Contributor: Justin McFail, MSN, RN

The world of nursing is changing. Healthcare has shifted. Nurses are leaving the profession in droves. Perhaps a side effect of the psychological trauma we experienced as a profession. The pandemic forever changed a generation – its ripples echo further than we yet understand, and I sit here at a time of quiet reflection.

At the beginning of the pandemic in 2020, I was still finding myself as an ICU nurse. I had a rough transition from med-surg to ICU life about 18 months prior and in late fall 2019 decided to make the shift from night shift to days, opening a new world of chaos. To say I was unprepared for what was to come was an understatement. In hindsight, we all were.

When the pandemic began, I was about halfway through my MSN in nursing education. I had just started working in my program’s department as a graduate assistant and begun my first few steps into the kaleidoscope of personalities that is nursing academia.

What leads me to writing today is this – A quiet unspoken understanding that we, as nurses, are mishearing each other. As I sit here and reflect, I find myself writing for three audiences. Three people, who I hope to hear this message.

To my first, those who were and became nurses during this time. Those who chose to serve on the front lines of fight we did not understand, know this, I understand your pain. We are not the same people we were before the fight began.

Literature, science – the rationale mind – would have us believe we suffer from a number of aliments – PTSD, PTSS, burnout, compassion fatigue (Andhavarapu et al., 2022; Dolić et al., 2023; Jo et al., 2023; Zareei et al., 2022). Words used to describe what is happening within us. A trauma response. But these are all words others use to describe us. Perhaps to some of you these labels help. To me, it’s just another box people want to put us in. So that they can pat us on the back and say we tried.

And we did try. Many of us worked ourselves ragged day after day trying to save others in a futile struggle to hold onto a fading life. Only to fail. I think that’s the part we still haven’t spoken. Barely to ourselves, barely to each other. Our job is to heal, to treat, to protect, but we did not. We could not. So, to anyone out there who needs to hear these words, know this – You are not a failure. You have been fractured and fragmented by forces greater than your own, but that does not mean you are broken beyond repair (Sachs & Wheaton, 2023). We did what we could, and that was enough.

Sadly, those that need to heal won’t read this. They’re not the type to find flowery nursing blogs that paint the world in a rose-tinted light. To the academics, the scholars that will read this I now turn to you to speak. I now stand where you stand. As educators, it is our job to guide the future. Many of you took shelter in your homes, faced with your own challenges you allowed the young the fight on the front lines. I do not fault you for this. Were I your age, I would do the same. But I hear and see a message, that leaves a bitter astringent taste, and hardens my soul.

Over and over again, I hear about fighting burnout, healing compassion, and reinforcing self-care. Journals, webinars, books, and conversations with friends and colleagues all striving to fix a broken generation of nurses. After all, we’re nurses, we fix people – it’s our job. But I think, academia, we’re missing the message. We want to fight, to force, to bend, to change, those that are crumbling to dust. When, what we need is silence. To be clear, I don’t mean inaction. Merely not reaction. Psychologists, counselors, therapists sometimes call this “holding space” (What ‘Holding Space’ Means + 5 Tips to Practice, 2020). We, the academics, the nurse leaders, those who guide the profession of nursing, need to hold space for those who need to heal.

Lastly, I’m writing this for myself, because I have been broken and beaten and shook by the pandemic. Because I needed to speak. I needed to heal. The fixer, the scholar, in me want to exhaustively search through the hundreds of articles and create a scoping literature review outlining how to fix those around me. Techniques, theories, practices – ways we help each other carry on and recover from the shared trauma we’ve all felt. But as I sit here and reflect, I find, what I need, is just to hold space, for myself.

                                                                    References

Andhavarapu, S., Yardi, I., Bzhilyanskaya, V., Lurie, T., Bhinder, M., Patel, P., Pourmand, A., & Tran, Q. K. (2022). Post-traumatic stress in healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Psychiatry Research, 317. https://doi.org/10.1016/j.psychres.2022.114890

Dolić, M., Antičević, V., Dolić, K., & Pogorelić, Z. (2023). Predictors of Post-Traumatic Stress Symptoms in Nurses during COVID-19 Pandemic: The Role of Occupational Stressors, Personality Traits, and Availability of Protective Equipment. Sustainability (Switzerland), 15(12). https://doi.org/10.3390/su15129555

Jo, S., Kurt, Ş., Mayer, K., Pituch, K. A., Simpson, V., Skibiski, J., Takagi, E., & Reifsnider, E. (2023). Compassion fatigue and COVID-19: A global view from nurses. Worldviews on Evidence-Based Nursing, 20(2), 116–125. https://doi.org/10.1111/wvn.12641

Sachs, C. J., & Wheaton, N. (2023). Second Victim Syndrome. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK572094/

What ‘Holding Space’ Means + 5 Tips to Practice  — G&STC. (2020, January 16). Gender & Sexuality Therapy Center Blog. https://www.gstherapycenter.com/blog/2020/1/16/what-holding-space-means-5-tips-to-practice

Zareei, M., Tabanejad, Z., Oskouie, F., Ebadi, A., & Mesri, M. (2022). Job burnout among nurses during COVID-19 pandemic: A systematic review. In Journal of Education and Health Promotion (Vol. 11, Issue 1, p. 107). Wolters Kluwer Medknow Publications. https://doi.org/10.4103/jehp.jehp_797_21

About Justin McFail

Justin graduated in Spring 2022 with a Master of Science in Nursing – Nursing Education from Millersville University. A registered nurse since 2015, Justin has worked in various specialties including medical-surgical and intensive care areas. In 2020, Justin volunteered as part of the Special Pathogens team in his home ICU. Currently, he still works in the Surgical ICU, which thankfully, has seen less COVID-19 patients. He is also an adjunct instructor and wearer of many hats for Millersville University. As an educator, Justin strives to bring creative models of education to the classroom.