Critical Care Nurses as Frontline Warriors During COVID-19 in Pakistan

Background The COVID-19 pandemic resulted in several short-term and long-term impacts on the physical, social, and psychological health of every individual globally, especially among frontline workers including nurses working in the critical care settings. In Pakistan, 85,264 confirmed cases have been identified and 1,770 deaths are reported so far. The death rate is 2.0% as compared to Europe (14.6%) and the United States (5.7%) per 100,000 population. Frontline workers are the most vulnerable population during this pandemic. Nearly 440 frontline staff including nurses, doctors, and other health workers have been infected with COVID-19 with 8 confirmed deaths reported in different provinces of Pakistan. These numbers are continuously increasing posing a serious threat for the health and well-being of the healthcare professionals especially nurses working in the critical care settings. Objective The paper outlines the challenges and experiences of critical care nurses working in acute hospital settings of a low resourced country Pakistan during a pandemic. Methods Literature search using CINAHL, MEDLINE, PubMed databases, local and international news papers, magazines, websites, international nursing colleagues and personal experiences/insights are included in the paper. Results Findings include common challenges such as lack of staff, lack of personal protective equipment (PPE), limited knowledge regarding standard infection control practices, isolation protocols, lack of administrative support, transportation, accommodation, childcare facility, and so forth. As a result, most nurses are reporting symptoms of fear, anxiety, depression, post-traumatic symptoms, spiritual, and moral distress. Nurses often become targets of violence and harassment by the general public in the Pakistani healthcare system, due to lack of awareness, cultural beliefs, low status/image of nurses, low literacy levels, and poverty. Conclusion Targeted interventions and policies are needed to maintain safety and protect physical, social, psychological, and spiritual health and well-being of nurses. Health authorities in Pakistan should take the responsibility in creating awareness, providing adequate guidance, and support to enhance nurses' well-being and quality of life during the pandemic.