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During this unprecedented time when COVID-19 is affecting everyone in some way, one of the biggest worries that health care workers and lay people are focusing on is how medical centers and hospitals are keeping patients and their workers safe.
Anne Dabrow Woods, DNP, RN, CRNP, ANP-BC, AGACNP-BC, FAAN, is Chief Nurse of Health Learning, Research and Practice, Wolters Kluwer. In addition, Dabrow Woods is also a critical care nurse practitioner at a large health system in the Philadelphia area, and Adjunct Faculty for Nursing and Health Professions a private research university with its main campus in Philadelphia, PA. She took time to answer our questions about what hospitals and medical centers are doing to keep patients and health care workers safe.
What are hospitals currently doing (or should do) to keep patients and their workers safe right now?
To ensure the safety of all clinical staff and patients, many hospitals have restricted visitors entirely to prevent COVID-19 from unknowingly entering the building. This measure is also helping sustain the availability of personal protective equipment (PPE) for hospital staff, which otherwise would need to be shared with patient visitors, amid a national shortage.
Hospitals have also established screening measures for staff entering the building for their shifts. As soon as they walk-in, employees have their temperature taken and are encouraged to disclose if they are or have been experiencing any symptoms related to COVID-19—such as dry cough and fever.
Upon entry into the hospital, all staff members must then don a mask and wear it while they are in the building. When with patients, staff must properly use personal protective equipment (PPE) based on the patient’s infection control precautions. In addition, hospitals have established hotlines for staff to call if they think they have been exposed. The hotline, which is typically monitored by an infectious disease specialist, assesses whether the health care professional is at a low, medium, or high risk and determines the appropriate response measures for the hospital and for the individual employee.
How bad is the current situation right now in health care facilities?
The current situation is very serious, especially in areas with large outbreaks. New York, Massachusetts, California, and Louisiana are just a few examples of states that are reporting widespread transmission to the CDC. These areas are critical zones that are experiencing a shortage of PPE and other equipment such as ventilators, with facilities reaching capacity while trying to accommodate a growing surge in infected patients.
To address this situation, some facilities have set up triage tents outside of the property’s main entrance for screening, as well as have begun utilizing a single ventilator, in some under-supplied areas, to ventilate two patients of similar size and lung capacity. Hospitals have also begun implementing alternative staffing models, such as fast-tracking training for staff that are outside of critical care expertise, but can provide a helping hand—including many fourth-year medical students, nurses from other areas, and recently retired nurses and physicians (who have also been asked to rejoin the workforce).
It is important to note that the impact of COVID-19 and the required safety measures have also created a unique and unfortunate situation where many patients are made to die without their loved ones by their side. As health care professionals, we do our best to provide comfort, holding the hand of our patients, and making sure they are not alone at the end.
What are nurses doing to keep everyone safe? How are they coping?
To keep everyone safe, nurses are following strict safety protocols and working as a team, now more than ever. Collectively, the mentality is “Let’s do this.” We’re at war with this virus, and to effectively fight it requires putting aside emotions and working together to focus on our patients and what we can do for each patient in the moment.
To cope, we have the support of our fellow nurses and other care team members, as well as the option of utilizing employee assistance programs and social workers, who offer a great resource and comfort in times of struggle. We have also found tremendous support within our communities. Hospital staff has been so busy, and some haven’t even had the time to pack a meal or make it down to the cafeteria to eat, so when community members drop off food at the hospital entrance, it is an amazing act of generosity and one that is deeply appreciated.
What are some steps that are recommended to keep everyone safe?
The CDC issued a Comprehensive Hospital Preparedness Checklist to help hospitals assess and improve their preparedness for responding to COVID-19, but an essential step to keeping everyone safe is encouraging non-health care workers to just stay home. The best way to prevent illness and reduce the transmission of COVID-19 is to not leave your home, except to buy food and/or receive medical care.
What resources are out there that nurses can utilize in their health care facilities?
Nurses need to have the latest evidence-based clinical decision support content at their fingertips, so they are taking the proper precautions in caring for COVID-19 patients. The CDC and WHO are consistently updating contact precautions as well as droplet and airborne precautions, and hospitals should ensure that point-of-care tools and evidence-based resources are readily available for frontline clinicians.
What are some things that nurses should never be doing in these kinds of situations?
During this crisis, nurses should never neglect their own care. If they don’t care for themselves, they will not be able to care for others. While nurses often run towards adversity, it is important to stop and put on protective gear before we put ourselves in harm’s way, regardless of the situation. We are at war with this virus, and therefore we need to wear the proper protective gear when going into battle. There is never an emergency that is too great to forego PPE.
Is there any other information that is important for our readers to know about keeping patients and workers safe?
I think it is important for your readers to know that we will get through this, one patient at a time. Resilience is vital for situations like this one. If we look at what we can do for our patients, not what we can’t do for them, we can reframe our perspective to think not of the of the patients we lost, but rather the many we saved.