International Nurses Day 2020: Case study of the week

14 April 2020

From the frontlines of the COVID-19 response: Italy

Contributor: Floriana Pinto

FPFloriana Pinto is a nurse working on the frontlines of the COVID-19 response in Italy. She recently took part in a live conversation with Elizabeth Iro, Chief Nursing Officer at WHO, and others on WHO’s social media. This is her story, and that of many other nurses in Italy and across the world.

We were all excited to prepare everything to celebrate this year, 2020, and to find ways to explain what nurses do to the institutions and citizens, but also to nurses themselves, because in Italy lots of nurses have lost their professional identity. But then the virus arrived, and we had to stop to fight this invisible enemy. Our lives have completely changed. People now call us “heroes”, but despite our continuous struggles, we were not recognised until a month ago. Did we need a virus to make people and institutions understand we are the backbone of our health system? Even though it is a sad situation, I think that this is our occasion, the right moment to show who we are, and after this pandemic emergency we will continue to fight for what we deserve: support, protection and investment.

Our lives now, in COVID ICUs and wards, are like continuous roller coaster rides: fatigue and anger, then joy at finally transferring patients from the intensive care with whom, despite the short time and protective clothing that barely allows us to breathe, we find time to talk and communicate to make them not feel alone. We are the only company they have and it is impossible to smile with the mask so we have learnt to talk and smile with our eyes.

It is not simple: we have had to change other wards into ICU wards; everyone is working to their highest competence in clinical skills or relational ones, to help…and that is the best thing I'm seeing these days: it is what I've always wanted to see. It is the proof that we are a really powerful team!

But then reality slams you in the face... The system is not protecting us and when we leave the COVID area we have to fight for a COVID swab, which it is not guaranteed we’ll find. We have to fight for proper PPE and proper staffing levels. Italy has called in student nurses to help but they have no experience. I feel responsible for them; in this group of recent graduate nurses engaged in this emergency, one has already become infected after a week! We are sending unprepared nurses to the front, while we still have colleagues blocked from recruitment due to cuts to health care system. We are also fighting for psychological assistance. You can understand that sometimes when you start to think, the anger can take over...

Are new ventilators and ICU enough to fight the virus? What about people infected at home who need our assistance? What about the staff? Do we have to raise our voices, as our representatives have been doing in recent days, to make it understood that maybe this is not the right way to treat nurses? If all the nurses stopped now, there would be the greatest human disaster of recent times!

The reality is that everyone, including nurses, know that we will continue to work with dedication and professionalism in this emergency, even at the cost of our lives. Before the pandemic, we were already exhausted; our salaries have been blocked for about 20 years; and our staffing levels have been reduced to the bone. But nurses have always, despite the increase in duties and the continued disappearance of rights, ensured that citizens maintain their health. The exhaustion and worry on our faces are the only visible part of the scars we have inside. Our attitude is to think and take care of people, and we are doing this as best we can.

The real problem will be when, at the end of this tragedy, we as nurses find ourselves in front of a mirror exhausted, unarmed, unable to put order to the thoughts and feelings caused by the emotional shock and physical stress due to this period. Maybe we'll fill pages of testimonials and interviews, everybody will keep calling us heroes, but maybe these heroes just need to be considered and treated as the professionals we are.

I believe and hope that this crisis, when it is finally over, will be a turning point to the destiny of a profession which is not currently considered or properly recognised. Everybody is talking about our sacrifice, but we are doing the same things we have always done, with the same competence and dedication. It may be in more difficult conditions, but we are the same competent, resilient, hardy nurses we were before the pandemic. Nurses will always be here, caring for citizens, improving health and aware of our professional identity. Everybody must know and understand, not only in moments of crisis, that without nurses there is no health.

Maybe all these lives and all this sacrifice will serve to make us aware of who we are and what we can do. History has taught us that nurses are able to do the greatest things in the worst conditions. This is the right moment!