Amid constant updates and government-issued safety measures to slow the spread of COVID-19, America is officially in uncharted territory. While the public is having to adapt to new precautions and changes at an alarming rate, the health care workforce has experienced unprecedented pressure: physicians, nurses and other health care professionals are straining to keep up with these waves of new protocols, new information and exhausting hours.
In this rapidly altering environment, a number of clinics (including Texas Tech Physicians) are even screening and taking the temperature of employees before they can come in the door. Some cities, like Dallas, recommend those with symptoms of the coronavirus go to new drive-thru style screenings, rather than risking a waiting room.
Currently, hospitals and clinics are canceling elective procedures, stretching their employees to face 12-hour days, and coping with a shortage of resources—in particular personal protective equipment, or PPE. In fact, recently-released guidelines from the Centers for Disease Control (CDC) provide recommendations that include, in critical circumstances, using bandanas and scarves as protective masks.
“The public health system has been chronically underfunded for decades,” says Lisa Campbell, DNP, RN, PHNA-BC, a professor and the director of the Doctor of Nursing Practice (DNP) program at Texas Tech University Health Sciences Center. Campbell is a former public health department director, and is able to fully grasp the impact that this virus has on every facet of our health care system, particularly the public health system, which accounted for only 2.5 percent of the U.S. health care dollars in 2013. According to the National Academies of Sciences, Engineering and Medicine (NASEM), the gap between current spending and needed spending—simply to achieve the foundational capabilities of public health—was reported at $13 per person (or about $4.5 billion total) per year in 2017.
Put simply, the public health system works in many fields to assure the healthy conditions of the public. As such, it is responsible for emergency preparedness and hospital preparedness state-wide, regionally and locally. While the system has been underfunded for quite some time, it is in these crucial moments that it becomes starkly apparent.
Public health nurses, in particular, are a critical part of our public health system—and today, as Campbell explains, they face challenges that could push them to the breaking point. Comprising the largest segment of the public health workforce, between 2008 and 2017 there were 55,000 public health nursing jobs lost across the nation.
“We are hearing from across the nation first-hand accounts of public health nurses who are having to work 12-hour shifts, seven days a week,” says Campbell. Some public health nurses are having to go home for mental health days because they are so stressed. “I talked to one last night and she said she’s been home for a week for mental health days. It’s seriously a grave situation for them.”
It isn’t just public health nurses who have been stretched thin, but across all practice domains. Nurses in acute care in hospitals, for example, are often working 12-hour shifts: six hours in direct patient care and six hours as a spotter for a team that’s assigned to care for COVID-19-positive individuals.
Attending to patients who have the coronavirus is not a one-person job, which means that hospitals are cross-training all professionals for the tasks involved. In some hospitals, this means cross-training even physicians. “They may not have ever had to do nursing procedures that they may have to do when they’re in a strike team,” explains Campbell.
Campbell also points out that additional training is sometimes required for procedures regarding the application of PPE. “They’re having to do real-time training. Oftentimes clinic staff don’t know how to put on PPE properly, so they need training as well.”
Campbell suggested one of the most helpful ways that members of the community can assist the dedicated nurses and other health care workers is by keeping themselves informed and not behaving recklessly. It is important, for example, to call ahead if individuals feel that they might be positive for COVID-19, so that the proper processes can be utilized. And, as always, staying informed means making sure you are receiving information from the right sources.
“Wherever someone lives they should look up to find their local COVID hotline,” Campbell suggests. “Some hospitals, some clinics and some local health departments have them set up.” Campbell also encourages those in Texas to take advantage of the 2-1-1 call line and website for helpful, basic information about the virus and proper information regarding testing.
Not only are nurses working on the front lines to stop the spread of this pandemic, but they are also stopping the spread of misinformation by giving the public accurate facts.
“Nurses should share not only with patients but with community members, neighbors, churches, professional organizations, and other platforms,” says Campbell. While she’s already seeing this in action, she would call for nurses to keep up the fight—including on social media—against those who claim inaccuracies.
“We need to correct misinformation and ethically provide information, whether it's a link to a study or the CDC. If you’re on social media and you post that, people read that,” Campbell encourages. “Nurses have a golden opportunity. We need to amplify that now more than ever and get out the correct information.”