'It’s hard to capture all the roles that nurses took on in addition to saving lives'

From the very beginning of this pandemic, nurses around the world demonstrated leadership by stepping up to care for those affected by COVID-19. Nurses participated in all aspects of pandemic planning while supporting patients and their families through the early uncertainty and fear of this virulent disease.

None of us did it for the accolades or because we were likened to heroes, but because we are professionals, uniquely positioned to be the ‘front lines’ because of our invaluable skill and expertise.

I have been a nurse practitioner (NP) for the last six years, but before that I was an ICU nurse for eight years.

I am still affected by the tragic deaths of young patients from the H1N1 pandemic in 2009. I naively hoped that COVID wouldn’t be as bad, but it has been far, far worse.

What has kept me going in this pandemic is the incredible colleagues who have been there for not just me, but everyone.

At the beginning of the pandemic, I was part of the team of NPs at the Rockyview General Hospital, which is a novel NP-led cardiology program. With the onset of COVID-19, my nursing colleagues in cardiology stepped up in a considerable way. They created a remote CCU on the ward, knowing that critically ill patients would need the beds usually intended for unstable cardiac patients.

As an NP team, we supported ward nurses with in-the-moment training to help care for this population. We rapidly developed protocols to identify unstable patients who could be cared for on the ward or transferred to other sites. When outbreaks affected different sites across the city, we stepped up to cover gaps in coverage to ensure there were no gaps in care.

About a year into the pandemic, I had the opportunity to contribute to a newly developed NP role at the Peter Lougheed Centre (PLC) CCU. Again, through more severe waves, the CCU and cardiology nurses at PLC stepped up and created a CCU on the ward as ICU patients took up our usual bed space.

The amount of time dedicated by the nursing leadership and administration to support this transition quickly and safely was significant, but it paid off. As a team we were able to care for unstable cardiac patients in the face of significant uncertainty and scarcity.

I can’t express how inspiring my colleagues have been to me. To give back in a small way, I offered to be redeployed to PLC ICU when the demand of critically ill patients exceeded the systems resources. It had been a long time since I worked bedside in ICU; my nursing skills had shifted over the years to reflect the NP role.

I was worried I wouldn’t be much help, but my experience redeployed at PLC was the highlight of this difficult year. The team welcomed me and supported me despite my clunky bedside nursing skills. I covered the outreach role and it reinforced my gratitude for the incredible skill and flexibility nurses have in their role.

ICU nurses not only cared for those within the unit but also supported nurses on the wards who were dealing with a high volume of very sick patients. In ICU, I also had the opportunity to work with redeployed nurses from paediatrics, the OR, even hospice. There was a team made up of nursing managers, physiotherapists and occupational therapists that went around twice a day, skillfully proning and unproning the sickest of the sick COVID patients.

There were nursing managers fulfilling the role of charge nurses so that ICU clinicians and senior nurses could take patient assignments. The clinicians who did take nursing assignments continued to support the redeployed managers, assisting with the assignment creation and bed placement issues.

It’s hard to capture all the roles that nurses took on in addition to saving lives. The result is that despite the unprecedented, worst-case scenario situations, patients received the care they needed, families were connected to loved ones despite visiting limitations, and ICU nurses supported all of us working in unfamiliar roles and spaces.

Even after the surges, my colleagues are working hard to reassess and refine the support future patients may need. There is no business as usual in between the worst-case scenarios.

What has been underscored throughout this pandemic by the actions of nurses is that care for each other is what is going to get us through this. Maybe that’s why we are all so hurt when small fractions of the public feel their own beliefs supersede the rights of the vulnerable or the sick. I count myself fortunate to have the opportunity to work every day with the people who can care for each other despite colossal challenges.