Silvia Mambelli: how the COVID crisis is uniting the Italian health workforce

“Despite 40 years of experience in various health-care roles, nothing could have truly prepared me for today’s COVID-19 emergency,” says Silvia Mambelli, director of nursing and technical services at the local health authority of the Emilia Romagna region in Italy.

Silvia coordinates the work of 10 000 health-care workers, among whom are approximately 7000 nurses, in the Italian region hit second hardest by the coronavirus.

“The work I used to do just over a month ago, feels like another life. Instead of working towards long-term goals, I now must focus on the here and now, answering pressing needs that we must adapt to rapidly.”

Curbing the spread of the virus

“The first challenge was a thorough reorganization of the health-care infrastructure, where many units were repurposed to provide services solely dedicated to COVID-19. This was necessary to contain the spread of the virus, while also ensuring continued essential health-care services, such as time-sensitive surgeries.

“The next priority was making sure that health-care professionals had the necessary protective gear – the right masks, gloves and goggles. The issue of a shortage of protective devices has been of constant concern, but more than that, what needed addressing was the fear of a shortage and the fear of getting infected.

“From the very start, we organized meticulous training on preventing infection, which also helped fight the growing fear among health-care professionals. Closely following WHO guidelines, we deployed virology experts in mobile units to reach all health-care facilities, including long-term care facilities for older people.”

Health-care professionals and citizens confronting the challenge together

“Now the most pressing task I face daily is hiring more nurses. In the past month, about 400 new colleagues, among whom are many new graduates, have joined us. So many rushed to help without a second thought. I feel a particular sense of responsibility towards those who are starting their career at this time; whenever possible, I ensure they are either located in non-COVID-19 dedicated structures or are working next to a more experienced nurse.

“Everyone is chipping in and contributing to the efforts – not only health-care professionals, but also regular citizens. Some donate food for health-care professionals, who work long hours each day and isolate themselves at home to avoid the risk of infecting others; some have donated mobile phones to hospitalized patients who otherwise could have had no contact with their families; and yet others, have donated protective gear.”

Personal sacrifice and solidarity

“These difficult times bring out our strengths and weaknesses. Now more than ever, supporting and motivating each other is important. I draw my motivation from the solidarity I am witnessing and the deep commitment of all health-care workers, who are dedicated to fighting this virus 24 hours a day.

“Nurses may forget to log in with their badges, because their minds are entirely focused upon their responsibilities. There is no mentally logging off from work, as the fear of infecting others is a constant companion.

“When a person tests positive for the virus they feel a sense of shame and even guilt; patients feel tainted and worry about having infected others. That feeling, and the enforced isolation, leads to an increased need for human contact. Here, the caregiving role of nurses becomes even more of the essence, as their support must replace what a visit from loved ones could have offered.”

An opportunity for change

“The collaboration and mutual respect between all health-care professionals today is unprecedented. Nurses and doctors fight this virus together, they fall ill together and they heal patients together. Unity is indispensable now, but it also shows the way for the future.

“I see in the current emergency, an opportunity to bring about change. We must draw on our unique competencies to identify the best way forward, for it is the people who work in the wards every day that can together, create a better health-care system. There can be no strong society without strong health care.”