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Editorial • Acta Paul Enferm. 33 • 2020 • https://doi.org/10.37689/acta-ape/2020EDT0006   copy

Coping strategies during the COVID-19 pandemic in nursing school

About the editors SCIMAGO INSTITUTIONS RANKINGS

Given the scenario imposed by the COVID-19 pandemic Brazilian public universities are required to organize their work process and measure problems and/or critical and emergency situations caused by this global sanitary emergency. The Paulista School of Nursing of the Federal University of São Paulo (EPE-Unifesp), an 81-years-old institution, became extremely involved in facing this reality and sought to adopt strategies to respond efficiently for teaching, research, extension, management and care demands.

As in other countries around the world(11. Pather N, Blyth P, Champman JA, Dayal MR, Flack NAMS, Fogg QA, et al. Forced Disruption of Anatomy Education in Australia and New Zealand: An Acute Response to the Covid‐19 Pandemic. Anat Sci Educ. 2020;13(3):284-97.), Brazil had suspended nursing students hospital care training practices and extension activities. After this decision, a number of actions were shared in relation to students' education and activities that would be conducted to avoid the academic curricula to be compromised.

At national level in education, a number of activities have been planned to keep students connected with colleges and university, even distant, as well as actions to rethink the curriculum of courses to guarantee the knowledge and social commitment needed for the education of qualified professionals for the Brazilian Public Health System (SUS). The EPE-Unifesp, followed by the orientation of undergraduate dean office of the Unifesp, adopted special distance activities as a strategy to guarantee continuing of theoretical activities. For students of the last year of the nursing undergraduate program, we opted to restart the face-to-face practical activities. Although the risk of COVID-19 infection during the care practice is considered high,(22. Bernstein L, Boburg S, Sacchetti M, Brown E. Covid-19 hits doctors, nurses and EMTs, threatening health system [March 17, 2020]. [Internet]. [cited 2020 Jul 17]. Available from: https://www.washingtonpost.com/health/covid-19-hits-doctors-nurses-emts-threatening-health-system/2020/03/17/f21147e8-67aa-11ea-b313-df458622c2cc_story.html.
https://www.washingtonpost.com/health/co... )students worldwide are concern with increase of consequences of the pandemic and they are seeking to propose actions that may reduce the negative impact that this situation may cause in their education.(33. Dewart G, Corcoran L, Lorraine T, Kristin P. Nursing education in a pandemic: Academic challenges in response to COVID-19. Nurse Educ Today. 2020;92:104471.)For this reason, the social commitment of EPE to educate future nurses for the SUS in such time of sanitary emergency was the guiding factor for planning the return of face-to-face practical activities, and the guarantee of the much safety as possible.

In terms of research activity, the public funding agencies destinated resources to the country to contribute with development of new diagnosis methods, treatment and measures for interrupting the transmission of the virus. Actions involved investigations related to the natural history of the disease; the development and evaluation of tests, therapeutic alternatives and vaccines; the evaluation of health care attention at three levels of complexities facing the outbreak; the use of personal protective equipment (PPE) in prevention actions, control, and management of the situation; the adherence and accomplishment of prevention and control measures; the management of services during the pandemic services, among others disease related topics. Research lines were established based on the guidelines of the World Health Organization (WHO) on topics aligned with national priorities defined in the discussions between the Brazilian Ministry of Health and experts in the country, considering the need of a rapid response and investments in more promising studies.(44. Siqueira SM, Jesus VS, Santos EN, Whitaker MC, Sousa BV, Camargo CL. Extension activities, health promotion and sustainable development: the experience of a nursing research group. Esc Anna Nery. 2017;21(1):e20170021.)Our university professors and researchers responded to this demand and submitted several grant proposals projects to express their commitment to respond with science to the pandemic ( Chart 1 ).

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Chart 1
Research projects written during the pandemic at the EPE-Unifesp

The extension activities, i.e., activities promoted by the university to interact with the community, were reorganized to the guarantee the exchange of general knowledge with scientific knowledge and to improve the interchange of new knowledge with the society to fight transmissibility of coronavirus and to promote health information.(55. Brasil. Ministério da Saúde. Governo do Brasil destina R$ 50 milhões para pesquisas sobre coronavírus [Internet]. Brasília (DF): Ministério da Saúde; 2020. [citado 2020 Jul 17]. Disponível em: https://www.saude.gov.br/noticias/agencia-saude/46634-governo-do-brasil-destina-r-50-milhoes-para-pesquisas-sobre-coronavirus.
https://www.saude.gov.br/noticias/agenci... )Students and professor participated in immunization campaign, as well as developed, by employing technological resources, structures that allowed higher approximation of health care community with the society in order to reduce psychosomatic losses reported by the population during the social isolation period.

