There have been so many changes over recent weeks, both within health professional practice and personally, that many are feeling almost overwhelmed. Simon Stevens as CEO and Amanda Pritchard as COO of NHS England (NHS England, 2020) issued a letter to NHS organisations to prepare for COVID-19 patients requiring healthcare support; similar letters were issued by healthcare leaders in the other UK countries. While the emphasis is on what hospitals can do to free up in-patient beds, including intensive care beds, through the postponement of elective activities and early discharge, the need to augment the workforce through health professionals being enabled to work outside their usual disciplinary and specialism boundaries were set out, with senior healthcare students joining the workforce. Community health services also have a major role to play through supporting the discharge of medically fit patients from acute and community beds and ensuring that patients who are cared for at home receive urgent care when they need it, as well as supporting those identified as high risk who are self-isolating for 12 weeks (or those being shielded by the NHS).
Extreme events often herald new approaches, and, in the case of the NHS, the use of digital technology is coming into its own, both to promote the efficient use of resources and to minimise infection risk. Thus, all health professionals are being asked to provide advice and support using digital technology unless a face-to-face consultation is essential, as may be the case to enable listening to heart or chest sounds. Primary and community care may never be the same again, especially regarding long-term condition monitoring. This will require all community nurses to embrace the potential of digital technology, as well as healthcare providers to ensure good connectivity across geographies; previous excuses for failing to adopt digital solutions are no longer sustainable (Queen's Nursing Institute (QNI), 2018; While, 2019).
‘Extreme events often herald new approaches, and, in the case of the NHS, the use of digital technology is coming into its own, both to promote the efficient use of resources and to minimise infection risk.’
At the same time, the entire population is being asked to change its way of life, including their working lives. The behavioural changes demanded are huge; the adoption of high standards of nasal and coughing etiquette alongside frequent and thorough handwashing; social distancing, which interferes with ‘normal’ family and friendship behaviours; and the use of the home as a workplace as well as a ‘school’ for those with children. Those with least resources are being asked to bear a heavier burden because their housing situation is likely to be less conducive for a lockdown, and their employment or income situation is more precarious despite the population being exhorted that ‘we are all in this together’. It is not surprising that, for some, the social isolation and uncertainty are almost unbearable and taking a toll on mental health, with Hans Kluge, European Director of the World Health Organization (WHO) issuing a warning (Nicolas, 2020). Indeed, the NHS England (2020) letter recognises the imperative of helping healthcare staff to remain well and able to work, which includes providing good wellbeing support during ‘what is going to be a very difficult time’, which will go beyond those working in healthcare.
The COVID-19 challenge provides community nurses with the opportunity to demonstrate their essential contribution to health services and their unique resourcefulness at the time of great need.