When Jean Andres, DNP, RN, arrived at the parking garage at Luminis Health Anne Arundel Medical Center in Annapolis, Maryland, she instantly heard the “very distinct scream” delivery room teams recognize. As the hospital’s labor and delivery director, she leaped into action.
Dr. Janelle Cooper, an OB/GYN, was delivering Elsa Artunez’s baby in the backseat of a truck.
Artunez’s grandfather was rushing her to the hospital. He stopped the truck in the parking garage by an entrance, which would have put Artunez only a few feet from the front desk, where a wheelchair would have transported her to the delivery unit.
But there was no time to put the car in park because the baby was coming.
When Dr. Cooper reached the truck, the baby’s head was already out, and Andres heard the scream.
“I put my lunch bag down and called the team to let them know we had a delivery in the garage. And I proceeded to assist Dr. Cooper with the delivery that she had performed.”
Daily Nurse honors Jean Andres as the Nurse of the Week for providing exceptional care and exemplifying the hospital’s #RISE values of Respect, Inclusion, Service, and Excellence toArtunez and the newborn.
Artunez gave birth to a healthy baby girl, Yesenia Patricia, and surprisingly, for a first-time mother, Doctor Cooper noted, it went quickly. “She did really well.”
Once Yesenia was born, Andres dried her off and kept her warm until the medical team came and took the family to a maternity room in the hospital.
“The fact that it was in a garage was very unconventional, but it was not chaotic,” Andres says.“It was a very beautiful birth.”
Baby Yesenia isn’t the first to be born in the medical center’s parking garage, Andres and Dr. Cooper note, nonplussed. “We delivered a baby in the elevator this week.”
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Do you have the guts to be a gastroenterology nurse?
All joking aside, this facet of the field is often overlooked because it may not be as exciting as, for example, working in an ED. But it truly helps to save lives.
Daily Nurse interviewed Alicia Carter, RN, BSN, BS, MHA, an endoscopy nurse at the University of Maryland Capital Region Health, about what it’s like to work as a gastroenterology nurse. What follows is our interview, edited for length and clarity.
How did you get interested in being a gastroenterology nurse? What drew you to it? How long have you been doing it?
I have always been interested in becoming a circulating nurse, and when I moved from out of state and began a job search in the area, I came upon the posting for my current position. After much research, I applied and waited impatiently to hear back. I was excited to train and learn as much as possible when I was hired.
Since it is not a “popular” sector of nursing, like ICU, ED, or OR, I was drawn in by knowing that I was entering into a specialty with more specific missions in each procedure than I had previously known.
I have been a gastroenterology nurse for two years.
Did you need to get additional education for this position?
Outside of nursing school, I did not get additional education for this position; however, it may not be best suited for a new grad nurse.
What do you like most about working as a gastroenterology nurse?
What I like the most about working as a gastroenterology nurse is that it’s fast-paced, for the most part. I like being on the move; working in Endoscopy gives me exactly that.
We get patients who are just coming in for a routine screening colonoscopy, and we get patients who are getting scoped because we are trying to find out if their cancer has spread, so we are getting the full spectrum of acuity in our patients.
Our advanced cases are much slower than EGDs or Colonoscopies, but as a whole, the day moves steadily when our schedule is full.
What are your biggest challenges as a gastroenterology nurse?
The biggest challenge that I have found as a gastroenterology nurse is trying to please everyone all at once—including the patient, the proceduralist, the anesthesia, your manager, and your techs.
Because many wheels are turning simultaneously, you can do your best to try to make sure that they all stop and arrive at the same point at the same time, but that doesn’t always happen, no matter how hard you try.
What are your greatest rewards as one?
My greatest reward as a gastroenterology nurse is that you are an integral part of someone’s journey to either fixing a problem or diagnosing a problem.
In addition to your position requirements, you are there to hold hands with a patient before they go in the room, you are there to give them comfort before them being sedated, and you are there as one of the first faces they see after they wake up.
Knowing that I am the person that the patient looks for to make sure that everything goes smoothly with their procedure and care is heartwarming, and when the patient wakes up and thanks me for being there for them, it makes my day.
Is there anything else that is important for our readers to know?
