When a 7-year-old answers her apartment door to discover two Ghostbusters clad in protective gear and heavy-duty backpacks, what does she do?
If she’s a patient at St. Jude Children’s Research Hospital, she probably invites them in to see her toys.
That scenario plays out often in St. Jude housing facilities, now that nurses are visiting patients’ rooms and apartments to provide routine care. It’s one of many ways the hospital is preventing the spread of SARS-CoV-2, the virus that causes COVID-19.
“We look like Ghostbusters,” admits Teresa Neal, RN. “We wear isolation gowns, masks and goggles, shoe coverings, head coverings and gloves.” The team is also laden with backpacks, carts and coolers that contain all the supplies they require as they move from room to room.
Soon after COVID-19 emerged in Asia and began its relentless global march, St. Jude leaders looked for ways to halt its progress. Staff gathered supplies, created and implemented new procedures, and brainstormed innovative ways to protect St. Jude patients and families.
The results include a team of nurses deployed to patient and family housing facilities. That means fewer patients go to campus for routine bloodwork or central line care. Instead, the care comes to them.
“If we can keep families in their homes, then we can help all the patients stay safe,” says Tricia Mamer, RN, nurse manager in the St. Jude Outpatient Clinics.
Tools and talent
Every day, people throughout the hospital pull together to ensure the nursing corps’ success. Families are contacted, schedules are verified, and armbands and labels are printed. Nurses double- and triple-check each chart to ensure they have the right number of tubes, needles, bandages, medications and other equipment.
Arriving at a housing facility, the team breaks into pairs. Each person dons personal protective equipment, which must be removed and discarded after every appointment.
“We are truly on the front line,” Neal says. “We don’t know if these kids or their families have the virus when we walk into their rooms.”
By the end of the day, the nurses who volunteered for this assignment are wilting with fatigue after working in stifling isolation gowns and masks.
“When they return to campus, their hair and clothing are drenched,” says Julie Morganelli, RN, of Assessment Triage. “But through all of this, they don’t complain.”
The approach is a hit with families. Parents appreciate that their children can remain safely at home, and many of the patients enjoy having visitors.
“Some of the children do a lot better in their own environment,” says Shana Ramey, an LPN who usually works in Assessment Triage.
Line care nurse Teresa Neal, RN, cites one child whose anxiety seems to have disappeared altogether.
“In the clinic, it used to take four people to do a dressing change for her,” Neal says. “But when we go to housing, she sits in a chair and her mother holds her hand. It goes smoothly because the little girl feels safe in her own home.”
Patients who enjoy sleeping late welcome the change in routine.
“A couple of times when we’ve arrived to see teenagers, they’ve been sound asleep,” says Shelly Veloz, LPN. “We draw their blood, and they go right back to sleep.”
Laughter on the front lines
Members of the nursing corps say they find joy in their labors. Their day is peppered with laughter. Instead of focusing on the hardships, they mention the visceral moments. The routine appointment that yields a poignant conversation. The scent of fresh-baked empanadas wafting through a patient’s apartment. The relationships they’re building with the families and with one another. The refreshing bottles of ice-cold water gulped at the end of an exhausting day.
“These nurses have stepped out of their comfort zones,” Neal says. “They’re making sacrifices, and they’ve done it with grace and with pride for the institution.
“They’ve really gone over and above to make sure our kids are safe.”