POSTED BY MARTIN KICH

This year, more than most years, we should be acutely aware of what all healthcare workers, first responders, and essential workers are enduring for the sake of their communities.

But nurses have been truly in the front lines.

Nurses are dealing with the sickest of the sick for extended shifts and under conditions that must make each shift seem almost endless.

Nurses are substituting for the families who cannot comfort their loved ones who are suffering and terrified, confronting the real possibility of their imminent mortality.

Nurses are enduring very cramped clinical spaces as hospital capacities have been dramatically “increased,” almost impossible short-staffing, and maddening, continuing shortages very basic protective equipment—all of which, taken together, have been increasing the tremendous risks to their own health and to their families if they have not been able to isolate themselves in their off-work hours.

Little wonder that the infection and the fatality rates for nurses are higher than for almost any group other than the most elderly.

Beyond that physical toll, the faces of the nurses in the public service messages running on television suggest the immediate emotional costs and the profound, longer-term psychological costs of what these nurses are enduring.

Where the pandemic has been most acute, the “curve” is flattening. But that just means that things are not getting worse. In most of these places, the improvement has been so incremental that it’s a misrepresentation to say that things have gotten better–unless that simply means that they have not continued to get almost unimaginably worse.

That we did not overwhelm our healthcare system in the first surge of COVID-19 cases does not mean that we can expect our nurses to continue to do all of this while we test the hypothesis that wishful thinking may work better with a second surge than it did with the first.

If we had widespread testing and contact tracing in place—if we had not wasted the last two months as we wasted the first two months—we could gradually re-open our economy with a greater chance of avoiding a second surge. But we have not done so, and we have, instead, allowed the most irresponsible and the most impatient voices to shape public policy.

To this point in the pandemic, our nurses’ dedication, endurance, and courage have compensated for the deficiencies in our healthcare system, our lack of preparedness for a public-health emergency, and this administration’s inability to coordinate a national response.

But endurance can be exhausted, even if dedication and courage are not. Just as this crisis has exponentially escalated the demand for personal protective equipment, ventilators, and the basic components of testing equipment, so, too, it has exponentially Intensified the demands on our nurses.

And as difficult as it has been to find those material things, it will be much harder and probably impossible to replace the nurses whom we are driving to exhaustion.

This pandemic seems to be masking, rather than highlighting, a serious issue in the nursing profession. Before the pandemic, the demands on nurses, especially among nurses working in hospital settings, had been leading to an increasing turnover rate among nurses. Trained to be “nurse managers,” our nurses are often handling more patients with less assistance with some of the most basic and physically demanding aspects of patient care. Many hospital nurses have migrated to positions outside of hospitals or have even decided to pursue entirely different professions. It is becoming increasingly unusual to find floor nurses in hospitals who have spent their entire careers as floor nurses.

I think that it is worth pointing out that many of the nursing faculty at our colleges and universities do not simply educate nurses in the classroom or in clinical settings.

Many full-time nursing faculty work part-time in clinics and hospitals to stay current on nursing practices or, in all too many cases, to supplement their incomes. Many adjunct nursing faculty either work full-time as nurses or work close to full-time in both roles simply to earn an income that allows them and their families to survive.

During this pandemic, many of our nursing faculty, including some who have retired from nursing or are retired nursing faculty, have made themselves available to our local hospitals to relieve the pressure on the nursing staff.

The sacrifices being made by all of these nurses seem to be giving many Americans a false sense of security about the scope and intensity of the disease whose impact they have managed to prevent from becoming an even more unimaginable national calamity. Those sacrifices need to be reciprocated.