China: Preparing the workforce for pandemics

A new coronavirus that previously had not been identified in humans emerged in Wuhan, China in December 2019. Signs and symptoms of COVID-19 disease developing from the coronavirus included fever, coughing and shortness of breath. In more severe cases, infection caused pneumonia, severe acute respiratory syndrome and sometimes death.

Liu Yilan, Director of the Hubei Nursing Association, had been a nurse at the Wuhan Union hospital for over 30 years. She witnessed the sudden appearance of the novel coronavirus and its rapidly progressing spread, as well as the many challenges faced by health workers.

She observed that the response to COVID-19 in medical institutions required a substantial workforce of nurses because of the sudden large influx of patients, and because donning protective clothing and taking necessary precautionary measures took time and slowed operations to a certain extent.

Liu Yilan also pointed out that responding to severe cases of COVID-19 required highly skilled nursing staff with specialized knowledge and skills in critical and respiratory care. “Some nurses from general departments couldn’t perform specialized tasks such as operating ventilators,” Liu said. “Fortunately, nurses learned relevant new skills with some training, and head nurses arranged shifts to ensure that at least some nurses with critical skills were on duty during every shift in the ward.”

Liu recalled patients in severe or critical condition experiencing uncertainty, anxiety and fear. “These patients were isolated from their family and friends. It was our nurses who stayed with them 24 hours a day. Nursing is important for patients’ survival and also for their psychological recovery,” she said.

The assignment and scheduling of nursing staff had to be aligned with the number of patients, their condition, and the requirements for protective equipment. If there were many patients in serious condition, more nurses were needed on-site. As the number of patients decreased, nurses were removed immediately to reduce unnecessary exposure.

Liu believes that to prepare for future epidemics, all nurses should have training on how to spot, assess and deal with sudden surges in infectious diseases, as well as training in critical and emergency care. Nurses and nursing students should also be trained in the correct use of protective clothing and other protective equipment.

In addition to preparing the health workforce, medical institutions should be able to ensure physical safety and security, and be equipped with adequate stocks of protective equipment. “Although COVID-19 virus proved to be very contagious, medical staff were relatively safe once proper protection measures were adopted,” Liu noted.

Liu said that tens of thousands of nursing experts and colleagues from across the country volunteered to support Hubei, which boosted morale in the health workforce. “While some nurses worked on the front line, hospital leaders, nursing department leaders and head nurses also gave care and support in so many ways,” she added.