- Nurses are waging the war against COVID-19 as a fearless warriors: WHO
- India has 43% less nurses than WHO norm, thus the work load is more: Expert
- Last 3 months were rough, incredibly challenging: Archana Dwivedi, Nurse
New Delhi: As the coronavirus outbreak hit the country, nurses across the states found themselves in situations never seen before. With long work hours in tensed and harsh conditions, wearing personal protective equipment and keeping up with continuously evolving guidelines on patient care, it has been a testing period for nurses everywhere. International Nurses Day offers an opportunity to reflect on the role being played by nurses during the COVID-19 pandemic response – be it their service or their sacrifice. NDTV spoke with nurses and experts to learn about the life and work of nursing personnel in the times of the COVID-19 pandemic.
While talking to NDTV, Lieutenant Colonel (Retired) Madhumita Dhall, Chief of Nursing, Rajiv Gandhi Cancer Institute and Research Centre (RGCIRC), Delhi said,
Serving humanity is one of the extraordinary callings. Nurses, of course, are playing an important role in the society. Today, nurses are at the cutting edge of battling pandemic, giving their best care with a smile. They carry hope and happiness with them for their patients and families. Courageously and selflessly, they are taking care of COVID patients, often giving least care to their own health in this crisis. Nurses have risen to the occasion and have gone beyond their core duty to help fight the deadly enemy.
Work-Life Balance Gone Topsy-Turvy But Duty Comes First
From wearing scrubs and surgical masks every day to work, to wearing extremely uncomfortable personal protection equipment set that includes hazmat suit (hazardous materials suit) with masks, face shield, gloves, shoe cover which cannot be removed till the end of the shift; the work attire is not the only thing that has changed during the pandemic. COVID-19 has affected every aspect of my life. Be it my work or my personal life, said 29-year-old Archana Dwivedi, Nursing Officer, King George’s Medical University (KGMU), Lucknow, Uttar Pradesh.
Ms. Dwivedi who has been working as a nurse since 2015 said that she has not seen her family since the last seven months. While during the first wave, Ms. Dwivedi was working for eight hours per day, now with the ongoing second wave there has been a drastic increase in work pressure on her and her fellow colleagues at KGMU. Now they are performing COVID duty in 12-hour shifts for 14 days at a stretch since January this year. After 14 days, nurses at KGMU are given a break of two days during which they are required to get tested for COVID-19 and then for the next 14 days they serve in other departments like Orthopedic department in case of Ms. Dwivedi, before being rostered for 14 days of next COVID duty. She said,
The working hours have just doubled this year. There is no time to think about my own health or my hobbies. At the end of the day, after reaching home, I cook something for myself, watch some news and find respite in watching few comedy videos. Then I take rest and prepare myself for the next day.
30-year-old Veenamary V, Senior Registered Nurse, BGS Gleneagles Global Hospital, Bengaluru who was supposed to get married on May 5 decided to postpone the ceremony and convinced her family and in-laws-to-be to let her stay at the nurses’ hostel of her hospital and focus on helping patients heal and fight the crisis. She said,
Despite the fatigue, I am proud to be working in order to overcome the pandemic. I may have had entirely different plans for this year and I was looking forward to the next chapter of my life but for me, as a nurse, duty comes first. I have to plan my life around my work as this is the need of the hour. This is my chance to serve my country. But, I do pray that the sense of work-life balance gets restored for all of us soon.
On the difference in amount of work during the first and the second wave, Sister Latha Nonis, Chief Nursing Officer, Fortis Hospital Bannerghatta Road, Bengaluru who has been performing COVID duty since the pandemic hit the country said,
Since the second wave has hit the country, we have been getting requests for one-on-one care for the patients from their family members and we are finding it hard to come up to their expectations. But being a nurse, one cannot compromise on the care. My family is really supportive. I have a 26-year-old son. And so even though maintaining life and work in a balance is tough, I am still in a better position as compared to other staff members who have young children in the family or elderlies but are staying away from them in the wake of the increased workload.
Pandemic Is Taking Toll On Physical As Well As Emotional Well Being Of The Nurses
Ms. Dwivedi highlighted that a nurse needs to monitor patients continuously, something which doctors do not do. She added that nurses do not get a chance to take a break during the shift or lie down for a minute or two. She said,
In April, on 8th or 9th day of my 14-day COVID duty, I felt dizzy because of the heat generated from the body in a PPE and sweating. I really wanted to take off the PPE for few minutes, but I did not do it because that could have exposed me to the virus. PPE kits are taken off in a very systematic manner to avoid infections which takes at least 20 minutes. So, I continued working even though I was feeling sick. Currently, because of the second wave, the situation is such that we cannot even ask for a leave. All the leaves have been cancelled. I understand that these steps are important, but these are affecting not only the physical health of nurses but also their mental health. The last three months have been rough and incredibly challenging.