It is important to note that no one size fits all for GI nurses. Depending on your facility, there will be different responsibilities for a GI nurse—whether it is an outpatient or inpatient facility. Either way, the work can be very rewarding, and even though it is not a specialty that many know a lot about, it is worth checking out for yourself to see if it fits.
When patients present with a specific type of heart attack (non-ST elevation acute coronary syndrome) or chest pain related to coronary heart disease (unstable angina), they often undergo several tests—many being invasive—and then they may be sent to other facilities for even more procedures.
It’s time-consuming, it can be confusing to the patient, it can be stressful on the patient’s body, and when combined, can lead them to abandon care.
Sarah Slone, DNP, MSN, FNP-BC, CCRN began to address this problem from an implementation science standpoint in her Doctor of Nursing Practice (DNP) project. She aimed to streamline the process of existing care options from acute symptom presentation in the hospital to discharge.
But ultimately that raised a new question:
Can we determine best practices for when patients need catheterization (an invasive procedure) so that we can establish a standardized approach and identify barriers to care that may exist?
“Any invasive procedure carries risk,” Sarah says. “There are non-invasive options like stress tests, information that can be gleaned from a patient’s presentation and previous lab work, and newer options with CT scanners.”
Now she’s pursuing the question from a discovery science standpoint. Her Ph.D. research examines “care pathways” from acute symptom presentation to various methods of invasive and non-invasive testing, to establish best practices for when patients are most in need of these procedures.
From Implementation to Discovery
Sarah Slone graduated from the DNP Executive Track in May 2019, then started the Ph.D. in August 2020. She is in a new Johns Hopkins School of Nursing program that offers an alternative pathway to Ph.D. for nurses who have earned a DNP. Students can transfer credits and earn their Ph.D. in about three years compared to about five years.
The DNP Executive Track is online with on-site immersions, but Ph.D. students must live in Baltimore. So Sarah moved from South Carolina to Baltimore, alone, at the height of the COVID-19 pandemic.
She considered delaying her start but didn’t want to let the time go to waste. And even before the move, the family living situation was complicated.
“My husband is an interventional cardiologist who works in a hospital. At the beginning of the pandemic, we had to decide if we wanted to live together since he would be at risk of being exposed. Our son is in college, but he returned home because of COVID. He decided that he wanted to remain in the house as well,” Slone says.
Now in her second semester, Sarah reflects that the Ph.D. is not harder, but different than the DNP.
“The DNP enriched my perspective as a nurse scientist, but I learned that questions arise from evidence-based practice, and I needed a Ph.D. to explore that further.”
—SARAH SLONE, DNP, MSN, FNP-BC, CCRN
“I’ve already grown a lot in terms of research,” she continues. “I came in with a specific idea of what I wanted to do and was able to develop my research project with my mentors into something not just fundable, but something that can grow into a wider program of research.” Sarah’s DNP mentor was Dr. Deborah Baker, Senior Vice President for Nursing of Johns Hopkins Health System and her Ph.D. mentors are Dr. Cheryl Dennison Himmelfarb and Dr. Kelly Gleason.
Sarah recommends that, if you are considering a Ph.D. and have a DNP, define your research questions early. “The sooner you can do it, the better you can align assignments, so they build and benefit you throughout the program.”
A Passion for Research
Sarah always had a passion for research—from working as a research assistant in a plant pathology lab in high school to initially studying biochemistry in college. She took some time off from undergrad to have a family and later decided to pursue a BSN. Upon graduation, she worked as an ICU nurse for five years, then became a family nurse practitioner, followed by work in general and trauma surgery. She discovered a passion for cardiovascular care when the 36-hour shifts in trauma surgery became too much (especially with a young family!) and the cardiovascular service was hiring.
“It’s fascinating,” Sarah says. “Cardiovascular disease remains the number one cause of morbidity and mortality in the United States. There’s so much opportunity to improve the lives of patients.”
Though African Americans are being hospitalized for COVID-19 at more than triple the rate of white Americans, wariness of the new vaccine is higher in the Black population than in most communities. The U.S. Centers for Disease Control and Prevention highlighted communities of color as a “critical population” to vaccinate. But ProPublica found little in the way of concrete action to make sure that happens.
