We see the unforgettable scenes play out on our television sets each night. Scenes that appear to be the brain-child of some Hollywood producer, certainly not accurate portrayals of the reality facing places like New York or New Orleans. However, the unsettling truth is that there are healthcare facilities that currently lack the healthcare capacity to meet the exponential demands of patients afflicted with the COVID-19 virus. These facilities have been overwhelmed with a daily inpatient census far beyond the usual bed count. Specifically, there is a lack of ventilators, personal protective equipment, and personnel to care for community members most impacted by this pandemic. Furthermore, nurses on the front line of the coronavirus fight have now begun to fall ill, causing a shortage of medical professionals to care for the sick.
In Arkansas, we are closely following Governor Hutchinson and the Secretary of Health’s daily briefings on how the COVID-19 virus is negatively impacting our state. So far, the numbers remain manageable. We have, for the most part, been able to keep the trajectory of viral spread well below the anticipated curve. Even though reductions in elective surgeries and fewer patient visits have led to unprecedented layoffs and furloughs of healthcare workers, these individuals will surely become the future soldiers needed on the front lines.
On March 11th, 2020, Governor Edwards declared a Public Health emergency in Louisiana related to COVID-19. To date, the Louisiana Department of Health has reported a total of 17,030 COVID-19 cases with 1,983 patients who are currently hospitalized. Furthermore, 490 patients are being mechanically ventilated and sadly 652 Louisiana COVID-19 patients have died during this pandemic.
I recently had the opportunity to speak with Dr. Linda Tate, PhD, APRN, from the Central Arkansas Veterans Healthcare System (CAVHS). Linda is part of a group of CAVHS nurses who heard the cry for help from their fellow VA nurses in Louisiana, and selflessly pledged their services, much like the veterans that they serve. Her role as the Palliative Care Coordinator at CAVHS doesn’t appear to be the most logical fit for the need for beside nurses, however, Linda is first and foremost a NURSE. Though her years of training, education, and expertise have put her in administrative roles, ingrained fundamental nursing skills such as physical assessments and medication administration, coupled with years of specialized training, have expertly prepared Linda for the current COVID-19 battle.
Linda began telling her story by sharing how she was greeted by her fellow colleagues when first arriving in New Orleans. She recalled being greeted with overwhelming gratitude by visibly exhausted nurses who had been struggling to save gravely ill coronavirus patients. The scene was something that Linda Tate had never before witnessed throughout her nursing career.
Linda explained that the orientation process was much less involved for her and other CAVHS nurses because they were already familiar with the policy and procedures of the VA healthcare delivery system. The first day included completing an overall facility orientation where she learned about relevant policies/procedures and the location of various departments such as the pharmacy, laboratory, intensive care unit (ICU), and COVID areas. On the second day, the CAVHS nurses were paired 1:1 with a nurse already employed in the Louisiana VA facility. Day three was spent helping in the triage area, where patients were screened for COVID symptoms. According to Linda, these first three days allowed the team of Arkansas nurses to better understand the flow of patients from triage to the appropriate level of care within the healthcare facility. Optimizing patient flow is important because the healthcare staff can quickly and efficiently move patients from the emergency department (ED) to other areas of the hospital thereby improving coordination of care and patient safety.
As Linda prepared for her next day, I asked her if she was nervous. She responded in a very calm manner and stated that, “…although the nature of this virus may be different [from] what we are used to treating, at the end of the day, our patients still need the same thing from us. [That is] compassion mixed with a commitment to provide safe care, whether that is treating cancer or a virus.”
Linda’s background in Palliative Care uniquely prepared her to implement effective strategies to meet the psychological needs of the veteran population. She assured me that every veteran who is triaged is asked the following screening questions: “How are you handling this current crisis? Do you need to talk to anyone?” She recognized that, especially in a patient population with a high incidence of post-traumatic stress disorder (PTSD), it is important to treat the whole person by supporting the veteran’s emotional, social and spiritual needs as well as medical symptoms. Likewise, meeting the psychological needs of the healthcare workers is being placed as equally important. Linda explained that there is a concerted effort made by the administration at the New Orleans hospital to reach out to the healthcare team each day and ask “Are you ok? Do you need to talk to anyone?”
Arkansas Center for Nursing recently put out a survey for nurses who have experienced a change in their normal roles and duties. To date, nearly 500 nurses from around the state have completed the survey. Many of these nurses, just like Linda, have been asked to transition to another role to meet the needs and surge of ill COVID-19 patients at various healthcare agencies. And, just like Linda Tate, many nurses are accepting the challenge with courage, compassion, and a commitment to fulfill their calling. We SALUTE these TRUE healthcare HEROES!
Linda Tate, PhD, APRN is a graduate of Arkansas State University and the University of Arkansas for Medical Sciences.