Hospital Preparedness & Response to COVID-19 From RN’s Perspective
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Overcrowded intensive care units. Fears of lack of ventilators. Elective medical procedure suspensions. Unit closures. Make-shift COVID-19 units. We have been reporting on the COVID-19 considerations for nurses for months, watching the news, and reading about the impact COVID-19 has had on communities and hospitals nationwide. As our nation begins to reopen in steps and phases, we want to know more than just the statistics, we want to know what is really happening and how hospitals and healthcare facilities are preparing.
At Nursa, we are always grateful when a busy nurse takes the time to fill us in on the latest nursing news. Recently, we had the opportunity to talk about these kinds of things with Heather who works the front lines at a rural community hospital in Northwest Ohio. Heather is a registered nurse with extensive work experience in hospital emergency departments (EDs) and pediatric intensive care units (PICUs). She is currently a full-time staff nurse who works in the emergency room at a rural hospital and assigned to work in the emergency room at a community hospital with a 113-bed capacity. So, it’s not a huge hospital, but rural hospitals are vital to the small communities in their area, and as you will see, they are facing similar struggles as the large hospitals.
How One Community Hospital Responded to COVID-10 Interview
Question: In terms of hospital preparedness, how did your facility perform?
Answer: We have prepared to have a ton of patients, we have shut down other units in the hospital and designated a Covid unit to keep these patients isolated from other patients. We have drive-through and in-house testing with results within an hour.
Staffing ratios we were able to have up to four, in the medical surgery unit it was normally four patients per nurse and now it is six. In ICU, the ratio is now up to four. Staffing ratios are changed and policies are updated daily and you never know what you are going to walk into.
Our hospital has started their own daycare for the kids of employees for twelve months old and up. The hospital had to acquire a temporary daycare license, but it solved a real problem for staff when schools closed.
Question: Do your kids go to the daycare right now?
Answer: I have not needed the daycare services, fortunately. My kids are 17 and 18 years old and sitting at home all day.
I am waiting to hear officially what we are going to do with our kids in school. No recess time? Take away gym class? No music class? They need smaller class sizes. The school thing is the most trying time about this whole thing now.
Question: Did you have any COVID-19 patients come in that needed treatment?
Answer: Yeah. We had some COVID-19 patients that were very sick, they had to be intubated. Those were mostly in the category of the elderly with many comorbidities. We still have the regular influx of ER patients on top of that. We have the COVID-19 patients and we do the best we can to bring in all of the things that we can possibly need. We use thin layer isolation gowns, goggles, gloves, and N95 respirators.
Question: Have there been any layoffs of staff from the hospital?
Answer: Our hospital has not laid off other nurses. Elective surgeries were shut down for a while. But now elective surgeries have been started back up. There are some restrictions such as elective surgeries that do not require more than a 24-hour stay. We’ve prepared for the crazy influx of patients, for a while had a lot of frequent fliers, now it’s back to the regular.
Question: How has it been for you, as a nurse working in a hospital during a pandemic?
Answer: It’s been really hard. I have had patients with heart attacks and other emergencies and patients who have had to die alone. I have had to do the facetime or video calls for my patients to say goodbye to the people they love. We have visitor restrictions, patients cannot have any visitors at all. It’s been very sad.
None of us signed up to fight something that we don’t know what it is. And at the same time, you have it in the back of your head “I have to do this”. We spend 12 hours a day in masks. Everybody complains of headaches from wearing those masks all day long, other areas of the hospital don’t want to come into the ER. There is a lot of fear culture, the pharmacy doesn’t want to come to the ER, so there is a lot more of nurses taking on extra responsibilities such as retrieving their own meds from the pharmacy or patient trays from the kitchen.
Question: How has the community responded to all of this?
Answer: We’ve done a good job with social distancing. Most of the community and patients are appreciative. Unfortunately, when you are dealing with patients though, sometimes they don’t understand the difference between what they want and what they need.
Heather shares her final thoughts on the community hospital preparedness to handle a second wave and COVID-19 public considerations:
“People have written letters to the hospital CEO, because they saw a nurse who didn’t have a mask. There have even been people even reporting nurses for having people over for dinner. At some point life has to go on though. The curve has been flattened, but now what? It’s not going to go away. It’s going to be here.
People keep focusing on the numbers of people who have died. What people don’t realize is that there are so many patients who are walking around that have never been tested. It is only people who were actually sick enough to get hospitalized. It would make a lot fewer deaths if they were testing everyone.
Now the governor wants everyone to wear the cloth masks out in public. My 17-year old that works at Walmart says people there are wearing masks with their noses out, they wear gloves but touch everything and their hands and faces, etc. In other words, the way people are wearing personal protective equipment out in public is usually not helping them when they constantly cross-contaminate. I do believe there will be a second wave, and because we never got the huge influx we prepared for initially and the hospital has put so many measures in place, I feel that our facility and staff are ready to ride that wave out if it comes.”
For Your Reference:
In our talk, Heather brought up frustration that many people are untested and don’t realize they have or had the virus. Upon some investigation of the subject, we found that:
She also referenced people being required to masks out in public. For more information about how the state government of Ohio is reopening the state including what is expected of people when they leave their house, you can go to coronavirus.ohio.gov.
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