And it could be hard to track which populations are getting the vaccine. While the CDC has asked states to report the race and ethnicity of every recipient, along with other demographic information like age and sex, the agency doesn’t appear ready to apply any downward pressure to ensure that such information will be collected.
In state vaccination registries, race and ethnicity fields are simply considered “nice to have,” explained Mitchel Rothholz, chief of governance and state affiliates for the American Pharmacists Association. While other fields are mandatory, such as the patient’s contact information and date of birth, leaving race and ethnicity blank “won’t keep a provider from submitting the data if they don’t have it.”
In the initial stages, vaccines will go to people who are easy to find, like health care workers and nursing home residents. But barriers will increase when distribution moves to the next tier — which includes essential workers, a far larger and more amorphous group. Instead of bringing the vaccine to them, it’s more likely that workers will have to seek out the vaccine, so hesitancy and lack of access will become important factors in who gets the shots and who misses out.
“There are individuals who are required to be on the front line to serve in their jobs but perhaps don’t have equitable access to health care services or have insurance but it’s a challenge to access care,” said Dr. Grace Lee, a professor of pediatrics at Stanford University School of Medicine and member of the CDC’s Advisory Committee on Immunization Practices, which is tasked with issuing guidance on the prioritization of COVID-19 vaccine distribution. “We can build equity into our recommendations, but implementation is where the rubber meets the road.”
Hesitancy is Rooted in Medical Exploitation and Mistreatment
About a quarter of the public feels hesitant about a COVID-19 vaccine, meaning they probably or definitely would not get it, according to a December poll by the Kaiser Family Foundation. Hesitancy was higher than average among Black adults in the survey, with 35% saying that they definitely or probably would not get vaccinated.
Mistrust of the medical community among people of color is well-founded, stemming from a history of unscrupulous medical experimentation. The infamous Tuskegee study, conducted from 1932 to 1972 by the U.S. Public Health Service, still looms large in the memories of many Black Americans, who remember how researchers knowingly withheld treatment from African American sharecroppers with syphilis in order to study the disease’s progression.
But the injustices aren’t confined to the past. The National Academies’ Institute of Medicine has found that minorities tend to receive lower-quality health care than white counterparts, even when adjusting for age, income, insurance and severity of condition. Black Americans are also more likely to be uninsured and utilize primary care services less often than white Americans.
“It’s not just about history. It’s about the here and now,” said Dr. Bisola Ojikutu, an infectious disease physician at Massachusetts General Hospital. “People point to racial injustice across the system. It’s not just hospitals; people don’t trust the government, or they ask about the pharmaceutical industry’s profit motive. From the very beginning, Black and brown people are marginalized from the enterprise of research. They think: ‘So few people look like us in research, industry and academia, why should we trust that someone at that table is thinking of our interest?’”
When it comes to vaccinations, the consequences can be grave. Black and Hispanic people are less likely to get the flu shot than white people, according to the CDC. At the same time, Black Americans have the highest rate of flu-associated hospitalizations, at 68 people per 100,000 population, compared to 38 people per 100,000 in the non-Hispanic white population.
Health officials have tried to assuage vaccine concerns in the traditional way, by publicizing specific individuals receiving the shot. The U.S. began its mass immunization effort by injecting a dose of the Pfizer-BioNTech vaccine into the left upper-arm of Sandra Lindsay, a Black woman and critical care nurse in New York.
Meanwhile, an onslaught of memes and conspiracy theories characterizing the vaccine as harmful are making the rounds on social media. One reads, “Just had the covid-19 vaccine. Feeling great,” along with the picture of the character from the 1980 movie “The Elephant Man.” Another image circulating on Twitter features the photos of three Black people and claims they are suffering from Bell’s palsy due to the vaccine. The Twitter user who shared the image asked followers, “still want those Tuskegee 2.0 genocide vaccines?”
It may only take one or two negative headlines to further sow fear, said Komal Patel, who has 16 years of experience as a pharmacist in California. After two health care workers in the United Kingdom experienced allergic reactions to Pfizer’s vaccine, Patel said she saw anxiety spike on social media, even though regulators have said that only people with a history of anaphylaxis — a severe or life threatening immune reaction — to ingredients in the vaccine need to avoid taking the shot. “Just two patients, and here we go, there’s all this chatter.”
