The document discusses how the COVID-19 pandemic has reshaped cardiology. It summarizes the impacts in three areas: clinical practice, education/training, and professional values. In clinical practice, procedures were prioritized and telemedicine was expanded. Education transitioned online and fellowship training was disrupted. Regarding professional values, the pandemic highlighted nurses' ethical obligations to patients and need for organizational support.

1. RESHAPING OF
CARDIOLOGY
DURING COVID 19
PANDEMIC
Mrs. Reena Thakur
Associate Professor

2. INTRODUCTION
India has proved its capability in terms of polio eradication
and is emerging as a leader in helping other countries in
managing a COVID-19 response. However, the greatest
emphasis now is on gearing up the surveillance systems in
India to prevent, address, and mitigate the effects related to
any pandemic diseases in the future.
The emergence of the novel coronavirus
infection (COVID-19) began a series
of unparalleled changes in health care
systems worldwide.

3. The discussion is structured
around three domains: clinical
practice, education and
training, and professional
values.
I describe the immediate
ramifications and potential
long-term impac.t of COVID-
19 on each domain

4. nurse’s primary commitment is to the
patient
Organizational support
continue to advocate for systems and
protocols
Online Learning

5. Clinical Practice
The rapid escalation of the epidemic
mandated immediate adjustments and
reprioritization of outcomes in several
aspects of our practice. The wellness and
safety of the healthcare workforce, in the
context of a pandemic posing great risk to
nurses and doctors who provide direct
care, now competes with patient access to
cardiovascular clinical encounters, testing
and procedures.

6. Prioritization of “essential” procedures
• First, the length of the deferment period is
uncertain and undergoing dramatic
evolution.
• Second, there are limited data to support
the safety of deferring certain procedures.
• Third, nurses and physicians are facing
another unanticipated problem; the anxiety
and stress inflicted on the patients and their
families due to delaying what they perceive
as life-saving treatment.

7. Expanded use of telemedicine
• Virtual visits to communicate
with patients
• To provide counselling
• To communicate with
caregivers of elderly family
members

8. Emergency Preparedness
restructuring in inpatient services, procedural
laboratory processes, management algorithms,
physician’s assignments, and other logistics.

9. Education
Nursing education needs reform.
Competency- based curriculum must
be devised, with emphasis on practical
skills. Wherever possible, nursing,
medical and allied health professional
training must be co-located to promote
inter-professional learning and team-
based training.

10. Nurse Practitioner training programmes must be scaled up.
Specialist nurse training programmes must be strengthened,
as many areas from critical care to cardiac surgery need
specific skills and knowledge-based training.
Nurses at the front lines must be given formal public health
training and become technology-enabled. Chronic
continuous care of diabetes, hypertension and coronary
heart disease is eminently feasible in primary care settings,
through the medium of technology-enabled nurses, as well
demonstrated in many countries including India.

11. Online learning
While the advent of Covid‐19 has required nurse
faculty be innovative, flexible, nimble and agile,
there have been challenges. For example, faculty
have had to move in‐person classes online,
conceptualise and offer alternative clinical
experiences, and re‐define how student
performance is evaluated and graded.
More thoughtful, systematic approaches will be
needed to make the transition to online teaching and
learning successful and permanent.

12. Planning meaningful clinical learning experiences has
been challenging, and in some instances, fraught with
ethical dilemmas. While some clinical agencies have
supported continuing to have students in their
agencies, others have not.

13. Fellowship Training
COVID-19 has also already disrupted universities and
academic institutions. Within the health field, nursing colleges
are bracing for unique challenges related to our role in helping
develop the next generation of care providers.
While the majority of learning is conducted online, students in
this program must complete in-person clinical placements to
fulfill the Nursing degree and diploma requirements.

14. Professional Values
The swift and extensive impact of
COVID-19 on cardiology practice and
education were easily measurable.
Nonetheless, the epidemic also led to
other less discernable effects on our
profession at large. Nurses are
concerned about professional, ethical,
and legal protection when asked to
provide care in such high-risk
situations, such as the COVID-19
pandemic.

15. Nursing profession's
nonnegotiable ethical
practice standard. The
nurse’s primary
commitment is to the
patient

16. • The nurse owes the same duty to self
as to others. These equal obligations
can conflict during pandemics when
nurses must continually care for
critically ill infectious patients, often
under extreme circumstances including
insufficient or inadequate resources and
uncontained contagion.

17. • During pandemics, nurses and
their colleagues must decide
how much care they can provide
to others while also taking care
of themselves. They must be
supported in these heart-
wrenching decisions by the
systems in which they provide
care and by society.

18. • There may be times when a
registered nurse must make a choice
based on moral grounds in order to
maintain professional integrity.
Hospitals, institutions, managers,
administrators, and health care
providers need to understand
employer and employee expectations
during times of pandemic

19. nurses may struggle with the call to volunteer and
respond in a pandemic.
Nurses may choose not to respond if:
• They are in a vulnerable group
• The nurse feels physically unsafe in the response
situation due to a lack of personal protective
equipment or inadequate testing
• There is inadequate support for meeting the nurse’s
personal and family needs, in the COVID-19
pandemic

20. • organizational support for the registered nurse is
a non-negotiable necessity. Effective
communication between registered nurses and
organizational management regarding a nurse’s
ability to provide care to patients is essential and
must be heard and valued at all organizational
levels. Nurses must not be retaliated against for
raising concerns.

21. • The registered nurse is responsible for being
knowledgeable about state law under which they practice
during a pandemic.
• Employers have the responsibility to create, maintain,
and provide practice environments that help meet the
medical needs of the community within a system that
protects nurses and other employees or volunteers. This
should include the provision of sufficient, appropriate
personal protective equipment, immunizations, physical
security, and operational protocols. Individual nurses are
critical participants in this work.

22. Nurses must continue to advocate for systems and
protocols that protect their ethical obligations as nurses,
as well as ensure equity and fairness to all concerned in
times of pandemics.

23. Crises are never wanted, often unpreventable,
but always result in major lessons to the affected
communities. The current epidemic has taken us;
cardiologists to uncharted territories (Figure-1).
While the COVID-19 story is still being written,
we can use the lessons we learned thus far to
revisit, refine, and reinvent key aspects of our
profession.