Necessity of Attention to Mental Health of the Front Line Nurses against COVID-19: A Forgotten Requirement

Today, emergence of infectious diseases has overshadowed many health beliefs and played a great<br />role in the history of health development. The United Nations Secretary-General has introduced<br />“Communicable diseases” as one of the challenges of our time. Viruses can be one of the causes of<br />contagious diseases. The Coronavirus disease 2019 (COVID-19) outbreak, recently launched from<br />Wuhan, China, has spread to more than two-thirds of the world, including Iran, and has reached the<br />pandemic stage.1 In particular, COVID-19 disease further affects the healthcare sector and leads to<br />many challenges for this important part of society.These challenges include increasing need for medical<br />staff; increasing costs for preventive and personal protective equipment for personnel, diagnostic<br />and laboratory costs and treatment costs; increasing the need for Intensive Care Unit (ICU) beds and<br />ventilators; and increasing mortality.1<br />In the meantime, health care professionals play an important role in managing such crises.<br />Nurses, as the largest group of health care workers, spend more time with patients than other<br />healthcare professionals and play an important role in the care, control and treatment of these<br />diseases. During the epidemic of emerging diseases, all social organizations, even the patients’<br />family members, are distanced from him/her, and it is the duty of the medical staff to take care<br />of the patient despite the potential health risks.2 To understand the significance of the issue, it is<br />sufficient to know that about 50% of those who died in the Severe Acute Respiratory Syndrome<br />(SARS) coronavirus epidemic were health workers who were somehow exposed to patients in<br />the hospital.3<br />Past studies show that mental disorders, including post-traumatic stress disorders, anxiety,<br />depression, panic attacks, irritability, delirium, mistrust, and even suicidal thoughts, were<br />prevalent among nurses who cared for patients with SARS. Developed mental disorders can lead<br />to psychological disorders, loss of appetite, fatigue, impaired physical ability, sleep disorders,<br />irritability, apathy, numbness, fear, and hopelessness.4<br />In accordance with the ethical Reciprocity Principle, hospitals have a reciprocal duty towards<br />the health care staff. Health facilities should provide the necessary infra-structure to support the<br />staff in the care of patients with emerging diseases, including communicating with the staff to<br />control infection, providing sufficient support to increase the staff motivation, providing personal<br />protective equipment, and especially psychological screening for nurses, psychiatric counseling<br />and psychological support.2 According to a recent report by the National Federation of Nurses in<br />Italy, the second Italian nurse has committed suicide after being informed of a positive corona<br />virus test.5 Therefore, the importance of paying attention to the psychological issues of nurses<br />during and after caring for patients with COVID-19 is obvious.<br />However, due to the increasing prevalence of the virus and also the increasing number of deaths<br />of nurses, which can be a stressor for other nurses, it is necessary to pay attention to mental health<br />of nurses. Stress and mental disorders can, like a vicious cycle, weaken the immune system and<br />lead to coronavirus infection, especially where nurses with a history of mental disorders are more<br />concerned. Nurses’ mental disorders can also significantly reduce their quality of care. Despite<br />the major importance of this issue and the findings of previous studies, this issue has not been<br />addressed yet. Therefore, it is imperative to pay attention to the mental and psychological issues<br />of nurses in the care of patients with coronavirus 19 as the current priority of care for nurses.<br />In this regard, experiences and measures can be used in the epidemic of SARS, Middle East<br />Respiratory Syndrome-related coronavirus (MERS) and Ebola patients, including screening of<br />nurses for mental health, psychological counseling, or training courses to provide comprehensive<br />and patient-centered care.

Abstract licence: CC BY

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