1. Fulton, Janet S. PhD, RN, ACNS-BC, ANEF, FCNS, FAAN

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The vaccine is here, coronavirus cases are decreasing, hospitalizations are down, and hope for a new normal is increasing. Last year in March 2020, the pandemic was declared during the week of our annual National Association of Clinical Nurse Specialist conference in Indianapolis. Attendees cancelled at the last minute, others left early, and the last day of the conference was cancelled when the governor declared stay at home orders. It was disorienting and eerie, being in a downtown hotel and watching the city close. The streets were decorated with banners for Big 10 March Madness. The tournament was cancelled, the restaurants closed. Those who could work virtually stayed home for a year. Nurses could not; we did what we do - enhance healing and provide care. And in some very challenging circumstances. What a year it has been.


Once the pandemic ends, nurses will continue on the front lines of healing and caring. Most immediate is the work of vaccinating the entire population - not just of the country, the population of the world. Vaccination is a technical skill and others in addition to nurses can help with vaccine administration. The real work will be in educating people, speaking truth, and allaying fears. As the most trusted profession, now is our time to lead public education. Healing and caring.


The year 2020 exposed and heightened underlying health problems, none of which are new to nurses. People in crisis seek relief. Alcohol consumption increased, the opioid crisis raged on, domestic violence accelerated as mounting fiscal and social pressures boiled over. Health disparities were highlighted daily in tables and graphs displaying evidence of the virus's disproportionate impact on minority communities. In lockdown conditions, health screenings were postponed. Chronic conditions denied routine treatments turned to advanced disease. These and other problems must be addressed in the coming days.


This moment demands two courses of action for nurses. First, we must address our collective fatigue, not just as nurses but as humans. The pandemic did not impact nurses equally, yet all grew weary. Some nurses worked long, difficult hours in a hospital, some were reassigned to unfamiliar care settings, and some were furloughed when primary care settings closed. We moved educational courses and professional meetings to online format, staring at close-ups of each other's faces in a manner we were never meant to do. Now we must make time to heal, find space for recovery and rejuvenation, and examine options for a new equilibrium. Acknowledging loss and grief is critical. A burst of rage, expressions of fear, withdrawal from friend groups - these may be signs of the need for mental health services. Let us be kind and tolerant; let us be advocates for mental health services designed for nurses. Healing and caring for each other.


Second, we must demand a seat at the table as the country addresses the health disparities and chronic problems exposed by the pandemic. We are grateful for the news video clips and feature stories demonstrating what coronavirus care looks like for front line nurses. The public has seen the tasks nurses perform; the things nurses do to deliver care to critically ill persons. Yet for all the stories there was limited to no emphasis on the judgement required by nurses to provide the care. Nurses are, above all else, judgement workers. We are highly educated, clinical competent, ethically grounded providers of judgement. We decide what to do, when to do it, and how best to do it. Nurses are deciders. Coming out of this pandemic, we should seize the moment and insist that the same nursing judgement that cared for a nation at a time of crisis can and must be included in policy initiatives designed to solve recalcitrant and lingering problems in health care. Delivering healing and caring is not an arbitrary act; it is supported by theory, science, experience, and professional standards. Now more than ever we are poised to take our seat at decision making policy tables. This, above all else, is what lies ahead.