Q. What kind of preparation and precautions have you taken on to prepare for an influx of COVID-19 patients?
Phillip: We have focused our attention on droplet precautions right now, and we’ve been taking bigger strides to prevent exposure. We have been very conscious with our hand hygiene procedures as well as our PPE donning and doffing. We’ve rearranged some of the rooms and the way procedures are done in order to reduce our exposure. Overall, things are okay right now, and the volume of patients is currently manageable. We’ve spent the last few weeks doing a lot of preparation to get ready for what’s to come.
James: We’ve really increased our hand hygiene vigilance, and we’re routinely practicing how to cautiously care for COVID-19 and safely transfer patients. We’ve also been working together as a team on “clustering care”. So instead of going into a patient room a number of times, we’re coordinating care so that we can just go into a patient room once or twice to provide what’s needed, and focus on reducing our potential exposure.
How has your day to day work in the emergency department changed? What would you say to people who might be fearful about coming to the ED at this time?
Phillip: Patient volumes are down because some people are afraid to come in, but we are still seeing people for all different reasons. If you’re having an emergency, you should come to the ED. There are also emergency health lines like Tele-health and Toronto Public Health that you can talk to about your symptoms and they’ll help guide you so you can decide what to do. I understand that people are generally worried, there’s a lot of anxiety about having COVID-19, and being in the hospital in general.
James: Although patient volumes are down in the ED, we are seeing other issues, like patients who are dealing with other types of pain, or people who are homeless who are coming in with health issues because they have nowhere to go. I’m worried about how this quarantining and social distancing will play out for other health issues down the road – not just COVID-19.
Some of the patients we are seeing are very scared. They don’t just require medical treatment for the issue that brought them to the ED, but also reassurance that it’s okay that they came in, and that they will be fine if they take the proper precautionary measures.
What are some of the biggest challenges you’re facing right now as medical staff?
Phillip: We’re wearing a lot of protective gear and that makes it difficult for us to communicate with our patients. With all this PPE on, they can’t see us, our faces, our emotions, and this coupled with people’s anxiety around COVID-19 really makes it difficult for us to communicate and to get the trust of our patients. It’s not just emotional barriers, we’re now dealing with physical barriers too – we’ve had to learn how to ‘smile through our eyes’ to convey emotion to our patients.
One of challenges I face is not knowing what to expect when I next come into work. I actually feel more comfortable when I’m in the work environment. I know how many cases there are, what’s happening in the hospital …it’s when I’m out of the hospital environment that I get caught up in watching the news and start experiencing the fear and anxiety.
James: I think the biggest challenge is really just not knowing what to expect.
What makes you feel positive?
Phillip: As a team we’ve become stronger. We’re working well together, and communicating more. We’re lifting each other up and playing to each other’s strengths, and we understand that now is an important time to support each other and push away any negativity. We’re really just trying to support each other the best we can, whether that’s through teaching, guiding or just talking to each other – we’re all in it together, we will get through this together, if we focus on the things we can control, rather than the things we can’t.
James: I’m so impressed with our team. We’re working well together and using a lot of humour to manage the situation. I’m also incredibly impressed with the preparation and response of the hospital, and the staff’s flexibility and willingness to be redeployed into areas with the greatest need. This is the job that we choose, and we want to do it as safely as possible.
Mental preparation and peoples’ perception of the situation is really going to play into how they respond when they get their diagnosis. Having a positive mental attitude and trust is very important. I’m feeling positive about how willing the community is to take on the health teachings we've been giving. Patients are interested and engaged in washing their hands and learning about how to manage symptoms at home. They should feel safe to come to their community hospital when they need to.