The most recent pandemic has been a tsunami of stress, washing away the professional landscape of care. Families and clinicians alike have experienced the loss of their plans for birth, expectations of care, and trust in support from healthcare organizations.
Issue 36:1 of the Journal of Perinatal & Neonatal Nursing is titled "COVID and the Pandemics." It represents the voices of both health providers and birthing families during the first phases of the COVID-19 pandemic. The continuing education article, "Acute Respiratory Failure and Mechanical Ventilation in Women With COVID-19 During Pregnancy: Best Clinical Practices," by Troiano and colleagues examines in detail the clinical demands that COVID-19 placed on perinatal clinicians. As the last 2 years have demonstrated, pregnancy increases the risks of hospitalization and pneumonia. While intensivist care is not part of the day-to-day for most perinatal nurses, recognition of early signs of respiratory decompensation is essential. Furthermore, many obstetric units have found themselves supplying staff to assist in caring for the sickest pregnant individuals. Both prevention and supportive care argue for every nurse to be familiar with these issues.
Moving beyond the clinical requirements of treating a novel pandemic disease during pregnancy, other authors in this issue addressed the stressors identified both by clinicians and birthing families. Brown and colleagues, in "A Qualitative Study Focused on Maternity Care Professionals' Perspectives on the Challenges of Providing Care During the COVID-19 Pandemic," were able to use an existing project to collect data on the effects of the early months of the COVID-19 pandemic on healthcare providers in their state. They noted that, just as during the aftermath of a very different disaster on September 11, 2001 (9/11), the professional effort required for disaster response was coupled with personal trauma; efforts to fight a disease that was not yet understood impacted families and communities. The complex challenges of rapidly changing policies and procedures, periodic lack of resources, and personal fear and stress demonstrated the need to plan support for staff resilience and retention into future pandemic response.
Similarly, Vanderlaan and Woeber surveyed clinicians in the early part of the pandemic for their article "Early Perinatal Workforce Adaptations to the COVID-19 Pandemic." They found that most participants saw the immediate policy changes as protective of patients but less so for providers. The lack of sufficient staff, protective equipment, and supplies was highlighted. In addition, their survey identified what has become one of the themes of pandemic birth care, a heightened interest in community birth settings.
Looking at the first year of COVID-19 from a patient perspective, Saleh et al shared the voices of women whose births were disrupted by the pandemic around them in "Mothers' Experiences of Pregnancy, Labor and Birth, and Postpartum During COVID-19 in the United States: Preliminary Results of a Mixed-Methods Study." The importance of support for birth and recognition of the mental health effects of a pandemic was emphasized, as well as the importance of information to help counter fear.
The commentary in this issue, "Pandemics, Past, Present, and Future: What History Can Teach Us," by Kriebs looks back to see what prior pandemics have taught us and reinforces the need for planning in anticipation of the next pandemic. Recognizing the failures of the healthcare system in responding to COVID-19 can be a step toward developing robust obstetric responses to the next world-shattering event.
What have we learned from COVID-19 about health policy and about supporting healthcare workers and systems? And how can better planning mediate the impact of the next pandemic? Listening to the voices of those who gave birth, and those who cared for birthing families in the last 2 years, may help guide perinatal care next time.
In this first issue of 2022, we reflect on the COVID-19 pandemic and the many lessons learned from this extraordinary global health crisis. Authors have submitted manuscripts from around the world on topics ranging from breastfeeding practices in Turkey to the needs and perceptions relative to emotional support in parents of preterm infants in Sweden. We also have articles reporting on the gloving and touch practices of neonatal nurses and the usefulness of the parental electronic diary during medical rounds in the neonatal intensive care unit (NICU). While these articles are not directly related to the COVID-19 pandemic, the issues covered by these authors are related to many of the challenging issues that neonatal nurses grappled with during the pandemic: infection control and maintaining family-centered care during a time of limited family presence in the NICU. Our readers will learn from all of our authors and, in doing so, translate this new knowledge to their practice.
In this issue, we are happy to introduce our Founders Column. In this column, we will feature perspectives on the history of neonatal and perinatal nursing. Our hope is that by featuring a historical perspective in each issue, we will gain new learnings for the future of perinatal and neonatal nursing. As always, we are grateful to all of our columnists, especially Carole Kenner, our Expert Opinion Neonatal columnist, Leslie Parker, our Breastfeeding/Nutrition columnist, and Terese Verklan, our Parting Thoughts columnist. We are always looking for new colleagues to join our JPNN community-please reach out to us if you would like to be a reviewer, editorial board member, or submit a manuscript. Thank you!
-Jan M. Kriebs, MSN, CNM, FACNM
-Linda A. Hunter, EdD, CNM, FACNM
Perinatal Guest Editors
-Katherine Gregory, PhD, RN, FAAN
Neonatal Editor