The performance and professionalism of nurses in the fight against the new outbreak of COVID-19 epidemic is laudable.

Dear Editor

The outbreak of Corona Virus Disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) at the end of 2019 in Wuhan, Hubei Province, China has become a major public health problem in China and even globally (Huang et al., 2020; Zhu et al., 2020). The World Health Organization (WHO) has designated it a Public Health Emergency of International Concern (PHEIC). As of February 29, 2020, a total of 79,824 cumulative confirmed cases of COVID-19 had been reported in mainland China, with 2870 death cases and 41,625 cases of patients cured and discharged from hospital. There still remained 35,329 confirmed cases (including 7365 in serious condition) and 851 suspected cases (National Health Commission of the People's Republic of China, 2020). Since the outbreak of the Covid-19, in order to race against time to treat patients, many medical workers from all over the country went to Hubei province to join battle against virus. More than 42,000 medical workers, including 28,600 nurses across China had been sent to Hubei province date to February 29, 2020 (The State Council of the People's Republic of China, 2020). A retrospective analysis showed that patients had received oxygen uptake (38%), mechanical ventilation (6.1%), antibiotics (57.5%), oseltamivir (35.85%), intensive care (5%) and invasive ventilation therapy (2.18%) (Special Expert Group for Control of the Epidemic of Novel Coronavirus Pneumonia of the Chinese Preventive Medicine Association, 2020). Much of the work with these patients who have to be cared for is done by nurses. Nurses should not only do therapeutic work for patients, but also life care, basic care and psychosocial care. So it is very big challenge for nurses to fight this virus.

In order to protect themselves, the nurses knew they should wear personal protective equipment (PPE), including goggles, N95 mask and protective suits when they were caring patients. However, working with and in these equipment for a long time is exhausting, for example, when wearing a N95 mask nurses needed to speaking loudly to make sure patients could hear. Some of the nurses’ skins and facial features were temporarily disfigured because of wearing N95 masks for a long time. They wore diapers and tried their best to have less food and water while working in order to save PPE supplies. Many nurses cut their long hair and even shaved their heads to reduce the risk of contamination between patients and between themselves and the patient.

Lacking of human resources, nurses needed to take on extra work during this battle to care for those with the virus. The 1000-bed Huoshenshan hospital and 1600-bed Leishenshan hospital, which were built especially for patients with novel coronavirus pneumonia completed construction and housed took patients in less than 15 days. A lot of nurses joined in to develop and open new wards in this arrangement. One nurse said they had only six hours to prepare 94 wards. They had to make sure the wards were comfortable and tidy as well as prepare many other things for patients, like instruments and equipment, furniture, bedding and articles of daily use. In order to finish the tasks the nurse shared that he walked 50,000 steps in 1 day. Another female nurse who was responsible for disposal of medical waste had to walk upstairs and downstairs dozens of times every day to transport of medical waste because it is forbidden to use the elevators to transport medical waste. Once she was too tired and fainted on the way to the warehouse, but fortunately a colleague was passing by and rescued her.

Nurses and other medical workers are also at risk for nosocomial infections even with PPE. As of February 11, 2020, a total of 3019 medical staff infected with the SARS-CoV-2 (including confirmed cases, suspected cases, clinically diagnosed cases and asymptomatic infected persons). Among these, at least 5 medical workers have died (The Novel Coronavirus Pneumonia Emergency Response Epidemiology Team, 2020). Faced with these difficulties, Chinese nurses bravely rose to the challenge. Healthcare workers were praised by the Chinese and hailed as heroes in harm's way. Even more nurses volunteered to go to the ‘battlefront’, requesting to join the fight against the epidemic.

In order to call for raising the status of nurses, The Lancet journal issued an editorial entitled “2020: unleashing the full potential of nursing” (The Lancet, 2019). The report states that nurses play very important role in universal health coverage and the value of nursing is enormous. There are about 20 million nurses around the word. But there is still a long way to achieve the goal of fully aware of the great value of nursing. With the commemorates the 200th anniversary of the birth of Florence Nightingale, who is the founder of modern nursing, 2020 was chosen to be first ever international year of the nurse and midwife which is designated by WHO. Governments and the wider global health community should recognize the potential value of nursing and provide more opportunities to demonstrate the importance of nurses in health care system. In this latest epidemic and threat to those they care for, Chinese nurses showed their courage, wisdom and sense of responsibility amid the novel coronavirus outbreak and won the respect of the Chinese people. Chinese nurses served the sick in the spirit of humanity and charity is the best way to promote the Florence Nightingale's spirit.

Conflict of Interest

We declare no competing interests.