Fever

Health in the Time of COVID-19: The View From Italy

Article written by a nurse from a hospital in Emilia Romagna 

Questions from nurses

How can we work with only one day off a week?

How can we work without adequate protection?

How can we work not knowing whether we have the virus, risking infecting patients and our families?

How can we work in hospital buildings that aren’t adequate for the Covid-19 emergency?

How can we work without a proper organization of incoming patients?

How can we work knowing only a few tests will get done because they’re too expensive?

How can we work knowing that the personal protective equipment we’re using is limited (and that if we use ‘too much’ our colleagues won’t have any)?

How can we work feeling constantly anxious that making one wrong movement can expose us to infection?

How can we work knowing that two nurses took their own lives because of the emotional and psychological burden caused by the coronavirus?

How can we work with constantly changing directives?

How can we work without psychological support?

How can we work knowing that after this emergency nothing will change in our public health system?

How can we work without professional dignity and recognition?

How can we work hearing ourselves being called heroes, when there’s so little that’s heroic about what we’re doing?

On the frontline

These are no doubt questions that daily fill the heads of doctors, nurses, healthcare assistants, technicians and auxiliary staff on their way to work.

For these professionals there never has been, and never will be an end. Keep going and then keep going some more. Fight and fight again. The government is now demanding we make an effort. An effort to win the war against the coronavirus and to make everything go back to normal. But this normality that is so often talked about is far from idyllic for those who are now on the frontline in hospitals, clinics and care homes. It is strange to think that the government, together with President Conte, between a press conference at 11pm and a round of applause from the country’s balconies, only realized in this moment of need how vital it was to have a decent health system.

In fact, the real effort should be made by those who have always speculated and profited from healthcare, making bad decisions that affect our lives, who then appeal to the “common sense” of those who work in hospitals and other health facilities. What a surprise, after years of bad reforms and reckless cuts, the only resource Italy has to save itself from coronavirus is the public health system. And those who work in public health are not people who take a step back, because you can’t take a step back when you’re dealing with people’s health (you couldn’t even if you wanted to, as the working conditions are so bad). So the shifts get longer every hour, obviously without paid overtime. Some nurses sleep in care homes to decrease the possibility of infection and protect the elderly, others spend some of their salary on buying better masks. This is happening on a daily basis.

That’s why there’s a lack of enthusiasm for getting back to normal. A normality of starvation wages (healthcare assistants are paid 3 euros per hour), exhausting shifts, little professional recognition and a severe lack of resources. But those who work in the wards know these things all too well. Yet these people are asked the impossible: to work for hours, with shifts much longer than normal, cold sweats because of the fear of infection and hot sweats because it’s heavy work moving and assisting patients wearing a “diving suit” (gown, mask, cap, gloves, glasses). And it’s OK that nurses are sweating now because they should be. You can’t take that step back when you have an intensive care unit full of patients on ventilators. But anger and dissatisfaction build up along with the sweating and fatigue. So President Conte can rest assured, all these workers are making an effort (they always have!). But where is the effort of the institutions? Where are the masks? Where are the tests for all health workers? But above all: what will be left once this emergency is over? When the much-vaunted heroism is over and we are once again back to mere everyday life, what will become of the workers who fought on the frontline against the virus?

It is not applause that the public health system needs, but concrete certainties, radical change and above all investment by institutions which in recent weeks have so often celebrated the importance of public services. It is said that the Italian healthcare system is one of the best in the world. Perhaps it once was. I don’t think workers working in hospitals today share that view. Can we really say that our system is better, when Italian nurses have the lowest salaries in Europe?

Now healthcare workers are busy treating and caring for people, but they are waiting impatiently for the end of this emergency to see what will happen. To see that all of this isn’t treated like a disposable mask, thrown away once it’s served its purpose.

First published in Italian in Commonware.

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