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Supporting Novice Nurses During the COVID-19 Pandemic

Horan, Kathleen M. MSN, APRN, CNE; Dimino, Kimberly DNP, RN, CCRN

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AJN, American Journal of Nursing: December 2020 - Volume 120 - Issue 12 - p 11
doi: 10.1097/01.NAJ.0000724140.27953.d1
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Abstract

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Figure:
Kathleen M. Horan
Figure
Figure:
Kimberly Dimino

Here we are in 2020, the Year of the Nurse and the Midwife. Ten years ago, we imagined a bright future. We thought our focus in 2020 would be on reviewing the goals from the 2010 Future of Nursing report, and evaluating how closely the profession had come to attaining those goals. Many gatherings would have been planned to celebrate nurses during this special year. Instead, we find ourselves fighting a pandemic. Eventually, we will be dealing with its aftermath. Now and in the future, we should do all we can to support the future of our nursing workforce, especially our novice nurses.

During this crisis, nurses have been hailed as heroes. Unfortunately, on many days they don't feel like heroes. Nurses—both novice and seasoned—have experienced moral distress as they grapple with the conflict between what they want to do for their patients and what they can do. They may know the right action to take but feel constrained by external forces such as shortages of personal protective equipment (PPE) or ventilators, ballooning numbers of patient assignments, or patients dying without family by their sides.

The experience of moral distress is especially disorienting for novice nurses. During the current pandemic, they may have to care for patients under extreme circumstances and in ways that differ from what they learned in nursing school. Imagine a nurse who has never witnessed a patient die suddenly needing to communicate with a dying patient, quite possibly alone in the room with the patient, or even having to communicate from outside the room because of the need for clustering of care and conservation of PPE. They may watch their patient die alone and go home knowing that it is all likely to happen again on their next shift. The resulting moral distress may cause some novice nurses to question their decision to join the nursing profession.

Because of such situations, new nurses may need more individualized attention than usual. We must support these nurses at this formative stage to maintain and develop their mental and professional health. Recognition of and attention to the emotional needs of novice nurses can be accomplished simply through engaging with them. In meetings with novice nurses, managers, preceptors, or mentors can commend them for their work, help them reflect on their experiences, and refer them to available resources. Another way to let them know they're not alone is by encouraging peer group meetings, either in person or virtually, with other novice nurses. Engaging new nurses in these ways will show them that they are valuable to their organization and that the organization is responding to their needs.

Through such approaches, we can emerge from this pandemic stronger and more resilient than before. Without a healthy and stable nursing workforce in the coming years, we will not be ready to provide day-to-day care, much less weather a repeat crisis or pandemic. An ebb and flow of retirements and new graduate hires has always been a constant in nursing, but the effects of this crisis remain to be seen. Will more nurses retire than expected? Will there be a higher rate of attrition for novice nurses? Will the number of nursing school graduates decrease? Will this finally prompt the nursing shortage that experts have been predicting for years? Although we don't have the answers to these questions yet, it is imperative to begin to work to support our novice nurses during and in the aftermath of this crisis.

COVID-19 came out of nowhere and tested our preparation, knowledge, skills, compassion, teamwork, communication, and strength. Most of all, it tested our resilience, and it will continue to do so. But this doesn't have to be the end of the story. Together we can support our novice nurses as they overcome the consequences of moral distress and in so doing reclaim 2020 as the Year of the Nurse and the Midwife.

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