Key States Lack Concrete Plans to Promote Vaccines in Black Communities
It falls to states to make sure their residents of color are vaccinated. But the speed at which the vaccine needs to be disseminated means that states haven’t had much time to plan communications efforts, said Lee, from CDC’s advisory group. “How do we make sure messaging is appropriate? You may want to emphasize different messages for different communities. We don’t have the time for that.”
ProPublica found that few states can articulate specifically what they are doing to address vaccine skepticism in the Black community.
Texas, Georgia and Illinois’ state plans make no mention of how they plan to reach and reassure their Black residents. Black communities make up between 13% and 33% of the population in the three states, according to data from the U.S. Census Bureau. None of the three states’ health departments responded to requests for comment.
California’s state plan includes “a public information campaign … to support vaccine confidence,” but does not provide details apart from the state’s intention to use social media, broadcast outlets and word of mouth. In an email, the California Department of Public Health did not provide additional information about outreach to Black residents, only saying, “this is an important issue we continue to work on.”
A spokesman for New York’s Department of Public Health said the state has been working since September to overcome hesitancy with expert panels and events like Gov. Andrew Cuomo’s November meeting with community leaders in Harlem to discuss concerns with the Trump administration’s vaccine plan, specifically for communities of color.
“Governor Cuomo has been leading the national effort to ensure…black, brown and underserved communities have equal access to, and confidence in, the vaccine,” a Saturday statement said.
Dr. Georges Benjamin, executive director of the American Public Health Association, said: “Media outreach is not enough. TV ads are one thing, but usually public service announcements are at midnight when nobody is listening, because that’s when they’re free.” Normally, public health officials go to barber shops, beauty salons, bowling alleys and other popular locales to hand out flyers and answer questions, but due to the pandemic and limits on congregating, that’s not an option, Benjamin said, so officials need to plan a serious social media strategy. That could involve partnering with “influencers” like sports figures and music stars by having them interview public health figures, Benjamin suggested.
Dr. Mark Kittleson, chair of the Department of Public Health at New York Medical College, said he’s not surprised to hear how vague some of the state health plans are, because states often focus on providing high-level guidance while county or regional level health departments are left to execute the plan. But he said specific efforts need to be undertaken to reach residents of color. “Spokespeople for the vaccination need to be a diverse group,” Kittleson said. “Dr. Tony Fauci is fantastic, but every state needs to find the leading health care experts that represent the diversity in their own state, whether it’s Native American, African American or Latino.” Kittleson also suggested partnering with churches.“Especially in the African American community, when the minister stands up and says, ‘Folks, you need to take your blood pressure medication and take care of yourself,’ people listen to that,” he said. “The church needs to be brought into the fold.”
Maryland’s state plan acknowledges the distrust among Black and Latino communities as well as rural residents, and says it will aim to tailor communication to each group by working with trusted community partners and representatives of vulnerable groups. A Department of Health spokesperson said in an email that “as vaccination distribution continues to ramp up, we urge all individuals to get the vaccine.”
Florida’s written plan includes a messaging strategy for everyone in the state, but does not specifically address the Black community. A “thorough vaccination communication plan continues to be developed in order to combat vaccine hesitancy,” a spokesperson for the Florida Department of Health said in response to ProPublica’s queries.
In North Carolina and Virginia, however, health officials started preparing months ago to reassure residents about potential vaccines. North Carolina formed a committee in May with leaders from marginalized communities to guide the state’s overall response to the pandemic. Vaccine concerns were a priority, said Benjamin Money, deputy secretary of health services for North Carolina’s Department of Health and Human Services.
The politicization of the pandemic has mobilized the Black and brown medical scientific community to dig into the research and how the vaccines work, Money said, “so that they can feel assured that the vaccine’s safe and it’s effective and they can convey the message to their patients and to their community constituents.”
The committee is advising North Carolina officials on their vaccine messaging and hosting a webinar for Black religious leaders. Similarly, the Virginia Department of Health has staff devoted to health equity across racial and ethnic groups and is putting on a series of town hall-style meetings speaking to specific communities of color.
