Search

Throughout the COVID-19 pandemic, frontline healthcare workers around the globe provided exceptional patient care despite fears of infection, shortages of staff and supplies, and the frustrations of trying to treat a novel pathogen. At the same time, COVID-19 exposed deep and systemic risks to healthcare team members' physical, psychological, and emotional safety driving burnout to crisis levels. Burnout is arising not only from the emotional toll of caring for sick and dying patients, but COVID-19 also exposed flaws in our health system and infrastructure. Systemic inequities were amplified as COVID-19 disproportionately impacted people of colour and Indigenous community members. A renewed and expanded definition of safety is needed to restore trust, recruit, and retain individuals to the healing professions, enable care to be provided with the greatest skill and humanity, and ensure the well-being of every person working in healthcare. In collaboration with CEOs of a diverse group of health systems in the United States, the author drafted a Declaration of Principles that expands the definition of safety to include safeguarding psychological and emotional well-being of team members, promoting health justice by declaring equity and anti-racism as core components of safety, and ensuring physical safety, which includes a zero-harm program to eliminate workplace violence, both physical and verbal. We invite Canadian leaders to embrace these concepts and commit to supporting team member safety and well-being as an essential foundation for public health. We must humanize healthcare and the time to act is now.

The purpose of this study was to describe the decision-making processes of 369 public health nurses in Canada, Finland, Norway, and the United States, and to discuss any differences observed among these countries. The results indicate that public health nurses used different decision-making models on the job and that these models varied considerably. Five different decision-making models were identified, each exhibiting features of different decision-making theories. The differences between decision making of public health nurses in different countries were statistically significant. The differences in decision making appear to be due to differences in health care systems in the 4 countries and the nature of the nursing task and context.