The effect of COVlD-19 on nursing in Southeastern Europe

Contributor: Besarta Taganoviq, Dean of Nursing Department, Heimerer College, Kosovo*

COVlD-19 has affected the lives and health of hundreds of millions of people around the world.

In Kosovo, the virus has particularly affected the healthcare system, which already suffers serious deficits in terms of infrastructure and human resources. COVlD-19 has also, inevitably, affected the safety of healthcare professionals, particularly nurses, who have been fighting on the frontlines to save the lives of those affected by the virus.

Since 13 March 2020, when the first case of COVID-19 was confirmed in Kosovo, the number of infected patients has increased significantly. The health service has rightly focused on the critical pandemic situation, but this has predictably caused other health services to suffer some degree of neglect.

One of the principal challenges encountered by secondary healthcare systems during the COVID-19 pandemic has been the difficulty of providing Continuous positive airway pressure therapy (CIPAP). Nurses with little or no preliminary professional training in the administration of this treatment have been required to apply it for the first time during the pandemic emergency. Data collected by healthcare services around the country where patient have been hospitalized with COVID-19 and treated with CIPAP show that these patients are all aged 30 and above. Depending on the severity of the patients' symptoms and their health condition, they have received CIPAP treatment for up to 10 days. Based on patient needs, CIPAP apparatus administers up to 150 liters of oxygen, which is followed by medical therapy. The purpose of this therapy is to raise oxygen saturation in the organism, which can increase the likelihood of faster and more efficient treatment. The use of CIPAP treatment for the first time in Kosovo during the COVID-19 pandemic is a major milestone in the development of healthcare in the country. The novelty and relative unfamiliarity of this therapy among Kosovan healthcare staff has, on the one hand, necessitated a longer period of adaptation, whilst, on the other hand, it has provided an opportunity to develop flexibility and the ability to adapt faster to other new treatments in future. CIPAP therapy is applied to patients who, because of the virus, have shown breathing difficulties or general complications of the respiratory system.

The response to the COVID-19 pandemic in Kosovo has increased awareness of the role of nurses, and their importance in patient care. The nurse's role was previously seen as auxiliary to doctors, and nurses were not routinely involved in the decision-making process around the treatment of patients. During the COVID-19 pandemic, nurses have shown that they have a key role to play in the provision of health services, and begun to play a stronger role in the decision making process on patients' treatment. They have demonstrated the value they can add in the prevention, management and control of infectious diseases. During the pandemic crisis, nurses in Kosovo have used and expanded their professional skills, incorporating evidence-based practice into the patient treatment. They have supported patients and their families and provided high-quality care for all patients, including those not infected with COVID-19, employing a holistic approach while respecting the values and beliefs of patients. Once again, nurses have confirmed the values of their profession, while clearly demonstrating how indispensable they and the care that they offer are within the healthcare system. At the national level, it is urgently needed to regulate the profession of nursing through development of the Advanced Nursing Practice (ANP) programme which would enable specialization and competence profiling in these fields. The APN role would also enable the different healthcare professions to be more competent in their key expected roles and responsibilities within the health system and increase effective and efficient team management, quality of health services, cost minimization, a supportive work environment, and the promotion of the nursing profession itself. Subsequently, it is expected that the prevailing high number of nurses leaving the country to be significantly reduced.

*All references to Kosovo should be understood to be in the context of the United Nations Security Council resolution 1244 (1999).