Above and Beyond the Call of Duty: CNO reflects on COVID-19

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“I can remember thinking late last fall as the news was coming out of China about this virus – ‘Get ready because that’s headed here!’”

That’s the reaction Cheryl Gagne, DNP, MBA, RN, CNE-BC, Vice President of Patient Care Services and Chief Nursing Officer for Southern New Hampshire Health had as news about COVID-19 spreading across continents was ramping up just after the New Year.

“As we started to see cases emerge in the United States, it became more real,” she says of the COVID-19 virus. “And then we started to prepare.”

Southern New Hampshire Health’s Incident Command team, along with Gagne, quickly went to work preparing to care for COVID-19 patients. It was somewhat familiar work as health care providers routinely update policies and procedures as new viruses emerge. In fact, just a few years ago, the team convened to prepare for the possibility of Ebola virus disease. What was less familiar was the threat of “surge” and what kind of response that would require in terms of resources – human and equipment. 

“We did a lot of the same things to prepare for COVID-19 as we did for Ebola,” explains Gagne. “We started screening patients about recent travel, identified isolation areas for patients presenting with COVID-19-like symptoms, reviewed personal protective equipment (PPE) use and availability, and then waited. We never saw any Ebola infected patients at Southern New Hampshire Health, but with COVID-19 we didn’t have to wait long. The first patients with the virus began to arrive by mid-March.”

At that time, the Medical Center activated the Incident Command team whose attention quickly turned to PPE. Nation-wide shortages of surgical masks, N95 masks, gowns, face shields, and cleaning supplies dominated the headlines. Inconsistent images of protective practices at different hospitals and in different countries became another source of concern. A plan to manage PPE was devised and put into place.

“This was not just about nurses. Inpatients are touched by just about every service in the hospital. They need to have food, clean rooms, diagnostic testing, medications, and other therapies,” says Gagne. “But nurses are the ones who spend the most time with patients.”

Understandably, many nurses at Southern New Hampshire Health expressed concern about caring for patients with COVID-19. They worried because so little was known about the virus and how it was transmitted. In response to the pandemic, one of the best things nursing leadership did for staff was to establish a process for daily rounding. At the height of the pandemic, rounds were conducted multiple times a day to answer questions and provide the most up-to-date information. Another great thing that was done to ease their concerns was to provide access to debriefing sessions with our behavioral health providers.

All essential workers coming to work at Southern New Hampshire Health rose to the challenge. In order to meet the potential for increasing demand, clinical areas were re-purposed and some staff were re-assigned to expand critical care capabilities. Teams also came together and collaborated in new and creative ways, such as using tablets for virtual family visits and continuous monitoring of patients.

What was unexpected was the outpouring of caring and compassion from the community to our staff in the form of care packages, food, home-made masks, and notes of thanks and encouragement. All of this has been greatly appreciated by our staff and it has helped to keep them going during this uncertain time.

Today, the pandemic continues. Gagne stresses the importance of continued vigilance both within and outside the hospital walls. But if a second surge should occur, she knows staff are ready, willing, and able to care for anyone who may require hospitalization.