Nursing Goes Back to Basics

The cancer care community continues to observe National Nurses Month and the Year of the Nurse and Midwife, celebrating the pivotal roles oncology nurses play on the multidisciplinary cancer care team. Since the dawn of COVID-19, these roles have expanded and, in many cases, become more challenging than ever before. Many nurses have been thrust into a “back to basics” mindset in workplaces in which limited—or even absent—resources have compelled them to improvise in order to protect their patients and themselves against a potent invisible enemy.

To address the role of nurses in this challenging environment, we spoke to Barbara Jensen, RN, BSN, MBA, the Director of Oncology at Skagit Regional Health Cancer Care Center in Mount Vernon, Washington, and a member of the ACCC Board of Trustees.

ACCCBuzz: What specific challenges has COVID-19 brought to today’s nurses?

Jensen: The challenges to nurses that have come with the COVID-19 pandemic are things that most of us have never experienced in our careers: bed shortages, equipment shortages, and—most important—nurse staffing shortages. In many parts of the country, nurses are coming out of retirement and getting back to the bedside to contribute to this huge effort. Many are working with technology that is new to them, but second nature to newer clinicians who have been raised and trained in a technology-driven healthcare system.

If anything, this crisis reinforces the fact that nurses are capable of wearing many hats and practicing in a multitude of clinical settings. Given that we are expanding our workforce to practice at the top of our licensure as we need to increase ICU capacity—and then contracting as we begin to stand down our delivery systems from crisis mode—demonstrates that this is a workforce that can rise to any challenge.

ACCCBuzz: Is there anything about the way that nurses are trained or the work that they do that has been especially relevant in responding to this pandemic?

Jensen: Experience is the best teacher, as I don’t think there is any way for us to prepare student nurses for this type of global response. Nursing training focuses on developing clinical assessment skills at the bedside in order to help guide treatment. It is important to take advantage of every personal, low-tech interaction—every med pass, every bath, observing every patient nuance—to help guide our care planning and assess the effects of the interventions intended to return our patients to wellness.

Many nurses come out of practicum and want to specialize in fast-paced, high-tech areas—such as the emergency department or CCU—so as to move beyond the basics of bedside care. If nothing else, this pandemic is reinforcing the basics of nursing care: to control the environment that the patient is in to support them into recovery. Nurses are keen observers, and often the first line of defense is to notice the slightest sign that something is off with a patient and then move to act on it. No matter what specialty nurses ultimately choose, it comes back to the basics of being a keen observer and advocate of your patient’s change in condition.

ACCCBuzz: Do you think the experience of caring for patients during this pandemic will have any long-term impact on today’s nurses?

Jensen: I think nursing will come out of this with new models of care in almost every setting that work to stretch our concept of the nursing “team.” We will develop new best practices based on having to work through the challenges of supply and staffing shortages, and I am most hopeful we will continue to expand our capacity for kindness. Nurses who have worked through this pandemic will be forever changed respective to the role they played and better suited to address future healthcare crises because of it.

For resources on COVID-19 as it applies to the oncology community, visit ACCC’s continually updated Coronavirus Response page. ACCC members can also access ACCCExchange, a forum that allows them to communicate in real time with their colleagues about how the COVID-19 virus is affecting their communities and their patients.