Black residents in Virginia have expressed concerns about how rapidly the early vaccines were developed, said Dr. Norman Oliver, Virginia’s state health commissioner.
“It all boils down to telling people the truth,” Oliver said. “The first thing to let folks know is that one of the reasons why these vaccines were developed so quickly is because of the advances in technology since the last time we did vaccines; we’re not trying to grow live virus and keep it under control or do attenuated virus and develop a vaccine this way.”
In addition to promoting reliable information, Virginia health officials hired a company to monitor the spread of vaccine misinformation in the state and to locate where falsehoods appear to be taking hold, Oliver said. The state hopes to target its communications in places where distrust is most intense.
The CDC has set aside $6.5 million to support 10 national organizations, according to spokesperson Kristen Nordlund. The funds are “to be disbursed by each organization to their affiliates and chapters across the country so they may do immunization-focused community engagement in the local communities they serve,” Nordlund said in an email. She didn’t respond to questions on whether the funds had already been disbursed and to which organizations.
Data Collection on the Race of Vaccine Recipients is Likely to be Incomplete
Every state has a vaccination registry, where data on administered shots is routinely reported, from childhood vaccinations to the flu shot. What’s new in this pandemic is that the CDC has requested all the data be funneled up to the federal level, so it can track vaccination progress across the nation.
“Race and ethnicity data should be recorded in states’ immunization data, but we do not know how reliably it is collected,” said Mary Beth Kurilo, senior director of health informatics at the American Immunization Registry Association. “We really don’t have good data on how well it’s captured out there across the country.”
Many immunization records are fed into the state’s registry directly from a doctor’s electronic health record system, Kurilo said, which can present technological stumbling blocks: “Is [the data] routinely captured as part of the registration process? Can they capture multiple races, which I think is something that’s become increasingly important going forward?”
When asked about historic rates of compliance and how they planned to gather information on race and ethnicity of vaccine recipients this time, health departments from Georgia, Texas, Illinois, Florida and California didn’t respond.
Maryland’s state plans indicate it intends to use information gathered through its vaccine appointment scheduling system, including demographic data gathered from recipients, to direct its communication outreach efforts. The Maryland Department of Health, which didn’t provide more detailed information, said it is “currently exploring all options as far as vaccine data reporting.”
North Carolina’s immunization records system routinely collects race and ethnicity information, and a spokesperson told ProPublica it has that type of demographic data for 71% of people in the system. Stephanie Wheawill, director of pharmacy services at the Virginia Department of Health, said that providers will be “asked to record that information” but didn’t elaborate on how the department planned to encourage or enforce compliance.
Data fields for vaccine recipients’ race and ethnicity are standard in New York, a spokesman said. But the state didn’t provide any details about rates of compliance in supplying that data.
“You’ve got to have the data to compare,” said Martha Dawson, president of the National Black Nurses Association and an associate professor at the University of Alabama at Birmingham’s nursing school. “Because if you don’t have the data, then we’re just guessing. There’s no way to know who received it if you don’t take the data.”
There is tension between gathering enough data to understand the extent of the rollout and the possibility that asking for too much information will scare away people who are already leery of the vaccine.
“The biggest concern people have is how will this information be used?” said Lee, from the CDC’s advisory group. “People need to trust that the data will be used with a good intent. “
Rothholz, with the American Pharmacists Association, said there could be ways apart from state registries to estimate vaccine uptake among minorities. “If I’m a community pharmacy in a predominantly African American community, if I’m giving away 900 or 1000 vaccines, you can track penetration that way,” he said. Geographic-based analysis, however, would depend on the shots being distributed via community pharmacies rather than by mass vaccination sites — a less likely scenario for the Pfizer vaccine, the first to be administered, which requires ultracold storage that will be difficult for many small pharmacies to manage.
It Will Be Up to Doctors and Community Leaders to Encourage Trust
The best way to help a worried individual, whether scared about data collection or the vaccine itself, is a conversation with a trusted caregiver, according to Dr. Susan Bailey, president of the American Medical Association.
“Time and again it’s been shown that one of the most valuable things to encourage a patient to undertake a change, whether it’s stopping smoking or losing weight, is a one-on-one conversation with a trusted caregiver — having your physician saying, ‘I took it and I really want you to take it too,” she said. “But patients have to have the opportunity to ask questions, and not to be blown off or belittled or feel troublesome for asking all their questions.”
