COVID-19: What is next for nursing in public health emergency?

More than 5.7 million confirmed cases of COVID-19 have now been reported to WHO, including more than 357,688 deaths, resulting in a public health emergency that has swept the world (World Health Organization, 2020). In the global reaction, everyone from front-line medical workers to ordinary citizens is playing a different role (Lin et al., 2020). Nurses provide care for patients with both mild illness and critical illness. There is an old saying in China, three points of treatment, seven points of nursing. When the Crimean war broke out in 1853, the casualty rate was 42 percent. Nightingale, the “Lantern goddess”, led a team of 38 nurses to the front line. The death rate of the wounded was reduced to 2%, which laid the foundation for the development of nursing.

In China, a total of 42,000 health care providers had been sent to Hubei to support of patients with COVID-19, of whom 28,600 were nurses (68% of total as of 29 February) (SCJDCMPC., 2020). Usually unknown nurses have become the main force in front-line medical workers. Non-pharmaceutical interventions remain central for management of COVID-19 because there are no licensed vaccines or coronavirus antivirals (Heymann and Shindo, 2020). The basic and essential strategies remain the early detection, early diagnosis, early isolation, and early treatment of the disease (Wang et al., 2020), in which nurses, especially public health nurses, play an important role (Kelly., 2018). COVID-19 patients with severe symptoms need disease observation, specimen collection, treatment plan implementation and elaborate care, especially for those who are critically ill. Intensive care specialist nurses closely monitor patients' vital signs and pay attention to their respiratory circulation. On the other hand, the management of artificial airway, renal replacement therapy, ECMO care, prone position ventilation and actively prevent ventilator associated pneumonia, catheter-related bloodstream infection, deep vein thrombosis, pressure ulcers and a series of complications.

After the outbreak of the COVID-19, rapid progress has been made in the identification of causes, development of diagnostic reagents, analysis of virus characteristics, clinical treatment strategies and development of vaccines (Cui et al., 2019; Wang and Zhang, 2020; Jiang., 2020). Meanwhile, new requirements have been put forward for the development of nursing in public health emergency.

First, it is important to strengthen the training of specialized nursing talents, broaden the nursing professional field, and carry out education and training on public health emergencies. In addition, teams should be set up in large medical institutions to deal with public health emergencies, and regular training and drills should be conducted to provide technical personnel reserve for dealing with public health emergencies.

Second, nurses should work quickly with other disciplines to build effective response teams and complete tasks successfully.

Third, the prevention and treatment of COVID-19 pneumonia is based on prevention, and science popularization education is crucial in prevention. Therefore, nurses can use media publicity to education and raise people's awareness of the epidemic hazards and prevention and control.

Fourth, during care from isolation of patients with mild illness to critical illness of a COVID-19 pneumonia patient, compassionate nursing runs through humanistic care.

Fifth, as most valuable resource against COVID-19, health workers should be concerned about their physical and mental health (The Lancet., 2020).

In conclusion, nurses play multiple roles, such as caregiver, educator, patient advocate, administrator, collaborator, coordinator, and researcher (Li., 2017). A continued effort therefore is important to strengthen the training and education of nursing, and broaden the research field in order to provide the evidence-base for the future prevention and management of COVID-19 illness and ensure the effectiveness of care delivery.