Why recognize the nurses and how to do so during covid and beyond

During one of my supervision meetings, Prof Tracy, a respected health economist who began her career as a nurse told me,” You clearly understand the nature of the task and show a really good understanding of your research topic, you are a passionate nurse , I am very glad to discuss with you.” These were not mere words of encouragement, but they meant much more by the fact a senior nurse was appreciating and motivating a junior one. It is on the same day I knew my two close friends, both nurses, one in the UK and the other in Kenya had been diagnosed with COVID 19. These friends are my pillars, they have immensely contributed to my milestones and it was time to stand by them; stigma and anxiety associated with Rona are real and social capital is a necessity at this point. My support of course was not monetary, but I could feel my contribution made a big difference in their lives. I know you will both read this article, you are very important people and I cherish you and other nurses in equal measure. Your experiences gave birth to why nurses need recognition and how to do it.

In the public domain, many perceive nursing as a noble profession that has a lucrative package. In Europe yes, I was almost convinced to seek greener pastures until one of the leaders confessed that the UK will not train their workforce but will continue stealing from developing countries they despise as lacking capacity. I was hurt to the bone marrow, a story for another day. However, this is not true in my beloved motherland. At the lowest level, some nurses earn lower than some domestic workers aka maids despite their level of training and scope of work. This is evidenced by the frequent and rampant strikes and threats for either salary increment, salary parades or pleas for allowances. Yes, nurses deserve better remuneration, but this is not the subject today. Let us explore why we need to recognize nurses especially during this crisis season. By recognition, I do not mean mere claps or jets flying with banner labeled God bless nurses or praises accorded to us when we die in the line of duty. No. Recognition goes beyond that.

First, let us explore the lifestyle of a nursing officer. Nurses are humans who deserve professional quality of life to be able to perform their duties. If their health is unstable, it is undeniable that they will not be able to offer their services to the required standard. Unlike others, their disease condition might be life threats to others. Once they live a good quality of life (physical, emotional, social, and even spiritual), I strongly believe they will be able to have compassion towards the sick. From my experience, nothing is satisfying like seeing patients’ condition improve tremendously or see a mother hold bundle of joy following a difficult labour. That satisfaction is both important to a nurse, patient, client, or entire community. But amidst compassion and satisfaction ecstasies, nurses are vulnerable to compassion fatigue. What I mean here is the nurses tend to care too much of the patients than even themselves; either forgetting to take their meals or use washrooms, going the extra mile to consult over phones using their airtime, or even raising transport fees for referral nurses in rural facilities. You go home only to find you carried a ward glucometer, ward phone or keys to the treatment cabinet! This phenomenon can be mitigated but not eliminated. These situations are precursors of either burnout or secondary trauma. Burnout arises from continuous working hours in an emotionally draining environment more so in poorly equipped facilities and low-quality PPEs. On the other hand, secondary trauma arises from carrying pain and frustrations of not only the patients but their loved ones and the weak health system. As a result, their maximum productivity is hindered. As institutions and society, we must strive to protect nurses from burnout so that they can renew their energy and zeal when patients recover from the ventilators everyone fears. You would never wish to be cared for by a nurse experiencing burnout. The good news is that once we leverage on the positives, it is undoubtful that our nurses shall maintain balance.

Why recognize nurses? This is a group of people who wake up each day up to a massive shortage of PPE, mask arguments either of the most effective, to wear or not, most at-risk population as they are front liners, and uncertainty of treatment plans surrounding COVID. Besides this, they work in a high-risk environment both physically and emotionally; some watch colleagues succumb to the disease helplessly. To confound the situation, our healthcare system is marked with a staff shortage. Nobody even highlights the exponential change of a caring environment. In nursing school, nurses are trained on the communicable disease. Unfortunately, COVID came unexpectedly and nurses were suddenly required to wear PPE like astronauts and work in them without even being trained in quest to curb spread of infections. Be assured, the scrubbing and lamination is not anything fancy, the public are uncomfortable with facial masks alone but nurses in isolation wards don the uncomfortable attire while gloved the entire day every day. Imagine the emotional state one finds herself when she finds out her colleague, who worked on the same shift for three consecutive days tests positive for COVID! As if that is not enough, every nurse is navigating through the challenges of traditional ethics of practice, your safety first versus others. These all happen within the healthcare system environs. As social beings, nurses are humans who need to maintain work-life priorities and balance. They have family members to bond with, their children need to be home-schooled, the community awaits them for the fundraising and such-like activities. Yes, they are expected to provide that human connection and provide quality care.

 Nurses deserve meaningful recognition. This can be in the form of positive feedback to acknowledge how a nurse’s action affects the lives of others relevant to the recipient which is equivalent to the contribution made. This is critical in mitigating compassion fatigue by replacing it with compassion satisfaction that yields emotional energy. I vividly remember several occasions I have received gratitude messages, seeing a patient get better in front of my own eyes, knowing that people I worked with had my back and recognizing that I am affecting more than I realize always motivates me to deliver my services diligently. It is evident to me that positive feedback, positive clinical outcomes (even if the patient dies peacefully), quality teamwork restores emotional energy, and increases self-awareness amongst nurses. With everything going on with the COVID and its uncertainty, little beacons of light like recognition make it all worth for nurses.

How then can we recognize our nurses? There are several practical ways. Yes. Some that require minimal budget but can transform the caring cadre are highlighted as follow. Institutions can collect nominations on nurses of the month which can be done electronically since we are in the technology age. Evenly, a facility can encourage peer to peer nominations. Alternatively, the facility can ask nursing leadership (not managers) to submit monthly extra-ordinary nurses. This method gives real-time information that motivates nurses. The nominees are later awarded, be it a certificate of recognition or a gift voucher; it makes a big difference. Another way is recognizing teams. This is the same as the individual level recognition but at a different level. It can be an emergency and accident team or inpatient team. The award is given to a team to tribute to a healing environment. This promotes teamwork and recognition.

Compelled by my experience, my friends who are passionate about what nurses do every day, our leaders should be responsible and accountable for the people they are in charge of. You ignore them, you lose them either to developed countries or worse to the graves. To my nursing friends, quick recovery, you will beat this monster. As Koozer and Posner said, “change is the province of leaders inspiring people to struggle against uncertain odds and persevere towards a misty image of a better future.” It can be done; everyone must play their part.

About Chepkirui Hildah

She is a nurse’s watchwoman. She is currently pursuing MSc Health Economics and Policy (University of Birmingham), holds MSc Global Health (University of Global Health Equity) and BScN and Public Health (Kenyatta University). She is a Chevening scholar, 120 under 40 global family planning leader, Ashoka changemaker fellow, YALI alumni, Ashoka changemakers fellow. Connect with her on www.linkedin.com/in/chepkiruihildah