“If someone says that they’re afraid of being a guinea pig, maybe drill a bit deeper,” Bailey suggested. “Ask, ‘What are you concerned about? Are you concerned about side effects? Are you concerned that not enough people have taken it?’”
The American Academy of Family Physicians uses the mnemonic “ACT” to guide their members in conversations with patients of color, president Dr. Ada Stewart said in an email: “Be Accountable and Acknowledge both historical and contemporary transgressions against Black, brown and Indigenous communities. … Communicate safety, efficacy and harms such that individuals can weigh their own personal risk to potential benefits, and exercise Transparency with regard to the development of vaccines and the distribution process.”
David Hodge, associate director of education at Tuskegee University’s National Center for Bioethics in Research and Health Care, urges Black and brown leaders such as pastors and community organizers to take control of the messaging right now and not wait for their local governments to tackle the issue.
“We’re not in a position right now to be patient. We’re not in a position to sit on the sidelines, we have to make it happen.”
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Getting to know the critically ill patients they’re taking care of is hard enough for ICU doctors under normal circumstances. But it’s even worse during COVID-19.
Not only are there no visiting family members to give you information, “but the patients are all similar in terms of their medical issues, they’re all on a breathing machine, and many are lying on their bellies,” explained Brian Garibaldi, MD, associate professor of medicine and anesthesiology at Johns Hopkins Medicine and director of the isolation unit at Johns Hopkins Hospital in Baltimore, in a phone interview. “You might go for days without examining the front side of their body, so we’re not seeing their face. That makes establishing connections with patients a little more difficult.”
An Idea From the Chaplain
One day Garibaldi was talking to Elizabeth Tracey, a chaplain at the hospital who also is director of audio production at Johns Hopkins Medicine — someone very familiar with audio recordings. She had an idea: how about if she interviewed patients’ family members and made a recording of what they say? “I could edit it down to a few things families really want their doctors to know about their loved one,” she said. Garibaldi was immediately on board.
In a separate interview, Tracey — who also edits and appears on MedPage Today‘s TTHealthWatch podcast, said she had heard from a chaplain colleague who told her that a physician had said after an extubation of a terminal COVID-19 patient that “I realized I didn’t know anything about this person; I didn’t know if he had children, if he was married. I didn’t know anything.” So why not give the physicians and the rest of the healthcare team personal details — “Do they have a dog? Do they like to play poker? It’s all the things that make them human,” said Tracey.
Tracey said Garibaldi emphasized one thing: “The only way this is going to work is if it’s in the voice of the family member.” So Tracey began calling family members and saying, “Hey, I’m part of the team helping take care of your loved one … Under normal circumstances you’d be here in the ICU telling us your loved one’s story. The team would like to know your loved one better as a person; would you like to spend 15 to 20 minutes talking about them?”
So far, only one person has turned her down since Tracey began doing this in April, and that was because they didn’t like the sound of their recorded voice, Tracey said.
After getting the family member’s permission, she records the phone call and edits the comments down to 2 or 3 minutes; she estimated that she has completed 30 to 40 recordings so far. Currently, the recording is distributed to the medical staff by an administrator at the hospital, although she hopes to eventually get it added as a link in the patient’s electronic health record.
A Message to the Healthcare Team
Tracey also added a second component: the opportunity for the family member to send a recorded message directly to the patient. “I said, ‘if you were talking to your family member, what would you say? Talk to them directly.'”
“They say these things that are just unbelievable,” said Tracey. One mother recorded a message for her adult daughter, whose autistic child the mother was the custodian of. “She says, ‘I want you to know that everything is forgiven,'” said Tracey. “How can you have a more powerful example of love?” Those conversations also are edited down to 2 minutes and played for the patient.
The recordings for the medical staff are very helpful, said Garibaldi. “Just learning the simple things — What would they prefer to be called by if I met them in the grocery story? What hobbies do they like? What favorite music can we program on an iPad to keep them awake and stimulated during the day? Also, learning things like what that person has accomplished in their personal and professional life; it really puts things in perspective, to put their current illness in the context of where they’ve been, where they are, and where they might want to be going.”
