Perhaps the biggest communication challenge we face right now is how we communicate to ourselves. The overwhelming loss of control can be so disorientating that we might forget our basic skills. One nurse questioned me about why a medication was ordered on a “COVID patient.” Before I could answer, he shrugged his shoulders. “Maybe this is part of a protocol.” I didn’t know the answer, but as he put the order in I asked him in response, “If this was not a COVID patient and a med was ordered that you had questions about, what would you do?” He paused for a moment and then said, “I’d ask the doctor.”

It was obvious and yet not obvious. The fact that we are unfamiliar with COVID-19 can make us forget that although we know little of the disease, we do know our nursing practice. The sense of vulnerability surrounding COVID-19 creates anxiety that can contribute to miscommunication. In this case, the communication challenge is about self-communication — what we tell ourselves. None of us know how to do this; it is unchartered territory. But what do we do when we are in unfamiliar surroundings? We rely on what we know. We rely on the parts of our practice we are certain of.

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This pandemic does more than challenge us by changing our practice. It challenges the way we process those changes. Instead of struggling to spend more time with our patients, we are working to spend the least amount of time in the room with them. The use of touch and facial expression to communicate to our patients is blocked by doors or masks. Confusing times lead to confusing feelings. The temptation may be to put our feelings “on the shelf,” to move through this pandemic by telling ourselves “I’ll deal with that later, when this is all done.” Yet if we put our feelings on the shelf, when we get through this pandemic, the shelf may have collapsed under the weight of it. We have to be cautious about holding too much in. It is okay to communicate that we are unsettled.

Nurses tend to respond to the tasks at hand, to push through and sometimes deny the stress. But we are stressed at work. We drive home through neighborhoods that are changed and arrive home to a life that is different. What we can do is acknowledge the stress this is causing. Creating a de-stress ritual can help. Since we are washing our hands so often, I’ve heard some use that time to whisper a prayer to themselves or maybe make the way they scrub their hands meditative. We can be purposeful on our commute home using the time for quiet deep breathing. I read of one family that takes their children out each day at 4:00 pm and lets them scream and holler for 5 minutes. We can scream in the car or in the shower. Each action communicates self-care, and each act of self-care is essential right now. Every aspect of how we live is impacted right now. How we practice is impacted. But we can talk about it. We can use this time to develop new ways of communicating, new strategies for connecting. And when this is over — and it will be over — although life and work and relationships are changed, we will incorporate what we learned from this into our practice and hopefully be stronger and more resilient in our profession.