As I write, I have no idea how the Russian-Ukrainian war will end, except that there will have been an unnecessary loss of life, many wounded and lots of distressed families. We have been given a crash course in Russian history by the media and the perceived threat of Ukraine's 2019 constitutional amendments, which stated a strategic direction towards EU and NATO membership. The current Russian invasion is an escalation of the 2014 occupation of the Crimean Peninsula and its later annexation and the ongoing contest for the Donbas Region of eastern Ukraine. There is a saying that ‘24 hours is a long time in politics’, and it seems that this is also the case in geopolitics, with many of the assumptions about the stability of Europe after the tragedy of World War II thrown into doubt overnight. Unlike in previous conflicts, continuous media coverage allows the UK's population to witness the horrors of warfare and its consequences for the citizens of Ukraine.
In the midst of this terrible situation, remarkable demonstrations of kindness and generosity, both within Ukraine and among its neighbouring countries, have been shared. There are lessons for us all in terms of inter-generational care, extended family networks and kindness to strangers, alongside the concept of compassion. In extreme situations, it seems everyone is capable of making a difference to those around them and the wider community.
In 2012, the 6Cs of nursing were launched by the Chief Nursing Officer of NHS England (NHSE) to counter the poor nursing care and lack of compassion revealed by the Francis Inquiry (2013) into the quality of care and treatment provided by the Mid Staffordshire NHS Foundation Trust. The compassion displayed in and around Ukraine, despite war-like conditions, is in sharp contrast to some of the practice reported in the Francis Inquiry. More recently, many nurses have demonstrated all the 6Cs (care, compassion, courage, communication, commitment and competence) during the COVID-19 pandemic, and have been lauded for all their efforts.
A feature of this Russian-Ukrainian war has been the centrality of communication and information-sharing. Volodymyr Zelenskyy, the President of Ukraine, has used his considerable talents as an actor to communicate with the world and Ukrainian citizens, both to share information and persuade others of the merits of Ukraine's cause. He has demonstrated the power of information-communication technology (ICT), which is now ubiquitous in our everyday lives in the form of smartphones.
Zhang et al's (2014) systematic review of 30 studies found a multi-dimensional view of medical devices among nurses, with some recognising their benefits for both patient outcomes and their practice, while others associated their use with increased personal stress, loss of autonomy and increased administrative time. Similarly, Baker (2020) noted the resistance to the use of digital technologies within the NHS prior to the COVID-19 pandemic, and the remarkable transformation to online and other digital support systems once the scale of the pandemic became apparent. Primary care was at the forefront of this transformation, with millions of appointments transferring to telephone or online consultations in March 2020; the rate of in-person consultations, while recently increased, has yet to return to pre-pandemic levels (NHS Digital, 2022). Baker (2020) described four pre-pandemic case studies to demonstrate the potential benefits of digital technologies to transform care for long-term conditions on multiple levels (which included greater responsiveness to individual need and patient empowerment, more effective teamworking and improved integrated care). He highlighted how collaborative design from the start enables the successful implementation of digital innovations because it reduces the likelihood of design problems and, if they arise, enables creativity and the development of solutions (Baker, 2020).
A community-based service model and mobile workforce means that community providers are well placed to embrace digital technologies to enhance care delivery (NHS Confederation, 2021). However, both adequate funding and a digitally skilled workforce will be needed to build upon the transformations achieved during the COVID-19 pandemic, especially if good interoperability is to be assured in a digitally transformed NHS.
Despite the widespread media coverage of the Russian-Ukrainian war, there has been little mention of healthcare workers, but they are saving lives and providing care albeit under very difficult conditions. Our challenges during the COVID-19 pandemic and now, while we learn to live with COVID-19 and rebuild economic activity and the social fabric of the country, are trivial compared to what Ukraine is facing. There is much for which to be thankful as a UK citizen.