Dale Needham, MD, professor of pulmonary and critical care medicine at Johns Hopkins, agreed. He noted that although the medical staff speaks with patients’ family members every day, “those conversations have to be efficient and focused, whereas Elizabeth has the luxury of spending more time, and distilling it into an audio file that we can listen to and understand and easily share.”
For example, Needham said, “we found out that one patient previously had worked at a Smithsonian museum, and we found out that one of our patients likes to tango. And we found out that one of our patients that we wouldn’t have expected — was a DJ” on the weekend, while he had a white-collar job at a law firm during the week.
“This can help us understand who the patient is, and as the sedation is lightened, it helps us interact with them in a more humanized way.” It’s also mutually beneficial because the families are aware that the staff knows a little about their loved one, he added.
“What a Gift She Gave Us”
Barbara Johnson, whose late sister was a COVID-19 patient at the hospital, agreed. “I thought it was an incredible opportunity, given that none of us could see my sister,” said Johnson, of Silver Spring, Maryland, who did a recording for her sister and one for the medical staff. (You can listen to the recordings in the player above; her recording for her sister Beverly is first, followed by the one for the healthcare team at 3:25.)
When she spoke with Tracey for the recording, Johnson said she was thinking about her sister, “What would I have said if I got to talk to her” the day she was intubated? “What a gift Elizabeth gave us.”
Regarding the recording for the medical staff, “I think that when you take away the family from a hospital room, it might be hard for doctors and nurses to relate to the individuals, and the fact that they wanted to was really quite powerful for me,” Johnson said. “I really wanted them to know what made her happy, and if she was there talking to them, what would she have told them? … I also wanted them to know — in case she woke up — that she was the kind of patient that would tell them what they wanted to hear. If she was not feeling well and wanted them to feel good about their job, she would say, ‘I’m doing great.’ So I wanted them to know, just read between the lines.”
Tracey has recruited several dozen additional volunteers — including chaplains and medical residents — to make the phone calls and edit the recordings. She also has expanded the service — which she calls “This Is My Story,” or TIMS — to include other patients in the hospital, since they also aren’t getting visitors during the pandemic. She said she hoped that other hospitals would adopt the practice.
Within the hospital, “there’s definitely a lot of enthusiasm from the medical units and also an enthusiastic response from pediatrics,” she said. “What parent wouldn’t want to record ‘Green Eggs and Ham’ for their kid?”
Sharon Tapp learned that a severe case of COVID-19 can threaten not only your life but also your sense of self. After a lifetime of good health, COVID transformed Tapp from a busy nurse case manager into a comatose ICU patient attached to a feeding tube and ventilator. Sharon fought for her life for 117 days. By the time she regained consciousness, her world had changed. “I was just like a newborn baby in a diaper,” she says. “I took care of everybody. Now, everybody wants to take care of me.”
At first, 60-year-old Tapp, who works at the VA Medical Affairs Center in Washington. D.C. lost her sense of taste. When she started suffering common COVID symptoms such as headache, chest pain, fever, and chills, she went to an urgent care clinic and was tested. Five days later the clinic informed Sharon that she had tested positive for COVID-19, and her boyfriend took her to their area hospital. After being admitted to the ICU, though, her condition became so serious that doctors transported her by helicopter to Johns Hopkins in Baltimore. There, physicians placed her in a medically induced coma and connected her to a ventilator.
Tapp survived the ventilator, pneumonia, and heart and lung failure before she rallied. Finally, she moved to an acute rehabilitation hospital, where she spent three weeks working to overcome the muscle breakdown and overall physical debility caused by the lengthy time she spent in a coma (she even had to learn how to swallow again).
Her recovery will be slow, as she is facing both physical and cognitive challenges, but Tapp is determinedly pursuing her speech, physical, and occupational therapy. She is using a rolling walker and a quad cane while regaining her sense of balance and building her strength to walk again. Sharon has a powerful goal in view: she is looking forward to her eventual return to the hospital (as a nurse). After all, nursing is part of who she is: “I like helping people. That’s just my nature. I really enjoy when they get better and I have something to do with it.”
