Guest Editorial

This year started out with excitement and hope after all it was to be ‘the year of the nurse’, 200 years celebrating the life of Florence Nightingale. The World health organization declared a notice about Covid-19 on 5 January with 44 cases known at the time in China, and on 11 January the first fatality was known. I was celebrating Chinese New Year in Singapore and Malaysia in January and I remember hearing about the ‘Wuhan virus’ as I knew it at the time, suddenly all the pharmacies ran out of hand gel and masks and put signs in their windows. It felt a bit eerie, with a reduced number of people taking holidays in the hotel where we were staying but we travelled home and carried on with our working lives at the hospital in New Zealand.

On March the 12th, Covid-19 was declared a pandemic by the world health organization, and the world as we knew it, once so accessible shut down, countries had been going into Lock down one by one since China declared lock down in January, with planes suspended from the sky and everything seemed to become unpredictable. However each country managed things differently.

In New Zealand we experienced our first case on February 28 (See chart below for the growth). By 19 March, New Zealand closed it’s boarders to non-residents with gatherings of more than 100 people unable to continue. We were meant to be holding our annual New Zealand Australasian Neuroscience Nurses Association Conference a few days later and therefore could not proceed despite all the organization completed! A four tier alert system was introduced nationally on 21 March starting with Level 2 (see box 1 for the levels). All people over 70 and those immunocompromised were asked to remain home. By 23 March, we had 102 cases, we went to alert level 3 with all schools closed the very same day, and all businesses given 48 hours’ notice to close their doors on 25 March, moving to alert level 4 with 155 cases. Level 4 was complete lock down nationwide with only supermarkets, petrol stations and health facilities open. Everyone was to stay home and walk locally but all beaches and parks were no go zones. We experienced our first death on 29 March. Our Prime minister, Jacinda Arden and Ashley Bloomfield, the director General for health, presented the cases each day on the television, 7 days a week. Jacinda used phrases like, “be calm, be kind, your job is to stay home, we can break the chain.” “It will take a team of 5 million to unite and stop the spread”. Ashley went on to become a national icon with tea towels and bags printed in his honour to raise money for Women’s refuge.

Life in the hospital changed dramatically, all non-emergency operations were cancelled. All doors were closed and entrances guarded checking every person coming into the building. No visitors were allowed during level 4 except for those at the end of life. Our PPE guidelines were issued and altered, sometimes on a daily basis. We had one ward set up for Covid patients, one for potential Covid patients awaiting test results; and a screening or testing zone on admission to the hospital. I work at Wellington Regional Hospital on the neuroscience ward where we care for neurosurgical, neurology and stroke patients. We reduced our number of neurosurgical cases and had to take the medical patients so they could become the potential Covid patient ward. We mostly remained full and staff were pretty stressed with the uncertainty of each day. Our ICU were prepared to take many cases and had trained more staff to support this work. I stopped my duties as a nurse educator except for teaching PPE requirements and worked on the floor as staff who were unwell had to take a test and would remain off work even with a cold. One day I was asked to care for a potential Covid patient on another ward post operatively who had a subdural haematoma. It was a strange shift being amongst a team I didn’t know, hunting for equipment in unfamiliar places and caring for one patient who was coughing and the unknown situation of whether he was positive or negative. When the test results were released at 11am, we all celebrated they were negative. A big sigh of relief! The patients could be moved to the appropriate wards and we carried on in the new normal. During this time, we pulled together as nurses, we were united, we boosted morale by creating a ward dance and we supported one another, we demonstrated adaptability for daily changes and resilience.

We returned to alert level 3 on 27 April and schools re-opened on 29 April, moving to alert level 2 on 13 May and on 8 June we moved to alert level 1 with no restrictions in place except for at the boarder and managed isolation facilities. On 12 August we returned to alert level 2, and Auckland to alert level 3 due to a new outbreak in Auckland. This was a sudden reminder that the virus is still very unpredictable and things can change very rapidly, we cannot become complacent. We currently stand at 1674 confirmed and probable cases (23 August 2020) with 22 deaths and 692,481 Covid tests have been taken. We watched the rest of the world loose colleagues, knew of friends working in difficult circumstances and our hearts broke for them. Even though this has been a different year, we can still celebrate the advances in neuroscience nursing, the skills, knowledge, leadership that our colleagues bring to work in a diverse culture. Nursing has been a travelling profession for many working across the world, but for now we are all staying local, celebrating local tourist attractions and celebrating the freedom we have as a nation.

As an organization, it has been an interesting year for the Australasian Neuroscience Nurses Association conference. This is my first year as conference Convener, we planned to hold the event in Melbourne in November, sharing with the Movement disorders chapter for the first time over 3 days. However we had to make an executive decision to move the conference to a one day online conference. I do hope many of you will join us on 13 November as we have quality key-note speakers as well as first time presenters with a great array of topics and you can watch from the comfort of your sofa close to all amenities! Whilst this year has been challenging, we continue to be innovative and determined using the strength and character we develop as Neuroscience Nurses. I stand proud of us all, Neuroscience nurses, united in our skills and knowledge, resilience and determination across Australasia as we provide the very best care for our nation’s health. We are in the spotlight now more than ever before. Florence would be proud of the profession!