Commentary on Chung BPM, Wong TKS, Suen ESB & Chung JWY (2005) SARS: caring for patients in Hong Kong. Journal of Clinical Nursing 14, 510–517

Abstract

The emergence of Severe Acute Respiratory Syndrome (SARS) posed a major challenge to the health care sectors of many countries of the world. China and Hong Kong were most severely affected by this new infectious disease. Being at the vanguard of the health care team, nurses were at the centre of the effort to fight this battle. As SARS was a completely unknown, highly contagious and potentially lethal disease, nursing patients with SARS was inevitably challenging and stressful. In fact, a number of nurses in Hong Kong had contracted SARS and the first health care worker who died as a result of SARS was a nurse. Being an unknown disease, SARS is heavily researched. Much of the work, however, has been reported from the perspectives of biomedicine. This paper by Chung et al. adds knowledge to this field by describing the lived experiences of nurses caring for SARS patients and raises a number of perceptive issues with regard to nurses’ roles and their contribution in health care delivery. It also provided us with an opportune invitation to reflect on what nursing is about in this changing health care context. Ever since the era of Florence Nightingale, public health and infection control have been important agendas in nursing. SARS served as a reminder of the indispensable role we play in dealing with a real threat to the health of the public. The experiences of caring for SARS patients as articulated in Chung et al.’s paper, however, have particularly reminded us of the ‘taken for granted’ features of nursing: being sensitive and present, ‘doing’ the little things that ‘go above and beyond just the routine’ such as getting patients a hot drink and buying a newspaper. Nurses in this study regarded these ‘little things’ as making a difference to the patients’ perceptions of being cared for. They also exercised their professionalism by demonstrating accountability not only to their patients but also their families. Families highly value the ‘physical and emotional presence’ of nurses, especially at times of crisis. These ‘humanistic’ aspects of nurses’ role, which have apparently been under-valued in the highly technological world of today, were brought out again in this crisis. Indeed, SARS has not only highlighted the major clinical, educational and public health implications for nursing (Thompson et al. 2004), it has also provided an opportunity for us to reflect on our roles in the health care system. As a result of inadequate manpower planning and the implementation of various cost-saving initiatives, nurses in Hong Kong, for example, have ‘delegated’ most of our basic care to health care assistants. Gottlieb (2004) commented that nursing and other health-care personnel were the first to suffer and made redundant when governments exercise fiscal restraints on the health-care system. It is a worry that while nurses are ‘giving away’ what the public has perceived as their responsibilities, they have not adequately demonstrated their other health care duties, which have a positive impact on patient outcomes. In fact, just before SARS, our graduates were faced with the possibilities of unemployment. The ‘arrival’ of SARS served as a wake-up call and ignited a great demand for nurses. It was evident that nurses were highly respected by the public for their professionalism and expertize in the SARS battle. They were seen as heroes and guardians of people's health. The question for us now is how we can best seize this ‘opportunity’, continue with this momentum to raise our profile and contribute our knowledge and skills to the planning and organizing of health care.