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The most difficult year

Richard Ricciardi |

When I first began to reflect on the past year, I was at a loss trying to find the right way to sum up 2020. So much change. So much suffering. So much hardship. So much pain. And so much death—of our patients and of our colleagues in global healthcare near and far—all in a year that had been designated the International Year of the Nurse and the Midwife. I must begin by acknowledging this has been the most difficult year for global health in the century since Sigma was founded. 

As I’ve spoken virtually with many chapters, regions, and Sigma members this past year, I’ve continued to share our 2019-2021 Call to Action—Infuse Joy. At first, this may have seemed out of place with such a challenging year. But—as I’ve heard from so many of you—in many ways, this year has underscored and reinforced the need for the three essential elements of that call: Awareness, Balance and Purpose, and Co-creation. 

Being a nurse in 2020 has required awareness on multiple levels. In addition to the awareness needed to perform our roles competently, nurses needed to be aware of the novel coronavirus, its likely impact, evidence showing how the virus spread, ways to slow the spread and, sadly, the burden on hospital and health system capacity. Nursing faculty had to increase awareness of technology, distance education, and innovation required to succeed amid massive disruption. Nursing students, those graduating and those continuing, needed to adapt to new ways of learning in clinical and distance education. The graduating students faced uncertainty and stress regarding how to enter the profession during a global pandemic. As the pandemic spread, nurses in all settings (clinical, administrative, academic, research, and policy) required awareness of the misinformation, confusion, and fear permeating their communities, and—perhaps most critically—the pandemic’s impact on their family’s and personal well-being and on friends and colleagues in the healthcare workforce. 

During the early days of the first wave of the pandemic, Sigma developed and shared a suite of COVID-19 resources on our Sigma is Here for You page, including webinars, books, and free continuing education courses. The page has been accessed nearly 14,000 times throughout the year. If you haven’t yet heard about these materials, I urge you to make use of them. 

For chapter leaders and nursing students impacted by the pandemic, Sigma staff members assisted chapter leaders transitioning from in-person to virtual inductions. Sigma also began offering a quarterly virtual second-chance induction for those chapters that were unable to offer or attend a local induction. It was my privilege and honor to speak at two of these virtual events, and I’m pleased that more than 1,600 deserving individuals accepted this offer. In a season when many traditional milestone events were canceled, Sigma and chapter leaders helped nursing students receive the recognition they had earned. 

One positive during this negative year is many people have become increasingly aware of the work nurses do and how critical they are to their local communities and global health. We have seen many acts of appreciation, ranging from nightly clapping for healthcare workers to food deliveries to work settings, to heartfelt tributes from grateful family members. All of these have demonstrated a high respect and regard for nurses and the nursing profession. 

Balance and Purpose
This year has been a trying one for those seeking balance. Overworked, overtired, overextended, and in many cases underpaid nurses have faced a daunting and prodigious task. While balance was elusive, self-care became essential, as did the ability to find small moments of joy and hope.

As the pandemic wore on, Sigma recognized how needs shifted. Midyear, we shared resources to help nurses address issues like burnout, self-care, forgiveness, and advocacy through Find Your Forward: Resources for Advocacy and Strength. These resources are free to all nurses regardless of Sigma membership. Consider accessing them yourself or forwarding to a colleague. My hope is these tools equip you to advocate for needed changes to instill balance within you, at home and in the workplace. 

If balance has been elusive, purpose has been at the forefront this year. Many of us became nurses because we are servant leaders. Our service in this pandemic year, and the consequences of that service, will be retold, analyzed, and felt for generations to come. 

Sigma remained committed to the purpose of connecting and empowering nurse leaders and disseminating nursing research. When it became clear that holding in-person meetings would not be possible, Sigma seamlessly transitioned both the 2020 International Nursing Research Congress and Chapter Leadership Connection to well-attended—and welcomed by members—virtual events. 

Balance and purpose will continue to be essential in 2021 and beyond. While there are glimmers of hope, we know that some dark days still lie ahead. I am profoundly grateful for and supportive of all of you and your selfless and courageous contributions to global health, this year and always. 

This year, I have been disappointed to see different factions attacking and disparaging colleagues in healthcare. This unfortunate development is the opposite of co-creation, the third tenet of my call to action. Co-creation can only happen when awareness, balance, and purpose have been fully realized, and it represents the best possibilities of nursing and healthcare. 

As an international nursing organization, Sigma connects nurses from every region of the globe. Our members come from countries that have responded to the pandemic in dramatically different ways and with dramatically different success. Because of this, Sigma provides a unique opportunity to share information, work together, and co-create a future built on the best evidence-based information.

Are healthcare systems equal? Are they perfect? No. Is there a need to address the inequities in healthcare? Yes. I believe in Sigma’s vision of connected, empowered nurse leaders transforming global healthcare. Co-creation is our path forward through the changes that must come. I have tremendous hope for co-creation of a future with less division, more evidence-based practice, more nursing leaders at the decision-making table, and more equitable inclusion and compensation for nurses.

Words of thanks
I am thankful to you—Sigma members across all regions—for your selfless and impactful contributions to global health. Thank you for stepping up to fill the gap. Thank you for working tirelessly through the most extenuating circumstances. Thank you for preparing future nurses—they are our legacy. Thank you for saving lives. 

I also want to extend my thanks to the talented and dedicated Sigma staff. With no notice, they—like many of you—were dispersed from the office and expected to carry on without a missed step. Not only did they do that, they innovated and advanced creative solutions to support members and nurses worldwide.   

In memoriam 
As I mentioned at the beginning of this article, we cannot look away from nor become numb to the nurses and healthcare workers who lost their lives while trying to save the lives of others. To the families, colleagues, and friends of those lost, I offer my sincere condolences and prayers for healing in this time of such profound grief. 

During this crisis, I have often sought restoration and healing in engaging in nature and art. I have reflected often on a poem entitled “Hope” Is the Thing with Feathers, written over 150 years ago by Emily Dickenson. I find the words relevant and comforting today. 

“Hope” is the thing with feathers –
That perches in the soul –
And sings the tune without the words –
And never stops – at all –

And sweetest – in the Gale – is heard –
And sore must be the storm –
That could abash the little Bird
That kept so many warm –

I’ve heard it in the hilliest land –
And on the strangest Sea –
Yet – never – in Extremity,
It asked a crumb – of me.

Looking to the future
With the recent approvals, initial shipments, and first administrations of the new vaccine, I look forward to making sustained progress against COVID-19 and continued awareness and support of nurses, all healthcare workers, and all essential workers and their importance to global health and well-being. 

My two-word charge to you all remains: Infuse Joy. May you develop the awareness necessary to adroitly perform the work at hand. May you find moments of balance and self-care, and may you never lose sight of your purpose. And may we all co-create the future we want and deserve. 


With much gratitude, 


Richard Ricciardi, PhD, CRNP, FAANP, FAAN

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