How does COVID change our health care system?

Submitted by Igram School of Nursing
October 24, 2020

Prior to the COVID-19 pandemic, the public health-care system had been under great pressure in Quebec. Nurse-patient ratio could be greater than 1 to 4. Burn-outs were not uncommon in nurses. During the first wave, long-term care centers were the major battlefields. Unlike acute settings, long-term care centers have even larger nurse-patient ratio due to residents’ less severities. Nurses do not provide direct care to residents. The most of assistance is done by PABs. However, nurses are responsible for residents’ well-being. The pandemic made those understaffed and lack of support long-term care centers become the worst spots. Many residents died from COVID were found in dehydration, malnutrition and poor hygiene. I could not image how those nurses worked in those centers felt. They must have encounter ethical distress. According to my previous experience, not related to COVID, geriatric units in hospitals received less supports in terms of equipment and staff. And those units were crowded, and workload was heavy. For the confused elderly, physical restrains were the common measures to prevent fall or self-harm. But, those restrains can make them more confused maniac and incontinence. Depressions may be used to calm down those elderly. Other complications can happen such as UTI, malnutrition and delirium. Elderly does not like young people, when their health goes down, it is very difficult for them to go back to their pervious states. Some may be placed into palliative care. In nursing school, I was taught to help patients live fully. I got ethical distress greatly when I worked in a geriatric unit. I understood there were systemic problems in our public health-care system. Too many demands, too little resources. Nurses and patients both sides were suffering. Quebec is the poorest province in Canada, revenues are low. During the pandemic, many patients were discharged or encouraged to stay home. Community nurses were responsible for them. One community nurse told me she only had a mask for a day and she was visiting multiple homes. Mr. Legault has hired thousands new PABs to support long-term care centers. Currently, there is the second wave mostly affecting young people like students. The situations of long-term care centers seem good. This pandemic has changed our world. How does it change our health care system?