A new year is generally a time for hope, evaluating the previous year’s achievements, and setting new goals. Last year changed that somewhat when we put many of our goals on hold to immediately respond to the pandemic and the needs of our patients, each other, and ourselves. This year, we hope that things will be better.
I recently read a letter written by a head of school to his student body that inspired me. An expert in the classics, he called on them to consider Janus, a Roman two-faced god. One of his faces perpetually looked backward to the past, ever aware of where he’d come from, of those who had come before him. He knew that he could draw on their strength during any hardship—whether war, economic downturn, or pandemic. His other face always looked ahead to the future, but even then he was still comforted in his knowledge of the past, the legacies of his forebears. He was not stuck wallowing in what was, but instead he saw opportunity and optimism presented for tomorrow. To the ancient Romans, Janus was the god of gates and fences, endings and beginnings, and crossing thresholds.
One thing we know as nurses: how we work will never be the same. The new reality brought on by the pandemic will have lasting effects. Efforts to minimize exposure and prevent transmission rapidly expanded technology and increased our use of telehealth to communicate with and monitor our patients from afar. The success of those interventions demonstrated nurses’ ability to reduce in-person patient visits and to deliver care in the home.
The Centers for Medicare and Medicaid Services’ rapid response to change reimbursement and for states to reduce barriers to care delivery improved access and expanded numbers of care providers. We don’t yet know whether the changes will remain permanent and whether we are able to equitably respond to the needs for broadband access and patient acceptance, yet the increase in our scope of practice is well supported by the many thousands of patients who received uninterrupted care that improved their outcomes.
Just as care was disrupted and new methods devised to overcome longstanding barriers to care delivery, the pandemic led to drastic disruption in thousands of clinical trials. However, many were able to continue through telehealth and relaxed requirements that allowed for direct mail of oral oncolytics to patients, electronic signatures for consents, and specimen collection at alternate laboratories. In addition, new trials to address COVID-19 were fast tracked and streamlined and led to unprecedented availability of data and new information. Researchers registered almost 3,000 trials related to COVID-19 with ClinicalTrials.gov from January–August 2020, and the lessons learned from that rapid design and launch of studies could benefit patients, practitioners, and research overall for years to come.
In our mindful moments, let’s think about Janus opening new gates based on the necessity of invention. As we enter a new year, have hope that we will quickly grow our immunity as vaccines become more available and that we can return to a way of life that is more stable and adaptive to our new reality. Oncology nurses will be called on to continue to innovate as we enter the post-pandemic phase of new care delivery models and draw on our experience and our rich legacy of nursing science for new beginnings. Happy New Year.