To the Editor:
Our celebration of 2020 as the International Year of the Nurse and Midwife takes place within the backdrop of the coronavirus 2019 (COVID-19) pandemic. Nurses are recognized as brave, resilient, and compassionate frontline caregivers during this unprecedented time. We add our voice of appreciation, but shift focus to the important, highly skilled care of nurses working in long-term care (LTC).
Nursing homes have emerged as places where COVID-19 has spread most aggressively and with tragic lethality. Approximately 30,000 LTC residents and employees have died from COVID-19 infection in the United States during the past 4 months due to the challenges faced by the nursing home structure and ongoing stigma placed against nursing homes and the personnel who work there (Yourish et al., 2020). More than before, these nurses and certified nursing assistants (CNAs) need our support and recognition for their essential, highly skilled work as they navigate the unprecedented complexities of COVID-19.
As the Program Director of the Geriatric Workforce Enhancement Program, which aims to improve care for older adults in LTC communities, and as nurse scientists, collectively, we have spent hundreds of hours working to enhance geriatric care in LTC communities. Our research has explored two topics: (a) collaboration between licensed nurses and CNAs, and (b) nurses' decision making in dementia care. Our experiences also include work as a LTC Clinical Instructor and Care Manager. In addition, we have had family who lived in LTC facilities.
We reflect on the staff we observed with awareness toward the difficult tasks they perform daily, amplified by COVID-19 prevention, and the fear and loss that accompanies this novel disease. We recall stories from nurses and CNAs about the countless, un-heralded acts they performed for their residents. We remember them treating residents as their family—especially during this quarantine. We think about the added challenges nurses and CNAs face during this time when personal protective equipment is in extremely limited supply, and we think of the extra time and sensitivity taken to explain to residents why their family is not there, or the extra time given to accommodate window/FaceTime visits. We think of CNAs who “care with heart” and “are happy when their residents are happy”—even though they earn <$30,000 per year in the United States (U.S. Bureau of Labor Statistics, 2019).
During this global pandemic, we want to remind everyone that nursing home nurses and CNAs are a group of highly skilled, compassionate, and accomplished professionals who face similar challenges to acute care staff. Nursing home nurses and CNAs are also burdened and at an increased risk for diminished morale. We are grateful to see warm appreciation extended to those who work tirelessly in emergency departments and intensive care units. It is well deserved. But we should use care that we do not inadvertently recognize select nurses as heroes while negating the work of others. Just once, we would like to see lines of people clapping for nurses and CNAs as they leave nursing homes. Next time you pass a nursing home, imagine you are cheering. Heroes work there, too.
Cynthia Beynon, MSN, CNE
PhD Candidate and Assistant Professor
Weber State University School of Nursing
Rebekah Perkins, PhD, MS, BSN
Huntsman Cancer Hospital
Salt Lake City, Utah
Linda Edelman, PhD, MPhil, RN
University of Utah
College of Nursing
Salt Lake City, Utah