The EPE in a partnership with leading areas of the Unifesp (Human Resource and General Administration Section) facing the current scenario has implemented the remote working to enable their professors and administrative technicians to keep operating. We created list of employees for part time on-site work to allow flexibility of operation, tactic, and strategy of the institution. Professors and education administrative technicians who were not in the risk group, i.e., those older than 60 years, hypertensive, asthmatic, diabetics, and smokers, participated of scheduled extension activities as well as supervised clinical training curriculum of the nursing undergraduate students from the 4 academic year and also in other special remote activities designed for students from the three other academic years. The academic activities of graduate program were remote only. The operating team was divided to ensure the normal functioning of all administrative activities. A number of important sanitary, physical, and electronic safety measures were implemented as standard operating procedures during the pandemic. The administration of EPE established the mandatory use of facemasks within buildings of the college and protective barriers and place markers such as tapes or cones were placed at receptions and common areas every 1,5 meters to provide individuals with visible cues that support physical distancing. Alcohol gel dispenser were placed and sanitization of common areas occurred more frequently, in addition, the measurement of body temperature became mandatory to all entering in the building of the college. The board of director of EPE-Unifesp had faced a number of challenges to guarantee the functioning of the college, however, the emergence actions adopted named “crisis management” allowed, minimally, to keep the organizational structure working.

In care areas, important measures were taken to guarantee the safety of professionals and students to increase the dynamic aligned with relationship and integration of teams. Measures that were constant in professional and student practice became indispensable and fundamental to enable practice of care. The nurses and nursing technicians staff involved in activities of the Hospital São Paulo/Hospital Universitário (HSP/HU) and outpatient units associated with the EPE-Unifesp, were trained both face-to-face and remotely to delivery care for patients with COVID-19.

Considering the current scenario, the EPE-Unifesp was able to implement a number of the initiatives to guarantee teaching, research, extension, management, and management and health care assistance. To provide guidance for student community, their families, and collaborators of the college, the leadership groups and health professionals, especially in those of the nursing area, and the departments that compose the EPE-Unifesp designed digital materials (flowcharts, cartoons stories, educative poster, among others), mobilized students to participated in vaccination campaigns against the influenza virus (H1N1 and H2N3) for older people, people requiring special conditions and military force, to stimulate and implement specific training for professionals who remained working during the pandemic to provide assistance, particularly auxiliary nursing, nursing technicians, and nurse of teaching hospital associated with the EPE-UNIFESP. In addition our college was contributed with the development of new discoveries, with funding from public agencies, during the social isolation period and he peak of transmission of the SARS-CoV-2 virus. It is important to highlight the campaign that was conducted for donation of PPE, as well as the providing of materials by the HU/HSP-Unifesp.

The COVID-19 pandemic has highlighted the essential role that nurses and other health care professionals play on protect people's health and save lives. A new report from WHO, titled “ The State of the World's Nursing 2020 ”, requests more investments in education, better working conditions, and promotion of the leadership role of nurses, as strengthen actions for the contribution of nurses to the health system.(66. Organização Mundial da Saúde (OMS). Em meio à pandemia de COVID-19, novo relatório da OMS pede investimento urgente em profissionais de enfermagem [Internet]. Brasília (DF): OMS; 2020. [citado 2020 Jul 17]. Disponível em: https://www.paho.org/bra/index.php?option=com_content&view=article&id=6139:em-meio-a-pandemia-de-covid-19-novo-relatorio-da-oms-pede-investimento-urgente-em-profissionais-de-enfermagem&Itemid=812.
https://www.paho.org/bra/index.php?optio... )Still, a number of activities need to be done, however, social contribution and lessons learned during this pandemic would be permanent and they would help to establish new ways of doing nursing at the EPE.

Acknowledgement

We thank Bruno Henrique Sena Ferreira for the intellectual contribution in the drafting of the editorial.

Referências

Publication Dates

  • Publication in this collection
    14 Dec 2020
  • Date of issue
    2020
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