Abstract
During the past 2 years, the world population has dealt with the acute and lingering effects of the COVID-19 crisis and associated losses. Trauma, in its many forms, has been inherent in nursing practice during this time, regardless of specialty (Chen et al., 2021). Caregivers have exited from the workforce, experienced compromises in care provision, and dealt with the interpersonal stress of loss in the workplace and daily life. Coping mechanisms have included using substances, and there has been an increase in depression and anxiety (Foli et al., 2021). The effects of the COVID-19 crisis have been a powerful, global influence on psychiatric nursing practice and on nurses coping with stress and loss personally and with their patients (Labrague & De los Santos, 2020). Are psychiatric nurses equipped to approach mental health with an understanding of the trauma emerging from the loss of friends, loved ones, routine, a way of life, or job in their patients and in themselves? This editorial will discuss the trauma of the past 2 years as a loss and, at the same time, as an opportunity for psychiatric nurses.
Chen et al. (2021) proposed that COVID-19 is the new mass trauma experienced globally. For nurses, associated losses have translated into a form of grief for others and for self that has translated into a part of the nursing identity. Nurses have watched COVID-19 be indiscriminating and take from all, including the physically healthy, youthful, and those not usually at risk for physical health complications (McCallum et al., 2021). This grief has altered nurses’ ability to tap into their resilience as they cope with the pandemic professionally and personally (Foli et al., 2021).
Slade and Hoh (2020) wrote about using Watson’s Theory of Human Caring as a model for nurses working with loss and grief. Written pre-pandemic, the article offers insight into types of losses and the ways that grief can be defined. They noted that loss of self/identity can result from perceived positive or negative experiences that result in grief due to the “unbalancing nature of the changes occurring, which can challenge self-concept” (Slade & Hoh, 2020, p. 5). Nurses can be vulnerable to cumulative loss due to the nature of nursing care in many settings. When this is compounded by the personal losses that have occurred during the COVID-19 pandemic, the grief can have many forms and be simultaneously related to both work and personal lives (Slade & Hoh, 2020).
What are the mitigators to trauma and subsequent grief that nurses might have experienced as they moved through the pandemic crisis? Labrague and De los Santos (2020) identified that increased levels of personal resilience, social support, and organizational support are associated with decreased levels of anxiety related to the COVID-19 pandemic. These researchers acknowledged that dysfunctional levels of COVID-19 anxiety “may have negative effects on nurses’ mental health and well-being, provision of adequate mental and psychological support should be prioritized by nurse managers” (Labrague & De los Santos, 2020, p. 15). They further noted that these evidence-based support measures should include access to psychological treatment or psychotherapy. The prioritizing of self-care among nurses with adequate time away, schedules that offer breaks, and generally reinforcing nurses’ coping strategies and self-efficacy will lead to improved resilience.
Nursing practice is inherently, at least in most work environments, emotionally taxing. The pandemic has weakened supports for coping and increased maladaptive coping. The pandemic has also resulted in many nurses questioning their work, its meaning, and the interpersonal costs and benefits (Foli et al., 2021).
Yet, perhaps “what we have lost” is actually “what we have gained.” In spite of the sadness, grief, stress, and loss of the last few years, nurses have a unique opportunity to examine their practice, themselves, and their work choices. The end result, after considerable disruption and change, could be a stronger and more focused workforce that could handle the next pandemic more thoughtfully and with preparation.