key: cord-0885448-9nmy8aj6
authors: Beckman, Beth P.
title: COVID-19: Never Seen Anything Like This Ever!
date: 2020-05-21
journal: J Nurs Adm
DOI: 10.1097/nna.0000000000000900
sha: 3bf7fe64748c876eaf6b61ccd5f6f0c7dd95725f
doc_id: 885448
cord_uid: 9nmy8aj6

nan

Nobel Laureate 1(p1) Before December 2019, COVID-19 was an unnamed virus associated with pneumonia cases in Wuhan, China. By January 30, 2020, the World Health Organization (WHO) had declared the "outbreak" to be a "public health emergency of international concern." 2 On February 11, 2020, the WHO gave this novel coronavirus a name-COVID-19 (genetically related to SARS-CoV-2). One month later to the day, the WHO officially declared the outbreak was now a pandemic. On March 11, 2020 , President Donald J. Trump declared the COVID-19 pandemic a US national emergency. By April 16, 2020, more than 2 million people across the world have become infected and more than 130 000 have died, and we were not close to peaking in the United States. 3 This is how quickly everything has changed. COVID-19 had virtually shut down most societal functions across the world. Healthcare was under siege, battling unprecedented COVID-19 volumes and acuity that was capricious and not well understood-all consequences of a novel coronavirus.

Treating infectious diseases is a common duty in healthcare. Most American healthcare workers (HCWs) of this generation have lived through numerous pandemics-AIDS (1981), severe acute respiratory syndrome (2002) , swine flu (1976 and 2009), Middle East Respiratory Syndrome (2012), and Ebola (2014). Yet, tenured and generally unflappable healthcare professionals have similar responses when describing COVID-19-"I have never seen anything like this before…ever." Why? What is it about COVID-19 that is creating such chaos?

This battle is unique. COVID-19 has impacted nursing and nursing practice in unexpected and unnerving ways. Contributing factors to the chaos include the following: Each of these categories, alone and collectively, represents a major disruption in nursing, nursing practice, and personal well-being. This crisis strikes at the core of the 1st three levels of Maslow's hierarchy of needs-physiological needs (survival), safety needs, and love and belonging. These levels represent "deficiency needs," meaning if the levels are met, a person feels nothing, but when they go unmet, then anxiety ensues. 5 Furthermore, posttraumatic stress disorder and depression may occur in some individuals when these foundational levels are not met.

Leaders across the world represented that "we are at war" with an invisible, tenacious, and unpredictable "enemy" virus. On April 5, 2020, Queen Elizabeth II gave a rare public statement to address the COVID-19 crisis calling this an "increasing challenging time" with "disruptions that have brought grief to some, financial difficulties to many and enormous changes to the daily lives of us all." 6 She further said "the pride in who we are is not part of our past, it defines our present and our future."

Nurses take pride in the 18 consecutive years (2020) of number 1 ranking in the Gallup Poll for public perception of honesty and ethics. 7 Public trust of nurses calls nurses to lead through the present and future battle of COVID-19. This coveted and hard-earned trust relationship must similarly bridge nurse leaders to direct care nurses. This will come through calm, resolve, and relentless dedication to optimize patient and HCW outcomes. Well-defined strategies and an abundance of courage promise to determine our success.

The Chinese symbol for crisis has 2 symbols-one is danger, and the other is opportunity. When Winston Churchill purportedly said, "Never let a good crisis go to waste," 8 I believe he was calling for leaders to find the opportunity. Nurse leaders may lack the COVID-19 roadmap, but make no mistake, there is no lack of ingenuity and insight to overcome the circumstances. Nurse leaders are being called to several key opportunities, including the following: 9 Kotter, 10 McKinsey & Company, 11 ADKAR, 12 and Kübler-Ross. 13 However, the warp speed of COVID-19-induced change may require nurse leaders to accelerate teams through the phases of change theory that would normally move organically at an unsubscribed pace. The difficult nature of this pandemic is that the pace imposes a sprint response when in fact this was a marathon event.

Monitor the resilience of your team. 3. Communicate, communicate, communicate: With transparent and timely communication comes trust and respect-even if the message is difficult or uncomfortable. Prethink and understand the priorities and concerns from those you serve, and when possible, start the conversation there. The consequences of COVID-19 are real, and they lived it daily. Listening and acknowledging the impact of the new normal is essential and results in trust. The noise of rumors and uncertainty will evaporate with timely and truthful communication. Nothing replaces face time; nothing surpasses authentic caring. If you are willing to be present in their work environment, this telegraphs that you also believe it to be safe. Nurse leaders cannot fix all things, but they can connect in meaningful ways. "Run to the roar and be present." 4. Leveraging influence: Nurse leaders are at pivotal decisionmaking tables and needed to know key priorities and how to move colleague stakeholders to quicker conclusions than generally comfortable. Hopefully, COVID-19 will be a once-in-a-lifetime experience. This time has awakened the world to the power of a novel virus. The emotional workload of COVID-19 has undoubtedly left an indelible mark of fighting and surviving a pandemic war. There will be lessons learned related to our practice and our lives-nursing and nurses will not be the same; we will be better. The transformations in care delivery and demonstrated agility during this time will be evidence supporting that, indeed, we can do things differently and more swiftly than we ever imagined. COVID-19 has created new alignments across the world-a spirit of "we are in this together"-and could potentially change the world optic to heal past deep divides and offered hope for future partnerships that may extend beyond healthcare. As the world recovers, the international community of nurses should evaluate the future roadmap of our leadership role and opportunities in future pandemics. I have always believed that nurses are uniquely positioned to ensure the humane response to the pain inflicted upon humanity.

How the current coronavirus pandemic links to questions of ecological sustainability in the Anthropocene

Statement on the second meeting of the International Health Regulation Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV). https:// www.who.int/news-room/detail/30-01-2020-statement-on-the-second-meetingof-the-international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-novel-coronavirus-(2019-ncov)

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Never let a good crisis go to waste

Field Theory in Social Science

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The four building blocks of change

The Prosci ADKAR model

The Macmillan Company