Sister Bindu, Nurse from Fortis Hospital Bannerghatta Road, Bangalore got infected with COVID-19 last year while taking care of the patients. She said,
I work eight hours a day and six days a week. Sometimes on all seven days depending on the situation. Being working in a COVID ward continuously, I was expecting that I myself can get infected even after taking maximum precautions. I got the infection last year, but I recovered fully within 15 days. I monitored myself well and took all medicines on time and increased my liquid intake.
But that is not it, with COVID-19 patients being isolated without visits from family and friends, nurses have taken it upon themselves to provide emotional support to them, said Dr Sukhpal Kaur, Acting Principal, National Institute for Nursing Education (NINE) at the Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh.
However, the pandemic is taking toll on their emotional well being as well. Watching patients die every day, enormous pressure of managing the patients pouring in since the second wave has started, being far from loved ones, long and tedious working hours, the physical burden of wearing PPE, no access to the washroom due to PPEs or the freedom to eat or drink water because you cannot just open the PPE kit anytime you want- this is all harming the mental and physical health of our nurses. Not a single day goes by without hearing about more than one nurse succumbing to the pandemic, Dr Kaur added.
Dr Kaur further added that in order to minimise the fear, anxiety and doubts and to boost the morale of the nursing staff, capacity building and capacity strengthening both in terms of quality and quantity for nurses are critical. Sister Latha Nonis shared that in order to help nurses deal with mental health issues, they have started the practice of having sessions with psychologists. They are also trying to deal with this issue by creating a WhatsApp group to circulate jokes and conduct fun activities to keep nurses enthusiastic.
Caring For The Caregiver Is Imperative, They Are Less In Number And Vital To The Society: Trained Nurses Association of India
Dr. L. Gopichandran, faculty at College of Nursing, All India Institute of Medical Sciences (AIIMS), New Delhi and Vice president of (TNAI) Delhi Branch said,
The life saving work of these frontline heroes during the COVID-19 will forever be remembered for generations to come. But today, it is extremely important to ensure safety of our caregivers. Safety not just in the medical terms but also in terms of their career development. Many of our country’s nurses go and serve in other countries because there they get much better opportunities. The Indian nurses are known for their commitment and competency, and the global demand for our nurses is very high. The migration of nurses due to low salary and working conditions in our country results in brain drain and is of great concern. It is high time that policymakers in India think about retaining our nurses in the country. We are already suffering an acute shortage of nurses. The work load on the existing nurses is extremely high. The country has 43 per cent less nurses than what IS recommended by the World Health Organisation (WHO).
According to WHO, there should be at least three nurses per 1,000 people. However, in a reply to a question in Rajya Sabha (dated March 3, 2020), Ashwini Kumar Choubey, Minister of State for the Ministry of Health and Family Welfare said that the country has 1.7 nursing personnel per 1,000 population which includes nurses, midwives, women health visitors and auxiliary nurse midwives. In total there are over 21 lakh (21,29,820) Registered Nurses and Registered Midwives.
Creating a better system for career development for nurses is vital to retain our empowered nurses in India, so that our country can benefit from its own competent and dedicated nurses who are integral in preventive and promotive healthcare activities to build a better India, added Dr Gopichandran.
There Is Still Hope And If All Cooperate With Each Other, We Will Defeat The Virus: Senior Nurse
Since the pandemic has hit the country, the situation faced by nurses on a daily basis has been traumatic, said Dr Lalitha Reddy, Vice President, Telemedicine society of India and Founder of ForMen And ForKids, an online health and wellness company. While talking about how people should derive inspiration from the selfless service of nurses, She said,
Nurses play a pivotal role in care of COVID patients and their recovery. Timely administration of the medicines prescribed by doctors, in correct doses along with detecting early warning signs, careful monitoring and supportive care lead to complete patient recovery. They are the most exposed to the patients and are at a high risk of contracting the infection. This exposure combined with tremendous stress, which lowers their immune system, puts them at great risk. However, they always carry on with their work without complaining. Most of the nurses have young children and elderly parents at home, but they brave the risks and carry on with their selfless work, doing extended duties and back breaking night shifts. At this hour of need, we all must come together, be inspired by our nurses, cooperate with each other and help them combat the virus. They are the backbone of healthcare system.
Talking about the need to remain hopeful, Sister Latha Nonis, Chief Nursing Officer, Fortis Hospital Bannerghatta Road, Bengaluru urged the nurses and patients to have a positive outlook and never lose hope. She added,
If people continue taking precautions like wearing masks, maintaining social distancing, monitoring one’s condition and along with this caring for each other, the we will definitely defeat COVID-19 soon.
In her message to people, Sister Bindu, Nurse, Fortis Hospital Bannerghatta Road, Bengaluru underlined the importance of self-monitoring the symptoms. She said that in order to reduce the tremendous burden that hospitals are facing currently, people should not rush to hospitals when getting infected. She said,
These are unprecedented and so people can get overwhelmed on getting a COVID positive test result. But please stay calm and do not rush to the hospital. Try contacting a doctor, stay at home and monitor your temperature and oxygen saturation. Go to a hospital only if you have a comorbidity like diabetes, kidney issue or any other such disease. Unless the situation is severe do not block an oxygen bed or someone in need of it might lose out.
NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene.