COVID-19: Were we Preapred?
Author: Ron Hilliard, MSN, RN
My name is Ron Hilliard, MSN, RN and I have dedicated much of my career to disaster preparedness and nurses being ready to respond. The COVID-19 pandemic put a whole different perspective on being ready for a major event. I am driven to understand the implications of the COVID-19 pandemic that occurred early this year and I would like to invite a discussion with nurses from the field to understand what they experienced and how we can work together to strengthen our response.
In 2001, I was detailed to establish and manage the HRSA Hospital Preparedness Program to respond to Bioterrorism in Texas under the Texas Department of State Health Services. For over 5 years there was a great deal of federal funding pushed into state public health to prepare for bioterrorism. This included training and equipping health care and public health to be ready if something happened. Great strides were made in expanding public health capabilities and health care, specifically hospitals, being able to handle surge if a biological outbreak occurred. This took a lot of time and effort by many to get to a point we felt like we were ready. Yet, it seems we have had to start all over to prepare for a large-scale disease outbreak while the COVID-19 pandemic is evolving.
That raises a lot of questions. How did it have a direct effect on nurses? Please share what you have experienced from the aspect of being prepared for this event.
- What did you, as a nurse, experience in being personally ready for the COVID-19 outbreak and your response to the pandemic?
- What advice can you give to other nurses, especially those new nurses that are struggling with entering the profession and facing a major disease outbreak at the same time?
It was 20 years ago that states started preparedness efforts for such events. Over the years, we had no major events that pushed us to fall back on those preparations and the readiness posture fell off the radar with the effort to sustain those preparations not staying as a priority. The result was we were not ready for a large-scale event. We first saw the gap in preparation for a biological event with the Ebola incident in Dallas that occurred in 2017. A large number of personnel that led these initial efforts have all pretty much retired and the historical experience has been lost.
I hope we can take this opportunity to learn from each other and promote activities that will make us stronger.
I’ve been a nurse (ADN) for 18 years. ~13 in trauma ICUs, 4 in ECMO and now 1 as a school nurse (and still pt ECMO). On the hospital level, I saw a scramble to define a COVID-19 plan and then further delay in implementing it. The plan would be announced, rebutted, retracted, revised, etc. even before we had a single COVID-19 patient in house. I’m wrapping up my BSN now, and as part of my leadership course change project, I made a proposal for the addition of a ‘Disaster preparedness, management and recovery’ course to the standard undergraduate nursing curriculum at my university. So many nurses at every level throughout the hospital had concerns and questions that could have (should have) been pre-answered. With nurses making up 70% of crisis responders, why has it not become standard before now?!
Many of us have been asking that question for years. I think it is because the accrediting bodies do not think it is important enough and thus give it inadequate attention.
• What did you, as a nurse, experience in being personally ready for the COVID-19 outbreak and your response to the pandemic?
I feel like I, along with a handful of my colleagues, were personally prepared for and ready to face this COVID-19 outbreak head on. BUT – we are also part of a team that trains and prepares to respond to high-consequence infectious diseases such as Ebola virus disease, MERs, and many others. As far as hour hospital system and CDC were concerned, we were over prepared – but don’t believe there could ever be such thing. Our group of nurses not only recognized the threat of the novel coronavirus in the beginning of January, but we followed developments closely and educated our peers back in our units and perspective hospitals. We were also some of the first to care for COVID-19 positive patients in Texas back in February as part of the Texas Emergency Medical Task Force (EMTF). Our hypervigilance of our practices in our PPE translated to a lower level threat back in our units once we started to see the patients emerge in our EDs and ICUs – but we were able to lead the charge along with our Infection Control nurses in creating protocols that have been tweaked many times over the last months. We are in a constant PDSA cycle to improve our methods, only striving to keep our staff and patients safe. I hope that looking forward this even will gain momentum to support our other hospital preparedness efforts and teams.
• What advice can you give to other nurses, especially those new nurses that are struggling with entering the profession and facing a major disease outbreak at the same time?
Focus on your basics. Create GOOD habits – this pandemic showed our weak links as healthcare providers in some of our behaviors and the chains of transmission. Focus on one day at a time and trust your PPE. This is an amazing and troubling time to be in, but we will all come out stronger on the other end.
I enjoyed this article. Thank you.