has about the nurse's role.  

The Canadian healthcare system is composed of many different healthcare staff, professionals and non-professionals, government-regulated and staff who are not regulated. Each person in their role fulfills a necessary piece of the structure that together creates a functioning healthcare system. Nurses are the most numerous pieces of this structure. Nurses are plentiful at the bedside and direct patient care level, but are also clinical leaders, managers, directors, CEOs, educators and researchers within the healthcare system. Nurses carry out doctor's orders, but, depending on the setting, level of education and scope of their role, nurses also make the orders, carry them out and lead care.  

ICUs and high acuity medical areas were overwhelmed with people with COVID-19, and in addition to opiate overdose crisis patients. Those same ICUs, medical units, Emergency Departments provide care to all. If a bus crashes or an apartment building fire happens the people needing healthcare use the same hospitals that are treating those sick with COVID-19. The majority of clinicians in those settings are nurses. Nurses train for crisis, it is not unusual for patients to become critically ill in a hospital or urgent care setting. But COVID-19 has rapidly increased the number of people that are becoming critically ill and the numbers of nurses that needed to quickly pivot to specialty areas that they were not previously working in prior to the pandemic.   

The majority of BC Nurses are under the age of 50, meaning they have not lived through widespread health crises like AIDS in the 1980s. Before the Covid-19 and opiate overdose pandemics nurses were burning out and leaving the profession. Today’s new graduate nurses are being welcomed into the profession with a very different experience. The moral distress, the exposure to unprecedented health crisis right from their student practicums into the beginning of their professional careers is rife with stressors like short staffing, resource limitations of yesterday, and death and sickness in greater magnitude than anything experienced in recent years. While this might not be happening in every hospital in every city and in Canada, collectively nurses are feeling this. Nurse resiliency is something that requires investment, policy support and resource allocation to ensure that nurses are retained through this crisis.  

Nurses are at the frontline. Canada needs them there, in acute settings, in the community, in long-term care, because nurses are the healthcare clinicians providing 24/7 care, saving lives, educating the public, training other nurses, leading research and managing healthcare services. The public messages of thank-you and voiced support mean a lot, they tell us that you see us and appreciate us. The public encouragement keep nurses going. But nurses need more than applause and accolades for their knowledge, compassion and care. Young nurses, experienced nurses, frontline nurses and nurse leaders must see action that demonstrates their value in all their roles throughout the healthcare system. Nurses’ experience and knowledge, kindness and empathy come from education, training, and research that are integral to the sustainability, progression and innovation of the healthcare system. Investing in nurses should be an economic priority.