Across the world, nurses are putting themselves at risk to save lives in the struggle against COVID-19. Many retired RNs are returning to the workforce, and nursing students are graduating into an exceptionally challenging environment. Other nurses are changing their specialty or learning a new one so they can provide respiratory care.
The challenges these people will face are numerous, and among them is the need for dependable, up-to-date information. In a situation where guidelines and research are updated daily, decisions need to be made fast.
But what does the future of the profession look like beyond the pandemic? Once the current challenges are met, can nurses look forward to a world of less stress brought about by better access to information?
Tim Morris, a former nurse and now Commercial Portfolio & Partnerships Director for Clinical Solutions at Elsevier, has been working with hospital providers who have student nurses in their third year of training now being assigned to wards to provide clinical support for patients acutely unwell with coronavirus.
“It’s hard to imagine exactly what these nurses are experiencing right now,” Tim said. “It’s already incredibly daunting going from a classroom environment to a ward environment.”
Tim points out that in the current situation, even just talking to patients is made tougher because of the restrictions of Personal Protective Equipment (PPE). That challenge, however, pales in comparison to the pressure of knowing you need the right information. He explained:
As a nurse who’s left nursing, the fear of going back is, ‘Do I have the right skills? Do I have the right knowledge? What’s changed since I was last working?’ We’re seeing a rise in the number of people returning to nursing, whether from retirement or moving from one specialty into another.
When nurses move into respiratory care and ICU from elective surgery recovery units, he said, his Clinical Solutions team is able to support them with online learning information to help upskill them and bring them back into nursing.
Clinical Solutions also provides nursing care plans, which standardize the information available for nurses and reduce the information variability, preventing potential problems and omissions of care. That way, when a nurse goes to assess someone for a respiratory compromise, they understand what they should be looking for and are supported with evidence based goals and interventions. When care planning is integrated into the electronic medical record, they’re prompted through the system on what factors they should be looking at.
“That should help reduce the stress, because you’re being guided through it,” Tim said.
His team is also providing access to ClinicalKey for Nurses to support the nurses who have qualified and continuing to develop in their practice.
That focus on information also extends to nursing students. “Across all our nursing education products, our content teams have been reaching into our content and quickly getting relevant information onto our platforms,” said David Hough, International Education Director for Elsevier’s Nursing Health and Education business.
For example, he mentioned the free NurseGuide app for medical jargon, terminology and procedures, “which is something that can be useful when you first enter a program.” The app is available in the English language markets UK, India, Austria and New Zealand, and the Germany, France, and Spanish language markets.
“We’ve seen about 260,000 downloads of that, and we’re adding content that’s directly related to COVID-19,” he said.
In addition, Elsevier currently has provided no-cost access during this challenging period to ClinicalKey Student for more than 200 nursing education programs in Europe, the Middle East, Africa, Latin America and Asia Pacific. “That gives access to all the nursing content they need in the educational program,” David said.
There are dozens of former nurses working on Elsevier’s healthcare and nursing platforms. Tim describes the way in which they’re moving to support the practicing community:
What they’re trying to do is make a difference for the people they’re working with. We all work very closely with active nurses. Some of us wish we could do more. It’s hard to see practicing nurses going into such a difficult situation, but without significant support, we wouldn’t be able immediately get back into practice. So we focus on delivering products to customers that make a difference. Our people are all proud to be part of that.
One example is around PPE. Everybody in a hospital who is interacting with patients need to know how to take PPE on and off, whether they’re a nurse, clinician or administrator. So we uploaded that information as a lesson into our Elsevier solution, and within a few weeks, 80 percent of our staff had completed that lesson.
Caroline also explained how having access to a single source of information means that staff are all on the same page, even when information is rapidly evolving and being updated.
A lot of staff wanted to know exactly when they had to wear PPE – whether it was something they needed with every single patient. Now we know that it’s only on contact precautions or with certain patients that you need to wear the attire. That gives everyone the confidence to know they’re making the right choices.
Furthermore, Caroline says, when all staff are working from a single information source, even when information is being updated rapidly, it empowers nurses to help establish best practice for patients:
What we see is that staff will challenge each other. When they have access to the same information, nurses are able to negotiate with the doctor about what would be best practice for a patient. Without it, they may not question things as often as they should. With it, they’re more confident about having that discussion and it leads to better practices.
While COVID-19 dominates the immediate future, Tim and David are also working with healthcare staff to establish what the world of healthcare might look like beyond the pandemic. The world will need 9 million more nurses and midwives by 2030 to meet sustainable healthcare goals, according to the World Health Organization, which has declared this the International Year of the Nurse and the Midwife. That means a focus on effective training and information needs.
Tim noted that one of the peculiarities of the pandemic is that while some sections of the nursing community are under huge pressure, others are quieter than they would normally be.
“We’ve been talking to senior nurses in several areas, such as NHS Wales,” he said, “They’re doing workshops and engaging with other senior nurses to improve quality of care – and they’re trying to figure out what happens next. As you might imagine, there’s a lot of focus on remote learning, and one of the questions we’re looking at is: ‘Will schools go back to normal, or do we have an opportunity to do things differently?’”
As well as supporting colleagues in the ICU, these nurses have an opportunity to plan for those future information needs. Currently David and his team are looking at remote learning and teaching and the best practices around that:
A lot of it comes down to training. Remote learning can be very effective, but it’s a different technique than face-to-face. So we’re spending a lot of time with our team and our education consultants on how to help faculty and students interact in the remote environment. After all, even when we are past this situation, this will be something all faculties want to build into their emergency preparedness.
In terms of the technology and resources that nurses will be able to draw on in the future, Tim described a more connected world of health plans and electronic health records that would further alleviate the burden placed on nurses:
We’re very focused on the value of standardized information in a clinical setting as a way of ensuring that every nurse is as informed as the next. So we can combine care plans with EHRs to ensure that they understand what to do for each individual patient, with comprehensive interdisciplinary care planning. That’s something we will hopefully be rolling out later this year.
The International Year of the Nurse has seen the profession cast into the public spotlight in an even more pronounced way than usual because of the pandemic. But as Tim says, it’s the world beyond the pandemic that offers a better future for nurses.
We hope that nurses are going to return to not only delivering care but also improving care through research and increasing knowledge from their daily practice. At the moment, people are focused on what’s happening around them, but we believe there is a lot to look forward to.
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