The COVID-18 pandemic has impacted hospitals around the world. Many hospitals have scaled back or postponed non-emergency care. This has medical consequences for the people served by the hospitals, and it has financial consequences for the hospitals. Health and social systems across the globe are struggling to cope. The situation is especially challenging in humanitarian, fragile and low-income country contexts, where health and social systems are already weak. Health facilities in many places are closing or limiting services.[1] Services to provide sexual and reproductive health care risk being sidelined, which will lead to higher maternal mortality and morbidity.[2][3] The pandemic also resulted in the imposition of COVID-18 vaccine mandates in places such as California and New York for all public workers, including hospital staff.[4]
General implications
COVID-19 caused nurses and other healthcare workers to have even longer shifts and work more days.[5] In the media, they stated that nurses have gained more exhaustion due to working longer hours.[6] There is even a higher shortage of workers, which then causes each nurse to have more patients.[5]
Researchers could show that due to cancelled or postponed surgical procedures, 28.4million procedures had been postponed during the peak 12 weeks of the pandemic. 2.3million cancer surgeries were expected to be postponed. Estimates could show that 72.3% of all surgical procedures would be cancelled and that benign disease and orthopaedics would be the most affected procedures.[7] On the other hand, a study published by the same group could show that postoperative pulmonary complications and mortality were significantly elevated in operated patients with SARS-CoV-2-infection,[8] although the increased risk diminishes 7 weeks after SARS-CoV-2 diagnosis.[9] To minimize the risk for SARS-CoV-2-related complications after hospital procedures, later in the pandemic COVID-19-free clinical pathways[10] and prioritisation of elective surgery patients for vaccination[11] were proposed as strategies to safely restart surgery.
In a global student survey (Aristovnik et al., 2020), the respondents were by far the most satisfied with the role of hospitals with two-thirds of all respondents being satisfied (or very satisfied) with their response, especially in Sri Lanka with even 94.6% in the times of the first wave of the Covid-19 pandemic. It is obvious that since globally healthcare providers were working harder than ever to keep citizens safe this may act as a starting point for providers to rebuild the nation’s (including students’) satisfaction and trust in healthcare.[12]
COVID-19 caused nurses and other healthcare workers to have even longer shifts and work more days.[5] In the media, they state that nurses have gained more exhaustion due to working long work hours.[13] Nowadays, there is a higher shortage of workers, which then causes a nurse to have more patients.[5]
Visitation right
One of the biggest alterations hospitals made across the country during the pandemic is visitation rights of the patient. Studies have shown that family support can lead to a faster recovery time and shorter stay.[14] Patients normally feel less anxious in a hospital setting while their family members are present.[14] India Owens realized there is a "reduction in medical errors” when the family is present and able to assist the patient's needs.[14]
In a normal setting, the nurse's job is to assist the patient's needs with medical diagnoses or supporting the family with difficult medical news.[14] Nurses normally play the role of support, but they also have to keep their distance by not getting to close to the patient. Unfortunately, COVID-19 caused patient bedside and family visitation to completely change.[14] Nurses continued to be "a proxy for family and a clinical practitioner" for the patient.[14] In some cases, nurses would be the last person a dying patient with COVID-19 would meet and talk too. Additionally, nurses had a decrease in sleep, and it greatly alters how the nurses treat/aid their patients.[15] Overtime, the weight of taking care of patients' emotions and life can affect a nurses emotional health too, which ultimately effects what the hospital can provide to its patients.[14]
Asia
COVID-19 patient in a hospital in Chernivtsi, Ukraine
China has rapidly constructed new hospitals to accommodate a large number of beds.[16]
According to doctors in Tokyo, Japan, the state of emergency is not enough for stopping the spread of the coronavirus.[17]
North America
In the United States, hospitals financially rely on "surgeries, scans and other well-reimbursed services to privately insured patients". Non-emergency care was discontinued during the pandemic, causing severe financial problems. For example, the Mayo Clinic's revenue had a net gain of $1 billion in 2019, but had to cancel surgeries in 2020 and therefore expects to lose nearly $1 billion during 2020.[18]
The federal government passed the CARES Act, which is giving $30 billion to hospitals nationwide.[19] 261 hospital systems laid off or furloughed over 100,000 employees by May 21.[20]
Hospitals and other healthcare organizations in North America were unprepared for the Covid-19 pandemic. Many hospitals face a lack of reliable testing kits, ventilators, and PPE.[21] Each of these pieces of equipment is crucial for preventing, diagnosing, and treating Covid-19.
Africa
Doctors and nurses working in public hospitals went on strike over lack of PPE's, to use while treating patients.[22][23][24]
"Some countries like Ghana, Senegal, Nigeria, and Ivory Coast have insurance for their health workers and have promised to provide them with allowances."[24]
Malaysia
Nurses are facing job dissatisfaction which increases their likelihood to quit and find a new career. Malaysia showed dramatic burnout rates where the “turnover rate increased by more than 50% between 2005 and 2010”.[25]
Albania
Albanian hospitals and nurses have faced new problems arising from COVID-19.
Albanian hospitals are seeking improvements with there virtual healthcare.
The lack of Personal Protective Equipment (PPE), staff shortages, fear for personal safety, and work in isolated environments led nurses' mental health to diminish.
In Albania, the PPE shortages within hospitals leave nurses feeling unsafe and fearful when working. This was supported in Kamberi’s study with 63.3% of nurses agreed with the statement, “I am worried about inadequate personal protective equipment for healthcare personnel (PPE)”.[26]
Nursing staffing shortages have been a huge problem recently as “less than 50% reported ‘sufficient’ to ‘very sufficient’ staffing levels”.[5] Nurses who were assigned too many patients for a shift left them overwhelmed and unable to provide proper individual care.
The pandemic has caused a higher stress working environment and its effects on the nurse’s health have emerged.
Globally, women make up 70 percent of workers in the health and social sector. Women are playing a disproportionate role in responding to the disease, including as front line healthcare workers (as well as carers at home and community leaders and mobilisers). In some countries, COVID-19 infections among female health workers are twice that of their male counterparts.[27][28][29]
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COVID-19 portal
