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Nurses reflect on the most challenging year of their career

From left to right: Daniel Arellano, PhD, RN; Maja Djukic, PhD, RN; and Kelly Kearney, DNP, RN, reflect on the most challenging year of their careers.
From left to right: Daniel Arellano, PhD, RN; Maja Djukic, PhD, RN; and Kelly Kearney, DNP, RN, reflect on the most challenging year of their careers.

Throughout the past year, everyone has faced challenges that have impacted their personal and professional lives due to COVID-19. While many retreated to their homes to stay safe from the virus, others – like nurses – worked the front lines, provided care to their patients via telecommunication, and carried on with research and teaching their nursing students.

As we celebrate Nurses Week, three nurses with Cizik School of Nursing at The University of Texas Health Science Center at Houston (UTHealth) reflect on the most challenging year of their careers.

Daniel Arellano

As a critical care nurse during the pandemic, Daniel Arellano, PhD, RN, felt the pressure of COVID-19 firsthand.

“This past year with COVID-19, things have been so intense and difficult,” said Arellano, assistant professor of nursing at Cizik School of Nursing at UTHealth.

With strict social distancing orders in place to help stop the spread of the virus, he recalled what it was like taking care of patients without their family to offer additional support.

“For over half a year, our critically ill patients did not have any in-person visitation. We provided intense emotional support for the families and the patients as they were dying. We held their hand, listened to their family pray over Zoom, and even read them religious verses as requested. We heard them say goodbye over a video call,” Arellano said. “We are trained to handle death and dying, but we typically expect that family would also be there for backup. During COVID-19, it was just us and the patient. They had no one else.”

After dealing with intense situations, Arellano said his perspective on nursing changed, as well as his relationship with colleagues. He learned to lean on his team for emotional support.

“The camaraderie that has come out of this is something I have never seen. Whether it’s sneaking off to the break room to cry together or vent, we lean on each other and make sure we can survive and take care of ourselves. It’s brought our profession together,” he said. 

Since tackling the pandemic, Arellano now feels a call to better understand the health care system. Recently, he traveled to Buffalo, New York, with the National Disaster Medical System and a Disaster Medical Assistance Team. There he helped distribute over 21,000 doses of the COVID-19 vaccine to underserved members of the community.

“I always knew I wanted to do critical care, but I never would have thought I would have done something like this. But when you are forced to do it because of a pandemic, it opens your eyes to other aspects of the health care system that are instrumental,” Arellano said.

Maja Djukic

As a researcher who focuses on nursing workforce, Maja Djukic, PhD, RN, knew the pandemic would hit nurses hard.

“We have never had to deal with a prolonged disaster that impacted the nursing workforce across the entire U.S. and world at the same time,” said Djukic, associate professor of nursing research at Cizik School of Nursing and the John P. McGovern Distinguished Professor in the School of Nursing. “The COVID-19 pandemic really challenged health systems in terms of meeting the surge in demand for nursing care without the usual fixes of shifting the nursing workforce to high-need areas for limited time.” 

The pandemic has highlighted the importance of the nursing workforce and Djukic hopes employers and policymakers will invest more in research to understand how to better retain bedside nurses during prolonged, widespread staffing surge situations.

“I have always known the complexity and greater need for nurses and the importance of the nursing workforce. But the pandemic has really put them front and center. It is necessary to examine what the pandemic means for the short term and long term,” said Djukic.

The COVID-19 pandemic has also created unprecedented disruptions to clinical education for nursing students. “These disruptions created major barriers for senior nursing students transitioning from school to work settings to enter the workforce well prepared to care for patients and offset the burden of nurses already on the front lines,” she said.

Djukic is in the process of developing two studies to research outcomes of nurses who transitioned out of school into the workforce before COVID-19 and those who transitioned from school to work during the pandemic. She hopes to understand how this and similar disasters impact new nurses’ readiness to practice.

“We have known for a long time that nurse job satisfaction translates to patient satisfaction. There is an urgency to finding solutions to keep nurses happy and able to provide patient care during prolonged and widespread disasters. To that end, I am working with nurse leaders at our clinical partner Memorial Hermann-Texas Medical Center to help start the Workforce Innovation and Learning Lab where we can develop and test new workforce interventions that can ensure happy and healthy nurses, patients, and the financial bottom line.”

Kelly Kearney

As a psychiatric and mental health nurse practitioner, Kelly Kearney, DNP, RN, understands the importance of face-to-face communication with her patients. But that all changed at the start of the pandemic.

“We switched to telemedicine visits at the beginning of the pandemic,” said Kearney, assistant professor of nursing and psychiatric mental health nurse practitioner track coordinator at Cizik School of Nursing.

She says it was different at first, but with time she learned to adapt to her new way of providing patient care.

“I feel like this past year has changed my perspective of being a nurse practitioner. I have learned to appreciate the little things, and improved my communication and approach to treatment. When you go from providing patient care in-person to online, it is a challenge. In person, patients can see your nonverbal cues of communication and when you have appointments online, you have to work twice as hard to make sure you are communicating effectively and in a therapeutic manner. I think we were able to learn and adapt for our patients.”

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