“Being a nurse is one of the best profession and life in this pandemic”
Novel Covid-19, a pandemic which has succumbed the whole world, starting from Wuhan city of China. The number has reached 7.2 million positive cases with more than 4 lacs death in the world and 2.76 lac positive cases and more than 7 thousand death in India on 10th June 2020. This pandemic has highlighted the importance of health care workers, especially nursing professionals as they need to work in close proximity with patients. Nurses are liaison of the health team and coordinate all the activity. The past had witnessed many such natural and man-made calamities in the world. Every time health care workers had won the battle with their effective management, still, loss of human beings was much higher side. This time we are again at the shore of the battlefield and facing a tough time with this COVID-19.
On the occasion of 200th birth year of Florence Nightingale WHO declared this year as ” THE YEAR OF NURSE AND MIDWIFE-2020” and continued for another three years due to the pandemic. This COVID-19 has brought the health workers to the centre of health systems discussion and fear in public. In India the nursing profession is always considered as a low-profile profession even then its importance is always proved at many places by stakeholders’ time to time. Nurses are not considered at the level of stakeholders in many institutes until the federations, unions, and associations representative take part in the system.
“ Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. It includes the promotion of health, the prevention of illness, and the care of ill, disabled and dying people”. WHO
The nursing profession is based not only based on science but also the art of care. This made nurses a specialized profession and can’t be replaced with other health team members. It has well-established ethics and codes. It needs a registration certificate to work as a nurse in the clinical area and even in the academic area. Highest monitoring agency is Indian Nursing Council which control the panoramic part of the profession. There was an attack on the professional roles and rights of nurses then associations, unions and other bodies played their role to highlight the importance us via newspaper and digital media.
I am a nurse working in Northern Railway Central Hospital (NRCH), New Delhi. I have been working here since 2007 and currently, designated as Chief Nursing Superintendent (same cadre as Assistant Nursing Superintendent). My hospital is 415 bedded and well equipped with all specialities of care along with AYUSH department. Currently, there are 263 nurses working there in three shifts and someday schedule duty pattern in some department.
This year begin with deadly pandemic a novel coronavirus. In the early stage, the hospital reserved four beds for corona patient as per the policy of MOHFW. Later with increasing the numbers of COVID-19 patients and lockdown applied by govt of India, NRCH has decided to increase the number of beds. Presently this hospital is equipped with a well-managed flu OPD (Screening area), COVID ICU, COVID wards with almost 200 beds. Among these reserved beds, more than 100 COVID-19 patients are taking treatment. As per the International Labour Organization (convention 19) and WHO (article 14) and 1988 Highpower committee for nursing in India has fixed 40 hours a week and were introduced in January 1990. But till today railway nurses are working 48 hours per week. Railway administration should need to recorrect this to bring the uniformity among the nurses across the country. In the earlier stage of this pandemic, there was a lack of clarity over the staff duty rotation and duty hours. Earlier we all staff were working 12-hour long shift in the hospital. These long shifts were adopted in both COVID and non-COVID wards. In non-COVID wards, staff were called alternate day to protect them from this deadly virus infection. In COVID area, staff were doing their duty for 12 hours for 14 days continuously.
Personal Protective Equipment Kit
COVID duty is not a simple one. We have to protect ourselves by wearing most haunted, most talked and most demanded, that was PPE- Personal Protective Equipment which consists of several parts. It includes a suite with zipper, goggles, shoe cover, N-95 mask, gloves and face shield. The complete process to wear and to remove PPE was a very cumbersome process and takes a long time. The process to wear is called Donning and to removing is called Doffing. Both processes are in such a way that starting from one point to go another and then come back to the same starting point
It takes 15-20 minutes and again the same to doffing. When you entered this PPE kit and remain inside there for long hours, you even can’t think of the problem you face. During this PPE kit, you can’t pee, can’t drink water and take food. Even many hospital have to wear an adult diaper to avoid the wastage of these kit. All the time you feel ill-ventilated and body precipitate deadly. Your clothes become wet due to perspiration. During that time, you may feel exhausted, hypertensive, nauseating and even can fall from electrolyte imbalance and dehydration.
Corona Warriors responsibilities
I was deployed as CORONA WARRIOR in the very first batch for COVID duty, the time when the standards for COVID-19 were in pipeline and were under trial and error. Every day the setting was different as per the changing the criteria. We were not provided with any training for COVID duty. This time was very crucial as we were afraid of getting positive as we were short of PPE kits and only one kit was given and above all the long 12 duty hours. It was a horrible time as patients were coming in with all suspects sign and symptoms. The testing rate was slow and the number of tests was very low. At that time, we as nurses need to play a dual role: one to protect ourselves and another to serve the COVID patients. Every patient coming in the ward or Out Patient Department (OPD) was feeling very depressed and we need to counsel them, care and educate them about this COVID disease. In this crisis and fewer resources, we have done our duty for 14 days continuously for 12 hours a day.
