Paul De Raeve, Secretary General and Elisabeth Adams, President of the European Federation of Nurses Associations state the case for being better prepared for the next health crisis in the European Union in light of COVID-19
The significant toll COVID-19 has taken on the European citizens, in terms of lives loss and human suffering, as well as the impact this has had on people’s daily lives is unprecedented. Across Europe, the commitment and dedication of our nurses on the frontline, in risking their own lives to save so many citizens’ lives, in exceptionally difficult circumstances is recognised and has been commended by the European Commission and many global leaders.
ln respect to the loss of life of our European citizens and, in particular, that of our nurses while doing their job in already challenging working environments with the additional complexity and uncertainty of this new virus, it is important we all learn from the past to prepare for the future. Of particular concern is still the lack of preparedness across so many elements of the response to the future health crisis, such as the limited and proper protective equipment to protect frontline practitioners with deadly consequences in some cases.
It is better to prevent than to cure!
The European Federation of Nurses Associations (EFN) recognises and appreciates the committed response of the European Commission to the COVID-19 crisis. The Commission Roadmap with a multidimensional policy approach involving balancing public health benefits against other social and economic impacts is invaluable. The European institutions accompanying measures recognising the importance of frontline nurses and providing the EU Member States support in expanding the capacity of testing, of data and contact tracing, and the healthcare service, and support of procurement and funding research, has been welcomed.
However, the “Lessons Learned out of the COVID-19 & Ebola crisis” raises key points on the state of our frontline preparedness to face the next wave. The significant findings, building on the 2014 Ebola crisis that nurses were confronted within the EU, concludes that we were not prepared. Taking this into account, the EFN raises several crucial points for both nurses and the nursing profession that the EU institutions and the national governments should urgently take into consideration. Nurses have been at the forefront of the fight against COVID-19, since the very first day. Despite a clear danger, our nurses – willingly and without hesitation – have been mobilising, redeploying, and upskilling to ensure that the health service could respond to the needs of the population. Whether testing for the virus or providing direct care to COVID-19 patients, they have been taking a great risk. There has been an extremely high transmission rate of the virus to healthcare professionals, with many nurses contracting COVID-19 at work, and at the global level, over 600 nurses have died due to the coronavirus. It is, therefore, imperative that EU institutions and national governments work together, including nurse representatives, to ensure the protection of frontline practitioners is at the forefront of every political decision made.
To this end, there are a number of critical factors to be taken into consideration:
- Our health services meet and traverse the EU borders (we have the Cross-Border Directive 2011/24/EU that regulates this), and that many EU nurses travel across the borders daily for work and services. It is, therefore, key that any travel restrictions implemented in times of crisis, as seen with COVID-19, do not endanger this and that explicit public agreement is made on this point at EU and national levels.
- The supply and availability of personal protective equipment (PPE) are paramount to our frontline nurses, as is the supply of ventilators and oxygen. One of the key lessons we learned from Italy is that transmission to staff had been happening at a higher rate in non-COVID-19 areas. It is, therefore, key to have full, appropriate PPE for the frontline in all COVID-19 positive areas, including all wards, theatres, emergency departments, radiology units, intensive care units, high dependency units and care of the older person units – both public and private. This must be to the appropriate standard for category A infections, as specified by the European Centre for Diseases Protection and Control.
- The wellbeing and mental health of frontline nurses have been severely impacted by the COVID-19 crisis. Therefore, appropriate support services must be put in place for nurses to address the impact of the numerous stressors. It is now important that healthcare professionals are all prepared for a next wave, ensuring their well-being and mental health is key to sustain COVID-19 preparedness, response and recovery. Action is required to be prepared for the next wave.
The EU institutions and the national governments should work closely with the nurses and the nurses’ representatives — at the national and EU level — to ensure that, in such difficult times, the frontline nurses get more supported in their efforts to provide the safest and most professional service as they can. Frontline nurses and other essential healthcare professionals need to be prepared for any Infectious Diseases of High Consequence (IDHC) crises, now! EFN is very concerned about the unsafe staffing levels, low pay and inequalities, and insufficient reform and investment in healthcare services. In recent years, there have been restrictions and limitations on the employment of nurses. This policy over time has had significant implication for the health and safety of our European citizens and has been clearly demonstrated in our limited ability to respond to the COVID-19 crisis today and in the future. It is, therefore, key that EU institutions and national governments policy take into account how safety and quality are impacted by staffing levels. Our nurses take real risks with their lives every day and that of their families and, therefore, should be fully supported beyond any crisis.
We need motivated nurses who safeguard citizens through the healthcare system, and who are present at the patients’ bedside and close to the citizens 24 hours/day, seven days/week to deliver optimal safe quality care in all sectors of the healthcare ecosystem. Nurses, often women, are the cornerstone of our healthcare ecosystem, so, take care of those who care. More than ever we need to strengthen nursing as a profession and develop citizens centred ecosystems.