Nurses’ Care of Patients Transforms with Coronavirus

Each patient’s room contains equipment that never leaves that room, to reduce the danger of nurses carrying the virus from a room and potentially into another, in addition to “washing their hands continuously.”

by Charles Romans, The Daily Independent, Ashland, Ky. / April 29, 2020

(TNS) -- Emily VanBibber, of Greenup, has a BSN in Nursing and is currently a manager in the emergency room of Kings Daughters Medical Center in Ashland.

The advent of the COVID-19 pandemic required numerous changes to the way KDMC treats its patients, and how the hospital staff keeps them safe while doing so.

“Before the COVID-19 pandemic, we typically admitted patients with respiratory failure, renal failure, acute strokes and things of that nature,” VanBibber said. These patients would be admitted to the Intensive Care Unit and be treated on a one-to-two basis, with one nurse caring for at most two patients, VanBibber said.

VanBibber explained that the reason behind the ratio was the considerable amount of care required for each patient. In addition to the previous category of patients, it was also common for the ICU to be sent patients from the operating rooms to be monitored post-surgery. Since the onset of the pandemic, the hospital only does emergency surgeries, so many of those previously sent to be watched over post-surgery are no longer there. This does not mean, however, that there is less work for the staff in the emergency room.

“Since the pandemic, we have opened up two more areas to accommodate these patients should we need to. Because of the complex care these patients needs, with the extra monitoring for instance, we have changed to a one on one care with our nurses. This makes much more focused work for each nurse,” VanBibber said. “And simply putting on the required PPE takes an extra three or four minutes every single time they enter the room.”

This time is in addition to the amount to time they spend disinfecting everything and attempting to group their care together. “So, we have had to completely rework the way we take care of our patients.”

There have been added measures, including a type of disinfectant wipe known to kill the virus stationed everywhere the nurses need to clean. Each room where patients are kept contains equipment which never leaves that room to reduce the danger of nurses carry the virus from a room and potentially into another. “And on top of all this they are washing their hands continuously. They are washing them so much that they are cracking open at times.”

The rigorous cleaning is designed to eliminate as much as is possible any potential spread of the virus, VanBibber said. “The hospital is even issuing scrubs, so that the nurses aren’t potentially carrying anything home with them. Nurses even keep spare shoes on the premises, to remove that threat of spreading the virus as well. “We do everything we can possible do to prevent spreading the virus to our families and the community.”

The amount of PPE required to treat patients during the pandemic is considerable. “But we have been very fortunate,” she said. “We have received a lot of donations, especially from Marathon Petroleum. They donated a significant amount and several other companies donated a lot as well. But from what I am being told, we are doing fairly well. The doctors and nurses have been told that the duration of the pandemic could lead to a shortage, however. So, they are being very cognizant of this and are conserving as much as they can, and we are reusing what we are able to. And we are able to sterilize the N95 masks to extend their life to around three days. That has been a big help in conserving our PPE.”

The treatment for COVID 19 isn’t a static procedure or length of time and varies from patient to patient.

Like most of the area’s front-line healthcare workers, VanBibber said all of the nurses, doctors, and support staff at KDMC are acutely aware of the potential spread of the virus, especially considering factors like an extended period of time (as opposed to the flu, for instance) before an individual shows any symptoms. As a precaution VanBibber’s son, Carter, is staying with his grandparents while his mother goes to work each day. “We just feel that it’s safer,” VanBibber said, though she added that she misses him terribly.

VanBibber’s sacrifice of time spent with her son did yield an unexpected silver lining, however. Her younger sister, Becca Brown, is also a KDMC nurse. She has come to live with her during the pandemic. “It’s like we just traded kids,” VanBibber said, finding humor in a difficult situation. And VanBibber added that the arrangement was her idea (though her sister agreed) because it would add another layer of protection for their family, and also eliminate one possible source of potentially spreading the virus.

Brown said, like her sister, she had always known she wanted to pursue a career in the health field. She considered becoming a doctor, or perhaps a veterinarian. She earned her nursing assistant certification before graduating high school and is currently in her second semester of nursing school, working toward a BSN. Brown said she worked two years at a nursing home (the deciding factor in becoming a nurse), and really enjoyed caring for the residents there and getting to hear the stories of their lives. Now she works full time at KDMC, a position she began late last year, and says it is a job she loves.

She said it is a balancing act to work full time and attend college (online due to pandemic restrictions) at Northern Kentucky University, but says her professors have been very helpful. The job and school keep her busy, but of course she said it is difficult not being able to visit with friends on her downtime due to social distancing restrictions. And due to often opposite shifts when she works nights and her sister and her sister’s husband work days it can get a little lonely, she said. “I would get home as they were going to work, then I’d see them as I left for work and they were just getting home. “We just saw each other in passing a lot,” Brown said. When she rotates to day shift she hopes to see her sister more, she said.

Brown said there are a lot of patients being tested for COVID-19 at KDMC.

“We have the drive-through testing at the hospital, and then the people who are having surgeries since they are opening that back up are being tested just as a precaution,” Brown said. “And then some people who come to the Emergency Room are being tested even though they might not have symptoms.”

One of the tests Brown mentioned was a rapid test, with the results coming back in two hours, that are often used on people showing a lot of symptoms. And if those tests are returned positive, the patients are sent to the COVID Unit. Another test can take two to three days for results, but with both types of tests, Brown said most have been returned with negative results.

“I fell in love with nursing when I worked at the nursing home,” Brown said. “I saw all of the impact nurses made on people’s lives, and I knew that was what I wanted to do with mine. And I enjoy the ICU even more, because you get to help people who really need you.”

Brown said that COVID-19 is a very serious issue, but she hopes people will choose to focus on the positive aspects such as the fact that most people do recover from it. “I think it would help to focus on that. Many patients are even sent home to recover.”

Still, as she said, it is something to be taken quite seriously. Brown said she looks around at her co-workers, most of whom have children, and said that she would rather take the risk herself than them. But she also knows that everyone in the hospital is dedicated to helping their patients however they are able. “Everyone is prepared and willing to do everything that is needed,” Brown said. “No one ever says something isn’t their job, because it is all our jobs and we work together.”

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©2020 The Daily Independent (Ashland, Ky.)

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