The impact of COVID-19 on health systems, mental health and the potential for nursing

Abstract

This paper offers a perspective on nursing and lived experience responses to the COVID-19 pandemic. It charts health systems and mental health impacts with a particular focus on children and adolescents, older people and people availing of mental health services. Issues of moral distress and the nursing reaction are considered alongside psychological and social concerns which continue to rapidly evolve. The perspective of a person attending adult community mental health services and the experience of engaging with a mental health service remotely is provided. Matters of note for acute inpatient mental health nursing are highlighted and informed by the lived experience of a mental health nurse. The need for integrated health systems responses across nursing disciplines and the wider interdisciplinary team is elucidated.

A Scoping Review of Psychosocial Risks to Health Workers during the Covid-19 Pandemic

“…Often, HCWs were aware that the decisions they need to take and the practices they follow because of the pandemic are against what is appropriate for the patient [ 93 ]. HCWs are exposed to continuous and increasing levels of emotional strain and moral injury [ 94 ]. Dealing with the Covid-19 patients’ feelings of distress, as well as with the loss of big numbers of patients and colleagues are identified as significant psychosocial risk factors affecting HCWs’ mental health [ 88 , 94 , 95 ].…”

“…HCWs are exposed to continuous and increasing levels of emotional strain and moral injury [ 94 ]. Dealing with the Covid-19 patients’ feelings of distress, as well as with the loss of big numbers of patients and colleagues are identified as significant psychosocial risk factors affecting HCWs’ mental health [ 88 , 94 , 95 ]. A commentary [ 93 ] on nurses’ moral injury during the pandemic suggests that the shift from patient-centred ethics in healthcare to public health-centred ethics imposed by the current circumstances, represents a major challenge for nurses and triggers moral dilemmas in instances when practices of triage or patient prioritization take place and are in conflict with the duty to care for each particular patient.…”

“…Moreover, studies show that HCWs are often the targets of intersectional processes of stigmatization across their professional roles, ethnicity, gender, and race. With nurses, women, Black, Asian, and minority ethnic (BAME) HCWs and all those combining these characteristics being more severely affected [ 69 , 94 ]. From a different viewpoint, HCWs often struggle with emotional distress that is caused by the representation of HCWs as heroes by the media and in the public discourse.…”

Intensive care unit nurses living through COVID‐19: A qualitative study

“…The COVID‐19 pandemic has put extraordinary pressure on health systems around the world (Chuang et al., 2020; Livingston et al., 2020). With more than 28.5 million cases in the United States alone (The New York Times, 2020b), hospitals have struggled to obtain adequate supplies of PPE (Kamerow, 2020; Livingston et al., 2020), mechanical ventilators (Alharbi et al., 2020) and staff (Alharbi et al., 2020; Frawley et al., 2020; Morley et al., 2020). Over time, hospitals have expanded the number of intensive care beds to meet patient demand.…”

Position Statement of the International Network for Child and Family Centered Care: Child and Family Centred Care during the COVID19 Pandemic

“…Children's voices may therefore go unheard and care delivered without their assent. Frawley et al (2020) argued that without a networked, integrated approach across traditional professional boundaries, the success of the nursing response to COVID-19 may be diminished.…”