To say 2020 has been a difficult year is a significant understatement. With COVID-19 (coronavirus disease 2019) wreaking havoc throughout the country, the unimaginable destruction and death due to the widespread fires in the western states, flooding in the southern states, and the racial tension throughout our nation, it is difficult to focus on the realities of our day-to-day lives and activities. Amid all of this, our goals focus on keeping our families and ourselves safe and healthy.
On the frontlines, health care providers have been challenged as never before. Work that is often a source of great joy has been complicated by stress, isolation, and sadness; it is difficult to find balance. Finding balance is always easier when we keep those we love close; yet this, too, has been problematic, as social distancing often requires prodigious family and personal sacrifice. As the novel coronavirus diffused into our lives, a new normal unveiled uncomfortable truths. We are not as safe as we believed. The fragility of everyday was exposed, as life slowed for some people and raged for others. Health care providers could not save everyone, even colleagues and family members. For many providers, life became hectic, frightening, unnerving, and exhausting—one continuous string of train-wreck days. The challenges were endless, the outcomes heartbreaking, and the fears constant. Mistrust of science amplified this uncertainty amid political misinformation and personal fears. Yet, medical professions remained a trusted source of information and secure care. Nurses responded with dignity, competence, and commitment. It was truly the year of the nurse.
Home and work settings became fortresses of solitude, redefining home, safety, and health. Mobility was restricted and travel unsafe. We waited as friends and family members returned from college or travel, as home base was the safest bet. But, for far too many, home and safety remain elusive. Inequality and inequity became painfully visible, a reminder of what we choose not to see in normal times. The most vulnerable among us were susceptible to the virus. The first victims included the elderly, people with chronic illness, disabled or compromised patients, and many who could not shelter from the virus, including many of our colleagues on the frontlines of care. As the pandemic fulminated, the lack of a national response reflected a failure of leadership and threatened our most basic convent with patients.1
Although many people could shelter at home, others had no home, or home was not a safe place. As schools closed, we knew that children would miss the sanctuary of school, which offered the protection of caring adults. Many would be hungry, scared, and often alone as their safe place shuttered. As the pandemic raged on, natural disasters continued to challenge the shelter and security of communities. During this time, social justice became a beacon for all, as the country once again confronted the blight of racism. Throughout these events, health care providers responded with dedication and compassion even as human touch and warm smiles surrendered to our mitigation efforts. Yet, behind every mask, shield, and gown, providers delivered exceptional care, using traditional and innovative approaches.
Technology helped us retain connections as the magic of the internet connected patients and families in the darkest hours of the pandemic. Hospitals and communities developed new ways to care for their populace. Moreover, science moved forward with new research techniques, protocols, and community engagement at breakneck speed.
As 2021 begins, we have new tools: therapeutics, vaccines, new knowledge, and the promise of a new beginning. The year will begin with resolutions. A renewal of goals, forged with new inspiration and energy unique to this New Year. Our goals may be delayed or overshadowed by a new time line directed by COVID-19, yet people will advance with new strength. Many will recover, refocus, and move forward with a new vision, guided by living through a pandemic. “What matters”2 drives a paradigm shift as we speak in terms of “before” and “after.”
Much has changed, as experimental and nonexperimental research and phases of clinical trials become topics of discussion among the general population. Population health and public health programs are at the forefront of each discussion. Health care innovations are accelerated, giving validity to telemedicine, new modes of testing, patient and visitor flow, supply chain procedures, new therapeutics, vaccine development, and numerous features of current hospital operations. Many people are participating in vaccine trials, population health screening, and community surveillance. A renewed passion for better care for every person, all populations, with efficiency and joy in our work, has given new meaning to the pursuit of the Quadruple Aim.3
After the pandemic, what will be different? The answer may be—everything. My family, friends, and colleagues begin each discussion with these words: “After the pandemic.” Goals center around family and events that will resume: holiday gatherings, weddings to celebrate, colleges to tour, travel plans restored, dinner with friends, in-person conversation, or simply sharing a hug with people we love. We hear a different tone in each conversation, as the words are kinder, more generous, hopeful, and grateful. New Year's resolutions and goals are centered on family and health. As for my resolutions, they will begin with gratitude, for health care providers, family, and science. My family is safe, growing and thriving during this time. Many are on the frontlines; some are participating in COVID-19 research, and all are ready to move forward with a renewed focus on health and safety. A new baby in our family, a Covidian (born in the time of COVID), already displays the strength and resilience of my Mom, born during the 1919 influenza.
The path forward is visible, but it will not be easy. The New Year will bring new challenges, perhaps a different political perspective, and a new focus on public health. It must start with sustenance from what we have learned both professionally and personally. In this New Year, science will be embraced, not mistrusted. A recent editorial in JAMA captures the essence of this year and the year to come, “This is a time of great societal upheaval, and the response to the pandemic has required difficult decisions. An effective COVID-19 vaccine, if widely available and with substantial uptake, will allow society over time to return to some semblance of normalcy.”4
As 2021 begins, it is with sincere gratitude and admiration for our colleagues that we commit to provide current information through scholarly publication. Our goals for Dimensions of Critical Care Nursing include gratitude—extended to our scholarly colleagues, educators, and staff. Dimensions of Critical Care Nursing is sustained and fortified by dedicated authors, reviewers, editorial board members, consultants, and a tireless production team, as they juggle unprecedented work challenges, new modes of providing quality education, and complex family responsibilities. Their commitment to scholarly work has endured, allowing us to disseminate knowledge without interruption. With your support, we will continue this work and move forward with resolution to do so with grace and gratitude for health care providers, who have endured much, but will embrace the New Year with new knowledge, tools, and innovations from 2020.
1. Hayes C. Protecting our covenant in pandemic care. Dimens Crit Care Nurs
. 2020;39(4):167–168. doi:10.1097/dcc. 0000000000000427.
2. Gould KA. Celebrating “what matters” for the holidays. Dimens Crit Care Nurs
. 2018;37(6):326. doi:10.1097/DCC.0000000000000327.
3. Feeley D. The triple aim or the quadruple aim? Four point to help set your strategy. The Institute for Health Care Improvement Blog Tuesday. November 28, 2017. http://www.ihi.org/communities/blogs/the-triple-aim-or-the-quadruple-aim-four-points-to-help-set-your-strategy
. Accessed October 10, 2020.
4. Bauchner H, Malani PN, Sharfstein J. Reassuring the public and clinical community about the scientific review and approval of a COVID-19 vaccine. JAMA
. 2020;324(13):1296–1297. doi:10.1001/jama.2020.18860 Assessed October 1, 2020 https://jamanetwork.com/journals/jama/fullarticle/2770681?guestAcce...il&utm_campaign=article_alert-jama&utm_content=olf&utm_term=091020