Health at the time of Covid19 – The view from Italy

Article written by a nurse from a hospital in Emilia Romagna 

“It is not an applause that the public health system needs, but concrete certainties.”

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

How can you work without adequate protection?

How can you work not knowing whether you have the virus, risking infecting patients in the workplace and your family when you go home?

How can you work with hospital buildings that aren’t adequate for the Covid19 emergency?

How can you work without a proper organization of the patients coming in?

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

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

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

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

How can you work with constantly changing directives?

How can you work without psychological support?

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

How can you work without professional dignity and recognition?

How can you work hearing yourselves called heroes, when there's so little that’s heroic about what you’re doing?

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 has not been and will not 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 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 good health system. In fact, the real effort must be made by those who have always speculated and profited, 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 are getting 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. So that's why there's a lack of enthusiasm for getting back to normal. A normality made up 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 on 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 sort of "diving suit" (gown, mask, cap, gloves, glasses). And its OK that nurses are sweating now because they should be. You can't take that step back when you have an intensive care units full of patients on ventilators. But anger and dissatisfaction builds along with the sweating and the tiredness. 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 an applause that the public health system needs, but concrete certainties, radical changes 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 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. These workers are not disposable.