World Health Day ｜ Jiao Yahui： ＂Frontline nurses are all nightingale＂

　　April 7th is World Health Day. This year, the World Health Organization has set the theme as: supporting nurses and midwives. In China, this year’s publicity theme is "Pay tribute to medical care and fight against the epidemic together". The reporter of Health News interviewed Jiao Yahui, the supervisor of the Medical Administration and Hospital Authority of the National Health and Wellness Commission in Wuhan, Hubei Province, focusing on the mainstay of anti-epidemic — — Nursing team.

　　● 70% of the medical aid team in Hubei are nurses, and there are more young people after 90 s and 95 s. They have practiced the Nightingale spirit well.

　　● Nurses have a particularly heavy workload and undertake professional nursing, life nursing and even trivial work, which is really hard.

　　● Compared with physical care, nurses play a greater role in psychological comfort. This is the real holistic nursing.

　　● Give nurses more training opportunities, invest in nursing-related projects and improve nurses’ salary.

　　Health News: How many nursing staff are there in the medical teams that rushed to Hubei and Wuhan? What is the principle of redeployment?

　　Jiao Yahui: This time, the nurses practiced the Nightingale spirit very well. The front-line nurses are all Nightingale, which is excellent. Specifically, there are 343 local teams with 38,632 people, including 26,530 nurses. In other words, nearly 70% of the rescue team are nurses.

　　At the beginning, the number of patients was relatively small, and the number of nurses sent was relatively small, mainly specialist nurses, such as nurses responsible for bedside hemofiltration treatment. At that time, there were dozens and hundreds of people in the rescue team. At the same time, because the shelter hospital was not built at that time, and the nursing staff in the designated hospitals were the most scarce, the specialized nurses who rushed to help were sent to the designated hospitals.

　　One day, I was particularly impressed. On January 27th, entrusted by the Supreme Leader General Secretary, Premier Li Keqiang, leader of the Central Leading Group for novel coronavirus’s response to the pneumonia epidemic, came to Wuhan to inspect and guide the epidemic prevention and control work, and to visit the medical staff who expressed condolences to patients and fought in the front line. That is, on that day, we received the task to send 800 intensive care nurses to Wuhan.

　　Later, the shelter hospital was built, and the mild and severe patients were separated. At the same time, we began to organize the medical team. Since then, nurses have basically never been sent alone.

　　When people arrive, they will match different human resources according to different positions. For example, in intensive care, it is basically a specialist nurse. However, there are mostly mild patients in Fangcang Hospital, and general nurses provide nursing services.

　　There is also a remarkable feature of the nursing team that rushed in this time. There are more young people after 90 s and 95 s, and many support hospitals have also sent male nurses.

　　Health News: In the front line of anti-epidemic, medical staff are "dancing with wolves" all the time. What are the challenges for nurses?

　　Jiao Yahui: In this battle, the workload of nurses is particularly heavy. From professional nursing, to life nursing, to some trivial work, all should be done by nurses.

　　During the epidemic period, many hospitals have no nurses, cleaning staff and workers. Nurses should not only feed patients with water and food, but also do basic care, such as turning over and patting their backs, as well as specialized care, such as hemodialysis. At the beginning of the epidemic, medical oxygen was insufficient, and nurses turned into porters, wearing uncomfortable protective clothing and pushing nearly 100 kilograms of oxygen bottles to the isolation ward.

　　Nurses are really hard. In the quarantine area, nurses stay longer than doctors. On duty at night, doctors can rest, but nurses can’t. In the early days, there were not enough protective materials, and many nurses had to wear a suit for seven or eight hours. During this period, they didn’t eat, drink or go to the toilet. In addition, at work, they all need to wear double gloves to operate, such as infusion, which is more difficult.

　　There is also a reality: the number of specialized nurses in the fields of severe diseases and infectious diseases in China is far from meeting the needs of fighting the epidemic, and a large number of nurses come from other professions, such as internal medicine and surgery. Once, I met a stomatological nurse in the ward. For them, the initial pressure is even greater. In order to ensure the quality and safety of medical care, medical teams and institutions have made great efforts in infectious disease nursing expertise and hospital infection prevention and control, and have been training continuously.