The standard physical set up for COVID ward was not fulfilled as just normal wards were converted into COVID wards. Each ward was having more than 30 beds in it and all beds were filling fast as at that time every person who comes with any suspected sign and symptoms were being made admitted. This was a crucial time for healthcare workers and specially nurses. Nurses were working day and night for many long days. The patients were in supervision of nurses and many of us have not been gone to house for many weeks.
Life during the COVID duty
This was a time where we were leaving in a fearful environment. We were not able to meet our family members, friends and even separated from society and have been quarantined in a hotel where we can’t go to each other’s room. We were not allowed to go to normal OPD to get treatment if we become sick. The chances to get sick were more as we were at high risk because of this duty. In my duty schedule, we were 4 people working in our shift for 20 patients. To deal them with their every requirement from food to medicine, from bed to head, from entertainment to information, from care to corona and every little bit help sought by admitted patient and on another side where we have to feed all required information to administration from admission to discharge. This is well known that many of health care workers have been got infected with this COVID-19 and some of them also lost their life.
Corona duty is a duty when stress encounter in our life. As a corona warrior, we were separated from family and all friend circle. We were away from our kids, from our parents. We were provided residential facilities with food. But this was not fulfilling the real nature of human being, the love, the affection, and social need. But this corona has brought down all wishes, attitude, egos, love, affection, social obligation and even faith to ground. This pandemic has closed the house of God, but the internal faith remains intact. People have maintained their faith in their mind, wishes in their prayers, love in distance, the social obligation in human services by going through the stage of corona warriors.
We are a human being, not angels
As front-line corona warriors, we have been appreciated many a time by honourable Priminister. The recognition to nurses in this pandemic was surprisingly raised. We were also honoured by our colleagues and at the administration level. Our services and skills were in high demanded in this pandemic. Government is doing its efforts in many ways while nursing personnel are playing their role in their services. Nurses need more attention to their well-waiting demands for their career progression, for their professional risk, skills and financial need. Although this is not the time for demanding any need still, we are a human being and we need the fulfilment our social and financial need.
This is the time where we need to show professionalism towards the community. It is not time to call them angels because every time by calling as an angel is not the solution as now this has grown as into complete profession. So, it should be treated as a professional way. Nurses who are playing their part have been well equipped professionally but their skills and expertise were not considered at local, state and national level planning. There were many incidents of nurses excel life-saving and preventive skills but still, they are not promoted based on their skill.
Health workers are the centre of health systems strengthening discussion. There is an immediate need to introspect and evaluate the value of them via recognising their skill, providing career progression and dignity of work by stopping them hiring on the contract or short time low salary based in the public health system and following a Supreme Court order on minimum pay at Private Health sector. This pandemic proved the importance of the public health system. We as health workers in the public health system and our institutions came in rescue than private health institutions. This should be a lesson to the government to spend more on the public health system and strengthen the primary and secondary levels too. Private hospitals looted the community in the name of pandemic and still, nurses and other health workers are underpaid. This is high time for the government to make the private institute to enforce this recommendation. Moreover, nurses should be met with the high time demand of their hardship and risk allowance as being corona warrior, it is the toughest part of their life being passed in great risk. Nursing personnel who have been recruited after 2004 also must meet with the old pension scheme instead of the new pension scheme as similar to defence personnel.
This pandemic has taught us lesion. A lesson for humanity, a lesson for service, a lesson for relation, a lesson for the profession. To work as a corona warrior is the biggest honour. It is a great time to work as corona warrior. The nursing professionals are always ready to face this pandemic with all precaution, with all dedication and with all efforts. This time too we proved ourselves and learnt the skills to handle the pandemic. I felt useful to serve as a corona warrior and I was posted at the very first batch of NRCH, where nothing was in pipeline, no clear rule and regulation, and even we were very stressed. I prepare myself to prevent such pandemic in the near future and ready to be as a front warrior in case of community need.
I convey my best wishes to all nurses and other health workers who are working as corona warrior. We are proud to be a nurse and always be proud of our profession and want to serve the nation with more dedication and full of my capacities.
Ghewar Chand (RN, RM, MA history, PGDHRL, MBA HR, PGDHR) currently working as a Chief Nursing Superintendent at Northern Railway Centre Hospital, New Delhi. He is not only passionate to care for the needy population but also to fight for their nurse's rights. He is General Secretary of ARNI( Association of Railway Nurses of India).