How might COVID-19 impact the future of nursing?

Author(s): Amber McCall, PhD, APRN, FNP-BC, and Sandra B. Inglett, PhD, BSN, RN

The world is facing a challenging 2020, topped by the devastating COVID-19 pandemic. Nurses and other healthcare team members have been given the daily task of learning how to cope with the unknown. We have been confronted with the certainty of mortality, including our own. Given these trying times, it may be beneficial for nurses to anticipate how COVID-19 may impact various areas of nursing in the short-term and long term.

Pre-licensure education

Education for pre-licensure must continue due to the ongoing nursing shortage. COVID-19 has shone a spotlight on the lack of qualified nurses within high acuity units. We may see more online, on-demand type learning. The biggest challenge for online learning is maintaining quality learning outcomes in the absence of a face-to-face instructor. In traditional schools of nursing, we may need to consider shorter more frequent knowledge and critical thinking assessments. It could be necessary to schedule any mandatory face-to-face skill assessments individually or in very small groups to limit traffic and exposure in a certain physical area. All educational offerings should aim to increase one’s clinical critical thinking. Ways to achieve deep learning include the incorporation of pertinent case studies. These could include commercially available virtual simulations and clinical cases from the instructor’s own practice.

Continuing education

Continuing education will remain important for nurses, especially those related to timely topics. It’s likely that conferences will be available to attend online or in a hybrid face-to-face method. If conference organizers believe a physical presence is required, there will be limited registrations allowed, thereby reducing the total number of participants in a particular venue. Nurses will likely see more niche-type conferences, which have the potential to be more expensive than more general conferences. Nurses also will continue to gather information about the pandemic and adjust their practices as needed. There will be such a flood of COVID-19 educational opportunities that other important and timely topics may not receive the necessary attention.

Practice

Nurses are likely to see many long-term changes in the practice environment related to infection prevention. Clients are likely to seek medical care only when necessary. It will be imperative that clients be taught the difference between urgent care needs and emergent care needs. Clients who are now experienced in the use of tele-healthcare may prefer this method of care and continue to use it in the future. Preventive care will need to be more organized and structured. Clinicians with multiple practice partners may wish to see only “sick clients” on a certain day alternating with “well clients” to avoid possible cross contamination of COVID-19. If infections continue to rise, it’s important not to relax infection control standards and to continue the use of needed personal protective equipment and social distancing. Potential hotspot outbreaks of COVID-19 will likely result in localized restrictions. These could take the form of shelter-in-place, closing and/or restricting certain businesses, and mandatory face coverings in public places.

Nurses must take an active role in health promotion, wellness, and public education during these times. Many clients may not wish to risk exposure to COVID-19 by making non-essential healthcare appointments at a physical location. A great deal of client communication can be done by secure email or text messages.

Nurses are in a key position to educate the general public concerning when and where to seek care, including meeting the holistic needs of the mind and body. Further, nurses may need to develop simple materials and interventions for clients regarding how to cope with stressors, such as the pandemic, social isolation, loss of income, and more. Nursing will use its interdisciplinary knowledge and connections while serving as a liaison to help meet client’s multifaceted needs.

Service

Nurses are known for their service, whether it be local, regional, national, or global. It’s highly likely nurses will see an increase in human needs both abroad and in our own backyards (for example, homelessness, social isolation, depression). There may be an unwillingness on the part of some nurses and nursing students to participate in service, for fear of contracting COVID-19. Current local COVID-19 data should be considered when making decisions related to continuing service commitments. It will be necessary to use caution in any activity, including those that are service-based.

During this unprecedented time, service obligations may need to be suspended or curtailed to allow nurses the needed time to assist their children with online school assignments, help elderly parents who may need assistance, and maintain their own safe home environment. As for nursing associations and other social gatherings, it will be necessary to convert to online events (for example, online induction ceremonies for honor societies) using low-cost technologies such as Zoom® and/or Microsoft Teams®. Nurses should embrace the opportunity to encourage interested individuals to seek nursing as a career choice despite the challenges of working in the field.

Research

Research does not have to be limited due to COVID-19, however there will be changes from the usual way of doing research. Intense face-to-face research involving detailed physical assessments, labs, x-rays, and/or blood draws will require special procedures to ensure the safety of the researcher as well as the safety of the client. For those who are unable to interact with clients, it may be possible to mine established databases, so long as the data is of high quality. Nurses can partner with basic scientists in various animal research studies if interaction with humans is not advised. Nurses also can develop interdisciplinary partnerships with other clinicians, such as pharmacists, social workers, and mental health practitioners to study COVID-19  outcomes. If one has an interest in genomic studies, it would be beneficial to note genetic differences in individuals who not only succumb to COVID-19, but also recover more quickly. There are additional opportunities for business focused research that include ICD-10 codes, staffing ratios and expenses related to COVID-19 care costs.

Looking ahead

The Covid-19 outbreak has forced nurses to look closely at our usual way of conducting business and delivering education. Nursing has always been an adaptive field. We’re known for having the public’s trust and for demonstrating flexibility, innovation, and quality care. This period in time may have lasting effects on how we carry out our duties but we will prevail and remain the most trusted of professions.

Amber McCall and Sandra B. Inglett are associate professors at Augusta University in Augusta, Georgia.

References

Jackson D, Bradbury‐Jones C, Baptiste D et al. Life in the pandemic: Some reflections on nursing in the context of COVID‐19. J Clin Nurs. 2020;29:2041-43.

Smith GD, Ng F, Ho Cheung Li W. COVID‐19: Emerging compassion, courage and resilience in the face of misinformation and adversity. J Clin Nurs. 2020;29:1425-28.

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