　　There is a detail that moved me — — Many nurses cut their hair short to reduce infection, and some even shaved their heads. For them, this is also a significant decision. Two days ago, when I sent the medical team back, I saw many people with small hair stubbles. They were so young and lively.

　　Health News: In this epidemic, what are the outstanding functions of nurses?

　　Jiao Yahui: Compared with physical care, the greater role of nurses lies in psychological comfort. COVID-19 is a severe infectious disease, and family members can’t accompany them. At this time, nurses have replaced the role of family members and given them care in words and actions. For example, for the patient’s birthday, painting, singing, while feeding water and food. Many medical staff bring their own milk, millet gruel and clothes to patients. What they have done has gone far beyond the scope of psychological counseling, and more is to comfort.

　　In my opinion, this is the real holistic nursing. In normal times, although everyone has been emphasizing and practicing quality nursing, they always feel a little worse. But in this special period and environment, everyone cares and takes care of every patient spontaneously and naturally, without education and words.

　　In fact, the goal of holistic nursing is to provide the best care for people according to their physiological, psychological, social, cultural and spiritual needs. Nurses should not only pay more attention to the patients themselves, but also pay attention to the factors that affect the patients’ recovery, such as their environment, psychological state and physical factors.

　　The daily system represented by holistic nursing has played a very important role in the prevention and control of this epidemic. They were not established because of COVID-19. They are all common core systems, such as the medical quality system that has been emphasized all the time, and the establishment of difficult case discussion, death case discussion and critical illness system by combining medical department, nursing department and hospital feeling office.

　　Health News: Last May, in Geneva, Switzerland, the World Health Assembly designated 2020 as the International Year of Nurses and Midwives. Tan Desai, Director-General of the World Health Organization, said, "Nurses and midwives are one of the pillars of health systems in all countries, and countries are called upon to invest in nurses and midwives in 2020, and strive to realize the promise of health care for all." What do you think of the word "investment"?

　　Jiao Yahui: First, nurses should be given more opportunities to receive training and strengthen their professional skills. Second, invest in the related work of nurses. For example, nurses need to develop nursing projects, as well as training materials and consumables, all of which need financial support. In addition, a reality that can’t be ignored is that the aging is becoming more and more serious, and the demand for nursing in families and communities is far more than medical care, and the on-site service of nurses is becoming more and more urgent. In this regard, how to make home care feasible and sustainable requires the state to provide funds or allow related services to be charged. Third, improve the salary and treatment of nurses, so that the income of nurses can match the workload and work pressure.

　　Health News: The epidemic situation has also left many reflections. What are the thoughts on the training of nursing staff?

　　Jiao Yahui: This big exam reminds us that the training of nurses should be a combination of basic nursing and specialist nursing, and both should be strengthened. Before, the contradiction of the shortage of specialized nurses was not prominent, but the epidemic situation fully exposed this contradiction. For example, nurses in the field of infectious diseases usually receive less training in critical illness and have weak coping ability, which is a shortcoming.

　　In addition to the prominent demand for specialized nurses, more exposed problems are that basic nursing needs to be further strengthened. After all, the main body of the nursing team in China is general nurses who can do basic nursing. In fact, both specialist nurses and general nurses must be able to do basic nursing first. On this premise, we will train specialized nurses. If we simply emphasize specialist nurses without basic nursing support, it will not only affect the nursing effect, but also affect the whole treatment result. For example, some serious patients have been hospitalized for a long time and have pressure ulcers, which means that the obvious basic nursing is not in place and needs to be corrected immediately.

　　In fact, in addition to nursing, the epidemic has also exposed some shortcomings in the medical and public health system. For example, in the treatment of infectious diseases, breathing, multi-organ support and other treatments are a weakness; During the treatment, some general hospitals requisitioned did not meet the requirements of infectious disease facilities, and there were no three areas and two passages, and the ventilation, heating and oxygen did not meet the requirements. The reserve of medical materials is even more fragile. Due to the previous policy of zero inventory and zero difference rate, there are almost no emergency materials in hospitals. Therefore, there should be an overall consideration in the future, because these shortcomings are not only in nursing and medical care, but also in system construction and material reserve.