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Nursing through a pandemic is Written by Jacqui Culver, Nurse Practitioner, Salutogenic Ageing and Advanced Care.

Jacqui has been working in the aged care sector for over 30 years, she is well known as a speaker at state and national conferences and has published both with Joanna Brigg Institute and in the Journal of Palliative Care. Over the last 10 years Jacqui has worked as a Nurse Practitioner specialising in palliative-aged care, gerontology including chronic wound management and dementia, her experience and practice spans acute, residential and community aged care.

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Nursing through a pandemic

I sit and reflect on the past two years.

Am I proud to be a nurse? – you bet I am, and, has this been the most challenging time in my nursing career? – you bet it has . . . . . ..

The grass is still green and the trees still standing, I have a fence around my garden, my safe space.

Tomorrow I leave this safe space and journey into the reality of this pandemic, everywhere I go, every person I meet, is a potential risk and I a risk to them, what trust we put in each other.

I felt it, long before it came, I felt it many years ago when online learning at the start of my master’s degree brought me in contact with nurses from China. In the middle of the 2003 SARs Pandemic, they were online sharing their stories with us.

They lived and slept at the hospitals where they worked, they kept studying and sharing, working 12hour shifts, 7 days a week. So far from us, it was hard to imagine such dedication, yet we felt their silent anguish as they left their families to live and breathe their job, not knowing if they too might succumb to this ‘mystery’ virus.

Oh, how I admired them and yes, I vicariously felt the fear of having to make those choices.

How would I face such a challenge, how would I ‘choose’ over my commitment to nursing, to humanity, or my need to stay safe for my family?

I never let go of that personal insight, in 2019, I heard another virus was gaining traction in China, and I knew.

Long before my family, colleagues or friends felt fear, my own anxiety elevated as I watched it insidiously creep across the globe. It was surreal, I had close family and friends in England and the number of deaths was terrifying.

My nightly ritual would be checking in on the safety of loved ones and then pouring over world health data to see where the virus was taking hold, I knew with certainty it would soon be here.

I felt relieved, yet highly privileged that we in Australia had time, time to prepare and to build some resilience in our communities, naive to its eventual arrival or the impact it would have on our lives.

Slowly it came, cautiously we remained optimistic, as health advice moved the nation to a place of higher alert, improving health literacy around infection control and upskilling the workforce.

In the aged care sector, we were travelling fast, putting in systems and processes to protect our most vulnerable. Building capacity of unregulated workers to use Personal Protective Equipment (PPE) appropriately, establishing emergency plans for potential outbreak and liaising with local area health with collegiality and recognition for the roles we all played in this profession of nursing.

It came naturally, the plans not to go home if an outbreak occurred, the long hours of calming and smoothing the anxiety of clients, residents, families, and care workers. Moving from part time to full time and beyond was accepted by myself and my family, starting early and finishing late became my new normal. I was a nurse after all, and this was my job, my vocation and I loved that I could make a difference, reassuring those around me that we would be OK.

So, this was the front line for me, we didn’t have any positive cases within my jurisdiction, but we knew that everyone was a potential risk, so we donned the PPE, we swabbed throats and noses, and we doffed. We led teams of care workers in calm efficiency to develop skills and understanding of how viruses spread, how they could protect themselves, their families, and the people they cared for.

We visited people at home and showed them how to wear a mask properly, when to use hand sanitiser and how to maintain their health and wellness to maximise their immunity.

We drove kilometres to purchase brewery made sanitiser, that we decanted into empty bottles that sat on many shelves due the shortages we were experiencing. We bought toilet rolls wherever we could and dropped them to our elderly frail clients, we taught how to do online shopping and video call family and we collapsed into bed each night exhausted, never knowing what tomorrow would bring.

As a Nurse Practitioner I had much autonomy, I was involved at a grass roots level, through to advising clinical governance. My manager was proactive and strong, she listened and responded to the clinicians in her team, my colleagues were as passionate and as committed as I, and the workforce on the ground was simply amazing.

I learned much in this time about resilience, community spirit and yes, also about bureaucracy, I observed with mild humour as no one likes to be out of control, but our governments were, and suddenly state politics became much more interesting. Time rolled on and another year has passed.

We are still here, the grass is still green and the trees still standing, I am still a nurse, wiser and much more confident in this Australian nursing skin.

My profession has evolved in this time, Nurses are more prominent in the public arena, our unique role more visible and valued.

The status of Nursing has shifted in Australia, this means we may see more equity in health care leadership. Nursing can then autonomously attract a fair share of the healthcare budget, aligning with other G10 countries in valuing nursing alongside medicine as a parallel profession.

A profession that is not just seen as a subset of medicine.

This pandemic has the potential to have far-reaching, positive outcomes for all Australians, as we face new healthcare challenges. Nursing offers a ‘Salutogenic’ / wellness model of healthcare which balances the ‘Pathogenic’ /disease focussed approaches that have traditionally driven the healthcare agenda in Australia in the past.

This is now, and tomorrow is another day.

Jacqui Culver, Nurse Practitioner