Keywords: COVID 19; Nursing practice; Psychological impacts; Research potential

Introduction

The COVID19 pandemic has left a mark throughout the world including increasing the visibility of the work of nurses during a crisis, in England nurses working in hospital and community settings have been at the forefront of the government responses to the effects of the virus on the population. These have been unprecedented times that challenged both professional and personal capacities and capabilities, UK nurses like so many in Europe have experienced and witnessed the increasing mortality of their patients. In the United Kingdom over 43,000 people lost their lives to the COVID 19 virus, however nurses rose to the challenges caring for patients while living with the impacts ofCOVID19 in their daily lives and practice.

Nurses have been witness to the emotional turmoil of overwhelming numbers of patient deaths and the joy at seeing critically ill patients recover to be discharged home and like many nurses globally have been physically exhausted, intellectually and emotionally challenged by the impact this virus has had on the personal the professional lives. A great many sacrifices have been made by nurses alongside their health and administrative colleagues at a time when the best and the worst of human behaviours were witnessed on a daily basis. Nurses in the UK have been brought to tears (Daily Mail, 2020) during the social panic during the early days of the pandemic, to the uplifting joy of watching national treasures such as Sir Captain Tom Moore (BBC, 2020) fundraise more than £32 million pounds for the NHS. The extremes of these emotional ‘ups and downs’ will have imprinted on nurses and influence their ongoing and future practice, however we do not fully understand the implications of this as initial research study results are only just beginning to emerge[1].

Nurses working within different aspects of the English health system have been challenged to re-write their practices, to become specialists in respiratory care and give minute attention to infection control. All nurses no matter their speciality have rapidly re-examined and adapted their practice as professional understanding of COVID 19 developed, reactionary and adaptable practice has become a feature of the nursing skills witnessed during this time. Like many global health systems, the English nursing response to COVID 19 has been affected by a lack of PPE[2], redeployment, concerns on personal safety, overtime and potential burnout with newly emerging mental health and well-being issues[2].Longitudinal studies such as the ICON study [2] is critical research for developing understanding and responses to the emotional and psychological impacts of COVID 19 on the nursing workforce and preparation for the future.

The national mortality rate associated with COVID 19 created a unique challenge for nurses supporting patients in the last moments of their lives, often where friends and family were not able to be present and physical touch was not possible. Nurses in England experienced the deaths of colleagues, exposure to COVID 19 while reacting to an uncertain future on a daily basis which when combined is likely to contribute to the current and future emotional resilience of nursing staff. Nurses who may not yet have time to adjust to emotional impacts of nursing during a pandemic, the reduction in acute cases provides an opportunity to reflect on experiences and psychologically debrief from an experience that will remain in the psyche of all nurses and nursing students[3].

COVID 19 organisational management included recruitment and redeployment of retirees and student nurses to manage the increasing numbers of the public requiring COVID19 treatment potentially at the expense of standard provisions such as cancer treatment, elective surgeries and out-patient departments. The impacts on trainees including nursing students volunteering for work in COVID 19 hospitals has yet to be considered or examined in any depth and may well become a significant factor for nurses in future. Perhaps now the immediacy of the crisis response to COVID 19 in the UK is diminishing and there is time for reflection, the impacts on professional practice and the emotional and psychological wellbeing of nurses will become a much needed focus of research.

We might argue that national healthcare services within England has become COVID centric, fixated with physical health by daily announcements of rising infection rates and death tolls however this does not fully recognise the work undertaken by specialist community, maternal and child health, learning disability or mental health services many of which are seemingly neglected stories within the pandemic reporting. Through the difficult times of nursing during the COVID 19 pandemic nursing in England there is a wealth of learning from a hindsight perspective, not only within the national nursing response but in the global nursing responses. Embracing the research opportunities within our own professional body could provide or provoke new opportunities to advance nursing practice[4].

Conclusion

Current research into COVID 19 impacts on nurses in England is beginning to emerge and nurses of the future may well face re-emergence of pandemics such as COVID 19 it is important to learn from our experiences to further professional practice. Investment in research has the possibility of bringing together strands of clinical, educational, policy development to embrace and enhance future nursing practices identified within COVID 19 responses. Examination of barriers to nursing responses during COVID 19, acknowledgement of successful adaptions or enhancements advancing nursing knowledge and competencies is a critical agenda for nurse researchers. As a professional body with one of the largest global workforces it is critical that nurses lead in the development of our own clinical expertise through evidence based research that helps to identify best practice to promote holistic patient and professional self- care using our collective COVID 19 experiences.