Joint Commission Issues Alert to Help Nurses, Healthcare Workers With COVID-19 Crisis

Nurses and other frontline healthcare workers tell their stories in a new publication, Voices from the pandemic.

The Joint Commission's Office of Quality and Patient Safety (OQPS) has issued a new coronavirus resource, Sentinel Event Alert 62: Voices from the pandemic: Health care workers in the midst of crisis.

The document is first in a series of Joint Commission alerts that address healthcare workers' concerns and provide guidance on how to respond to crisis, preparing them for the often-overwhelming circumstances of caring for patients during a pandemic.

One Iowa nurse quoted in the publication explained in stark terms how the continuing onslaught of COVID-19 is pushing nurses and other frontline healthcare workers beyond physical exhaustion and inflicting emotional damage on those who care for patients.

"To be a nurse, you really have to care about people," the hospital nurse said. But when an ICU is packed with COVID-19 patients, many of whom are likely to die, "to protect yourself, you just shut down. You get to the point when you realize that you've become a machine. There's only so many bags you can zip."

This nurse's experience is among more than 2,000 COVID-19 related comments from healthcare workers, their loved ones, and other community members to OQPS.

Comments made to OQPS reflected some of the most common concerns healthcare workers are experiencing:  

Fear of the unknown

This fear results, in part, from unclear, confusing, or contradictory guidance from various leading sources about what precautions to take to contain the spread of COVID-19. Shortages of personal protective equipment (PPE), certain medications, and critical medical devices made this lack of direction even more complex and troublesome for workers to manage, said Raji Thomas, director of The Joint Commission's OQPS.

Fear of getting sick

Fear of getting sick from the COVID-19 virus was high within the healthcare workforce, especially among workers more likely to experience serious complications from the virus due to their age, preexisting conditions, or other factors. Such fears were amplified by PPE shortages.

Fear of bringing the virus home

Fear of infecting family members, particularly older adults and children, reflected a significant percentage of the complaints received from workers. They shared stories about living in hotels, changing out of their clothes in the garage before entering the house, and showering as soon as they came home. Some workers opted to leave healthcare altogether during the pandemic due to this fear.

To address these concerns, the alert encourages healthcare organizations to:

1. Foster open and transparent communication to build trust, reduce fears, build morale, and sustain an effective workforce.
2. Remove barriers to healthcare workers seeking mental health services and develop systems that support institutional, as well as individual, resilience.
3. Protect workers' safety using the National Institute for Occupational Safety and Health (NIOSH) Hierarchy of Controls framework.
4. Provide clinicians and others with opportunities to collaborate, lead, and innovate.

"The COVID-19 pandemic has lasted for much longer than many of us anticipated, and healthcare workers are feeling the physical and emotional strain of longer hours, higher patient-provider ratios, and rising patient death tolls," said Ana Pujols McKee, MD, executive vice president and chief medical officer, chief diversity and inclusion officer at The Joint Commission. "While vaccinations offer an opportunity to end the pandemic, healthcare organizations have a responsibility to support their workers' well-being for the long term."

For more resources, The Joint Commission has compiled the Coronavirus Resources portal, which contains links to recommendations for staff health and well-being, webinar recordings, and information on The Joint Commission's advocacy efforts for healthcare workers during the pandemic.