Dealing With COVID-19 Post-Traumatic Stress

Strategies for Preserving the Nursing Workforce and Supporting all Vital Frontline Personnel

Therese A. Fitzpatrick, PhD, RN, FAAN; Nancy M. Valentine, PhD, DSc(hon), MPH, FAAN, FNAP President


Nurs Econ. 2021;39(5):225-238, 250. 

In This Article

Unprecedented and Unpredictable

This amount of stress on clinicians and healthcare systems, worldwide, is unprecedented. No one could have been fully prepared for this traumatic experience and associated social disruption, which continues.

Who could have predicted (or even prepared for) how much would fall on the shoulders of staff caring for the COVID patient population? John Barry's (2004) book, The Great Influenza: The Story of the Deadliest Plague in History, presents striking similarities how the 1918 flu pandemic played out politically and how quickly it spread worldwide, but there were not nearly as many hospitals at that time and certainly not the technology available to support patients with severe respiratory illness. Barry's account provides some context for COVID experiences.

In 1918–1920, people saw three waves of the virus where friends, neighbors, and entire families died primarily at home. Bodies stacked up in spare rooms or warehouses for the poor, given the backlog of burials. Limitations of what doctors and nurses could do was painfully apparent. Physicians gave advice such as stay warm, keep feet dry, drink fluids, keep bowels open, avoid crowds, enforce isolation, while they desperately administered treatments to fight the flu, without success (Barry, 2004).

Interestingly, during the 1918 pandemic, the skills of nurses were most valued, as they could provide tangible comfort and support to both patients and families. Nursing them in their misery was coveted and families of means fought over the few nurses available to be hired for private duty in the home (Armstrong, 2001; Clark, 2018).

There were simply not enough nurses to go around, either in hospitals or in the community. An estimated 50–100 million deaths, 5% of the world's population at the time, died of the virus. In the afterword of the book, Barry makes a set of recommendations based on lessons learned. Had these suggestions been read and followed by today's leaders, we would be in a very different place.

Although 100 years later we marshalled more resources and applied state-of-the-art technologies, the helplessness in saving lives still prevailed. Lack of specially trained nurses to deal with this experience has been an ongoing issue. And, of course, there are new challenges, such as the impact of social media and fear of vaccines, among others.