In January 2020, a young college student returned from Wuhan after the holidays and was sent to our facility with symptoms on a Friday afternoon. This was the first probable case and we started strict 1:1 isolation with a trained observer for every entry and exit from the negative pressure room. On that weekend, I went to the hospital on both shifts of nursing to be sure all PPE was being properly don and doff and there was adequate supply. I was there to answer their questions and they were told they could page me with any questions. As an IP with 22 years’ experience, I felt they needed a lot of support and wanted to be there for them. This was all new to them as many had not experienced SARS or MERS.
I was on call on Sunday, February 9th, my pager was non-stop with calls about symptomatic people coming to the hospital. Several challenges arose based on the changing information from the CDC. How to handle the influx of symptomatic patients in the Emergency Department without adequate negative pressure rooms. Making a wing of the facility to be a COVID unit only. Working with medical staff office that all COVID suspect admissions would be admitted only under a Hospitalists so as not to expose anymore physicians and associates as possible with intent to minimize exposures. The ICU was being overwhelmed with multiple patients requiring ventilators. The nursing staff was being overwhelmed with the stress and grief of caring for these patients. The ICU nurses came up with the idea of having the IV pumps outside the room for their easy access. They called me to discuss the process and ask for approval. I thought it was a great idea and we did a small test change. The emotional aspect on the nurses was overwhelming. I received a text message from an ICU nurse at 11 pm at night expressing her dismay that this is not what she signed up for as a nurse. Her emotional status was at the breaking point. I still have no idea how she got my cell number to unload her anxieties, but I was so thankful for her feeling comfortable to express their feelings. The next morning, I went to administration to ask to get a psychologist into the ICU to help that nursing staff. I contacted one who came and sat with the nurses to help them in the initial phase of COVID. This was a partnership with ICU that was never present to this extent prior to COVID. All the nursing associates knowing they could call. We would discuss ideas in the care of the patients was a very unexpected, pleasant outcome for me as I look back at the timeline of dealing with COVID. My concern was THEIR process and what can we do to keep them safe within the guidelines. This approach helped in our success of prevention of spread among the healthcare workers. There were nurses who designated themselves as the “COVID unit nursing staff”. Their dedication was heartwarming to me. They kept me updated on issues they encountered so that as the Infection Preventionist I could work with the supply chain. Strong relationships developed with our Supply Chain Manager.
Being a Certified Infection Preventionist was a testament to my ability to deal with the Pandemic due to the respect I received from physicians. Physicians including the Hospitalists would call and have discussions about our plans for PPE shortage and we would talk about the science behind the decisions that were being made.
The CEO supported me fully and made the comment that whatever I planned was supported by him. This was the most difficult experience in my 22 years as an Infection Preventionist. Past experiences included dealing with the initial episodes of MERS, SARS, Anthrax, West Nile Virus, Ebola, Zika was also a element that helped in my approach to dealing with COVID and the anxieties of the frontline healthcare workers.
I would like to honor all the front-line nursing staff, nursing assistants, phlebotomists, radiology technicians, lab personnel and respiratory therapists who worked so diligently during the early pandemic when information changed every day. These are the real HEROs, they made me thankful for being able to make decisions to protect them and the community. As an Infection Preventionist this has been one of the worst times of my career with the rapidly changing guidelines and staying up to date and explaining to the front lines the science of the changes. It has also been one of the best times of my career in the camaraderie that developed between Infection Control, frontline HCW and ancillary departments.
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