Abstract
When we started planning this edition, and our guest editor Dan Wolstenholme, commissioned papers, we had no idea it would be published in such unprecedented times.
In the face of a global pandemic, not only do we have to step up as a profession (Maxwell, 2020) and lobby hard to create the conditions where we can provide safe and effective care (see for example, RCN position on COVID-19, https://www.rcn.org.uk/covid-19/rcn-position), underpinned by the art of nursing practice and the science of nursing knowledge, but the whole of humanity must play its part. No one is immune. No one is risk free. Doing nothing, or carrying on as normal, is not an option.
The impact of this crisis is profound and we have already seen people grieving for what they are have lost alongside fear of what they might lose. People are angry with governments and employers for not having acted sooner and with fellow citizens who appear to act with impunity. There is evidence of denial from those who think they are immune and carry on as ‘normal’. There is also fear, which in part, may be seen in the appearance of panic. In some countries there have been reports of bulk buying among those who have the resources to do so. For the majority, this may be to see them and their families through a period of enforced isolation and quarantine; however, for a few it may be excessive and recognised as hoarding and could essentially deprive others. In a worst-case scenario it may even be in anticipation of a black market for sought-after items, such as hand sanitisers, where demand has already outstripped supply. Scenes of people fighting over toilet rolls leave me incredulous. Nevertheless, whether these behaviours are the result of careful planning, fear, greed or something else, they ironically create the conditions that exacerbate the impact of the virus; they compound the problem.
Meanwhile, the plight of those who do not have the resources to engage in these practices needs to come into sharper focus. Those living in poverty and dependent on foodbanks, such as the homeless and the many other groups in society whose voices are seldom heard, are just as much a part of this as the hoarders. Politicians must now turn their attention to groups within society who neither create wealth nor capture votes if they are to take a holistic approach to flattening the curve, which they must.
Rather than focusing on what we have lost, we can see some people already channelling their energy into thinking and acting differently. For example, the farms, the hotels and the cafés who are offering takeaway and delivery services; the social-enterprise café near me that has turned itself into a community shop so it can carry on supporting local suppliers; the line manager who has established a virtual pub quiz to keep his team connected beyond the day-to-day needs of the business; the Pilates teacher who is providing online classes; and the wealthy hoteliers who have opened their doors to health workers free of charge. We can all do this. We can all think and act differently.
When we talk of innovation, we sometimes describe it as being incremental or disruptive. The former ‘doing things differently’, the latter ‘doing different things’. This pandemic requires us to call on every ounce of creativity and innovation we can muster to undertake our professional practice and live our personal lives differently as we work collectively to create the conditions to reduce mortality and healthcare demand (Fergusson et al., 2020) while supporting, in whatever ways we can, those who are providing care and essential services to those with the greatest need.
As we publish this edition, we start planning a future edition on Quality and Safety to be guest edited by Gwen Sherwood (the Call for Papers in on page 316). When we come to publish that edition, our world may look quite different. Let us work towards preserving the best of our responses to this crisis, blend them with what we know works well and build more compassionate communities and a sustainable planet.