Ann Nurs Res Pract. 2021; 6(2): 1045.
Pasquot L¹* and Giorgetta S²
¹Department of Biomedical Sciences for Health, University of Milan, Italy
²Valtellina e Alto Lario Asst Hospital, Sondrio, Italy
*Corresponding author: Pasquot L, Department of Biomedical Sciences for Health, University of Milan, Via Carlo Pascal 36, 20133 Milan, Italy
Received: August 28, 2021; Accepted: September 11, 2021; Published: September 18, 2021
Many are the aspects we should ponder on, after 17 months from the burst of the COVID-19 pandemic, especially as nurses.
Due to the numerous cuts to the public health sector in the last decades in Italy, the sanitary emergency has been a great sacrifice for health professionals, as public health was completely unprepared to withstand it.
The Italian government reacted to this lack of preparation with exceptionally urgent measures. Although, these measures were implemented long after the initial state of confusion and of inappropriate management, they brought about stability and led to a containment strategy for the spread of the virus across the nation . The reduction in the number of COVID-19 diagnoses was mainly achieved through social distancing. At first this was only required to a small number of communities affected by high infection rates, but was eventually extended to the rest of the country from March 2020 .
The national lockdown during the first COVID-19 wave (from March to May 2020), was replaced by regional lockdowns in the second wave (from November 2020). As of now, regional lockdowns are integrated by the vaccine campaign and Green Pass enforcement. In November 2020 the Italian Prime Minister at the time, issued legislative measures to enforce regional lockdowns, limiting nonessential movements, cafes, restaurants and other public places opening hours. This legislation established to classify the national territory in different levels of restriction based on the infection rate: red zones - highest risk of infection, orange zones - medium high risk and yellow zones with a minor risk of infection. A later legislation introduced the white zone for territories with the lowest risk of infection (DPCM-14th January 2021). The infection rate has been important to establish a region’s tier status; however, it is not the defining parameter anymore. A new legislation from July 2021 (n.105 - 23rd July 2021), opted to classify a region’s tier status according to the hospital bed’s occupancy rate for COVID-19 patients in intensive care and other medical areas.
In Italy, the first COVID-19 weave was characterized by fear and death. The months of March and April 2020 marked a sudden traumatic rift in social balance, due to the severity of COVID-19 symptoms, the poor chance of recovery of heavily affected patients, and for the virus’s rapid spread among the population that was causing a large number of deaths. Data published on Osservasalute 2020 report shows the diverse COVID-19 spread within the national territory that mainly affected the Northern regions during the first wave. The lowering in cases brought about an official end to the national lockdown through the Prime Minister Decree-law on May 17, 2020. Data from the first wave shows that of the 225,886 infected people 32,007 died, and that the daily rate of infection peaked on March 21, 2020 with 6,557 new cases per day, which went down to a minimum of 114 cases per day in mid-July 2020 .
Among the daily bulletins on infection and death rate, there has been a widespread media interest in the work done by nurses to care for people affected by COVID-19. Journalists gathered testimonies, interviews, points of view that highlighted the health professionals’ sacrifice while working in such a dangerous and distressed situation (of 256,000 nurses, 10,000 were infected between March and April 2020 ), and expressed their gratitude for what these health professionals were doing for hospitalized patients. As revealed in a Content Analysis of national and local newspapers in Italy , nurses’ widespread appreciation was connoted by a heroic language that recalled that of epic narratives, regarding them as angels, saints, martyrs, poets, stars and patriots. The word ‘heroes’, seemed however to be the most commonly used, even at international level, to express the admiration towards nurses’ abnegation and bravery.
The Content Analysis goes beyond the evaluation of the language used by Italian newspapers; it wishes to highlight how nurses’, within the context of the pandemic, appear valued for their professionalism, are recognized for caring for patients, for their humanity and compassion towards dying patients left alone and far away from their families. However, from the nurses’ statements emerged a level of uncertainty on the possibility of still being considered important figures to society, even after the end of the pandemic. Thinking about this uncertainty not only requires necessary actions to contrast it, but also new values and perspectives on the image of the nurse.
As the Italian philosopher Giorgio Agamben states, during this pandemic people’s life experience has been split into a purely biological existence on one side and a social, cultural and emotional existence on the other . The biological one became prevailing in regulating the population’s behaviour, also through the adoption of defining political measures. The biological existence dominated the journalism narratives, highlighting and praising the importance of the health professionals’ work. So, during the pandemic, even nurses, usually absent, placed in the background or negatively portrayed by the media, have been widely present and valued for their crucial role.
As stated by Mcgillis & Kashin, the media’s grown interest in nurses’ work is nothing new and has already occurred in previous sanitary crises . The masses seem to perceive the nurses’ work in a dynamic way that can spark different feelings and portrayals by the medias. These portrayals by the media can greatly positively or negatively affect the nursing profession.
A positive connotation of the nurse’s role is pivotal in affecting the amount and kind of people that choose to undertake the profession. According to Miller & Cummings, talented students are in fact less inclined to choose the nursing career if considered of low social status . In addition, the consolidation of a positive image of the nurse can encourage legislations and funds in favour of nurses and can help them acquire strategic roles at local and national level.
The results from the Content Analysis cited above have shown a grown positive and realistic portrayal of nurses as an essential and highly qualified profession. However, the appreciation and gratitude expressed by journalists missed to impact the political agenda, in order to help increase nurses’ social status and economic return. This illustrates the fragility and superficiality of the praising phenomena that happened in Italian newspapers. Thus, the risk that the nurses’ valorization will culminate with the end of the sanitary emergency is real. Without effective measures, the hardships that Italian nurses have long been facing would remain unchanged, such as the lack of available staff (only 5.7 nurses per 1000 people), one of the lowest incomes in Europe, lack of nurses in strategic political and management positions at local and national level, lack of formal and economic acknowledgement for nurses’ specialistic competences. These issues not only negatively affect the perception and attraction of towards the profession, but also impact the self-esteem and satisfaction of professionals themselves, consequently influencing their performance [9-13].
The absence of an adequate political action to solve such issues, would be a great disappointment for nurses that have been demonstrating the value of their work during the months of March and April 2020, when they worked with little and inadequate medical equipment through long and tiring working hours, constantly putting their life at risk as well as their mental health, due to the high stress, anxiety and fear.
So, medias interest towards nurses seems to merely be a temporary celebrative campaign that grabbed the readers’ attention, when initially scared and fearful of COVID-19 symptoms. Medias certainly helped raise awareness of the nurses’ role, of their abilities and compassion, all aspects previously ignored by people before the pandemic. Being a mere media campaign, the nurses’ heroism successfully seduced readers, but failed to raise the issues within the nursing profession and to become a priority within the Italian political agenda. For instance, it is pivotal to persist in spreading a positive and realistic representation of nurses. It is essential to keep on reminding of nurses’ fundamental contribution and role during the sanitary crisis and beyond. When nurses’ media coverage will fade, respected professionals should persist in speaking up to emphasize the nurses’ work, what they have done and will continue to do in the future not only within hospitals, but also how they can contribute to the research field and as leaders to help improve the management of national and local health services.
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