SARS battle prepared nurses to take on COVID-19
Lessons learned by three Hôteldieu Grace Healthcare (HDGH) leaders when they were frontline nurses during the SARS epidemic in 2003 are informing measures they now take to help keep patients, staff and the community at large safe during the current coronavirus pandemic.
With 586 confirmed cases and 49 deaths in Windsor and Essex County attributed to COVID -19 as of April 29, the local impact already far outstrips Ontario’s 375 recorded cases and 44 deaths related to SARS (severe acute respiratory syndrome) during its entire course. The gravity and swift spread of COVID -19 has healthcare workers on high alert, on and off the job.
“SARS taught us lessons in preparation and infection control practices,” says Margareta Campigotto, chief nursing officer at HDGH at 1453 Prince Rd. in Windsor. “There will be lessons learned from this pandemic, as well.”
Back in 2003, she was working at the Ouellette Avenue hospital and in the U.S. “SARS was a very stressful time,” Campigotto recalls.
Staffing shortages challenged nurses with “heavy workloads and double shifts due to deterioration in nursing human resources capacity in the years leading to the SARS outbreak. Hearing about the epidemic’s impact to healthcare workers in Toronto, we were fearful ourselves and worried we’d bring the virus home to our families,” she says.
“We were not provided with a lot of information on transmission and prevention strategies during SARS. The only information we received was from hospital memos, or what we heard on the news. Today, numerous scientific resources are available which provide evidence-based best practices and guidelines on COVID-19 virus.”
Unlike in SARS, today we have better emergency preparedness plans and great community collaboration. Staff are better trained on hand hygiene and PPE, social distancing, better screening practices to assess staff and patients for any signs and symptoms and better data and resources to guide our practices.
Campigotto and other local chiefs of nursing along with community partners meet at a virtual regional table often to discuss strategies for empowering local hospitals to function optimally. Windsor Regional Hospital (WRH) attends to acute and emergency cases, whereas HDGH provides strictly post-acute care services including palliative care, rehabilitation and mental health.
To alleviate COVID -19 strain on acute care hospitals, HDGH added 72 new patient care beds. “We have also hired a number of new staff to support patients decanted from the acute care facilities,” Campigotto says.
Optimizing capacity from March 1 to April 15, 2020 has enabled HDGH to admit 291 patients who were receiving acute care at other local hospitals and at the same time discharge 332 patients with the assistance of community partners. Everyone has worked extremely hard to assist our acute care partners to ensure they have the bed capacity to deal with patients admitted with COVID -19.
Healthcare providers such as nursing staff, social workers, exercise specialists and other staff from HDGH’S temporarily deferred programs were trained and redeployed to assist with bathing, feeding and ambulating patients as well as assisting with screening at door entrances.
With the hospital in lockdown, visitors are restricted unless the patient is palliative. To assist patients with the social isolation, HDGH’S family support team is using tablets so people can visit virtually with their loved ones.
“Now that the weather is growing nicer, the team is organizing courtyard visits with patients and families outside at a safe distance.”
Acknowledging that “hearing about COVID-19 deaths on the news is depressing,” Campigotto says, “I think the pandemic is taking a toll on everyone.”
She misses being with her grandchildren and her family. When delivering groceries to her high-risk mother, the nurse stays more than six feet away and wears a mask.
“I know some of my staff are sleeping in separate bedrooms or other facilities to keep their families safe. Our community has done an excellent job preparing for the pandemic. Even so, I don’t think anyone expected it to be of this magnitude.” Campigotto reflects.
‘WE’RE ALL VERY CAUTIOUS’
Nurse practitioner and frontline SARS veteran Shauna Carter appreciates the efforts of patients, their families and healthcare workers during COVID-19.
“Testing and screening is important, but to ensure prevention of transmission of virus, we must act as though everyone has the disease,” Carter says. “This is such an evolving virus and pandemic, as new information about COVID 19 has become available we have been continually receiving updates from Public Health Ontario (PHO), and our leaders at HDGH have been very transparent and timely in updating staff daily on any new changes in recommendations.”
Nursing staff who worked at more than one healthcare facility were mandated to choose one workplace.
“It was the responsible decision to contain community spread; however, it was hard for nurses to choose one workplace, knowing their patients count on them,” Carter observes.
She is grateful for the access to electronic records and the Ontario Telehealth Network, and the ability to conduct rounds virtually, so that she is able maintain her other roles in providing regular care for her residents and patients at the Village at St. Clair and VON Pelee Island nursing station. “We did not have such advanced technology during SARS”.
Some of HDGH’S Registered Nurses and Registered Practical Nurses have volunteered to be deployed to local retirement and nursing homes struggling with staff shortages, which aligns with HDGH mission of serving the healthcare needs of our community.
With halls emptied of most visitors and some hospital services on hold, HDGH has still been very busy accepting higher volumes of admissions and safely discharging patients home to help our partnering acute care facilities build capacity should a surge of COVID occur.
“Although we do not have an ER or ICU and may not be seeing the patients with acute COVID symptoms, our staff, patients and families have felt the impact. One of the starkest differences between SARS and COVID is the length of lockdown and visitation restrictions,” says Carter. The hardest part of this journey was telling patients family members that they could no longer come to visit. Our patients family members are more than visitors, they are an extension of our patient’s healthcare team, assisting in meeting the crucial psychosocial, physical and emotional needs of our patients.”
Our local community of Windsor-essex has continued to ensure healthcare workers and patients know their community is there for them, however. Restaurants and organizations send healthy snacks and meals. Homes and businesses display hearts and thank you messages. When a convoy of Canada Post trucks honked their way through the HDGH’S parking lot, a rash of grins broke out among staff.
“It all means so much to us. Such morale boosters!” Carter says.
Sharing the love, HDGH staff formed their own vehicle parade on April 25 and drove by their hospital and some long-term care homes.
In this time of pandemic, National Nurses Week, which began on Monday, takes on even greater significance, underscoring how truly essential nurses are.
Colleagues are buoyed by weekly in-person visits to every department made by Janice Kaffer, HDGH President and CEO.
‘TOGETHER WE STAY STRONG’
Kaffer vividly recalls being a frontline nurse manager at a Peterborough hospital during the SARS outbreak. “I remember the impact it had on my family.”
After catching a TV news story reporting the Sars-related death of a nurse, “my young kids asked me often, ‘Why do you have to go to work?’”
Says Kaffer: “I know our staff today are hearing that same question from their own families – and we are working hard to ensure they can say with some assurance that HDGH is doing everything we can to keep them safe.”
On the hospital campus, people wear T-shirts with a heart logo, local hospital colours and the words “Together We Stay Strong.” Kaffer believes the message is “a reflection of the way HDGH, WRH and Erie Shores Healthcare are working so well together.”
“I’m proud of what we have done to protect our patients and ourselves. And I’m especially proud of our own nurses who do it all with empathy,” Kaffer says.
To learn more about Hôtel-dieu Grace Healthcare, its team and its COVID -19 response, visit hdgh.org or Facebook.com/hdghf.