As a hospice nurse in Seattle, Diane Speer mentioned giving out hugs to sufferers and members of the family was a routine a part of residence visits.
But within the midst of the coronavirus pandemic, she now tells members of the family to maintain their distance.
“There’s no touching hands or handshakes,” mentioned Speer, who works for Renton, Washington-based Providence St. Joseph Health. It’s “time for a virtual hug.”
Hundreds of hundreds of well being care staff like Speer go into houses across the nation to supply important providers for seniors and disabled folks. But with rising considerations concerning the coronavirus and the actual hazard it poses for older adults, these staff could possibly be endangering their sufferers and themselves.
“There is the knowledge that these are health workers who have skills that can benefit you, but the fear is the health care worker: Who is the last person they saw and where have they been lately and are they bringing something into my home?” mentioned Dr. Thomas Schaaf, chief medical officer for Providence St. Joseph’s Home and Community Care division.
Hospice and residential well being nurses, residence care aides and momentary nurses are stepping up protecting measures. These embrace calling sufferers at residence earlier than they go to to see in the event that they or anybody within the family have a fever or different signs of COVID-19, the illness brought on by the virus. They’re additionally washing arms in entrance of sufferers and sporting masks and different protecting gear to scale back infections and to make sufferers extra comfy about their precautions.
Still, residence well being suppliers say they’re seeing some sufferers flip them away for worry of getting the virus.
“It’s been quite a challenge — we’ve had patients discharged from the hospital for a home health referral who have refused to have our caregivers come in,” Schaaf mentioned.
Providence nurses go to sufferers at residence, nursing houses and assisted dwelling services. Visits are sometimes vital for wound care, to make sure sufferers are taking their medicines and to evaluate if a affected person’s housing is protected to attenuate falls and different risks.
He mentioned his giant well being system has been attempting to maneuver care visits — resembling these achieved by social staff or chaplains ― to telephone or video conferences.
“We are trying to balance the clinical needs of the patient with the need to limit contact as much as possible,” Schaaf mentioned.
‘Flying By The Seat Of Our Pants’
Marie Grosh, a nurse practitioner in Cleveland who calls on aged sufferers at residence, mentioned she has shifted her schedule in order that she now sees sufferers with communicable illnesses on the finish of her shift to scale back an infection dangers to others. She’s additionally stopped visiting sufferers who want solely a checkup and don’t have instant acute points.
When visiting sufferers, she now not sits down or places down her bag of medical provides to scale back the chance of coming involved with germs or spreading an infection.
“I am going from home to home. If I get sick, I can get over it, but I can’t risk taking anything from one home to the next home I am going to,” Grosh mentioned.
“We are all trying and flying by the seat of our pants,” she mentioned of looking for one of the simplest ways to maintain seeing sufferers whereas lowering an infection danger.
To alleviate sufferers’ anxieties, Schaaf mentioned, nurses wash their arms within the residence as an alternative of utilizing hand sanitizer of their automotive. They are additionally calling sufferers forward to see if they’ve any potential COVID-19 signs, resembling fever, and, if current, they put on masks and gloves.
Dr. Amy Moss, a senior vp at Baton Rouge, Louisiana-based-Amedisys, a big residence well being, hospice and private care chain, mentioned it’s crucial for workers to be utilizing commonplace infection-control protocols resembling hand-washing to guard employees and sufferers.
“Health care workers prepare for this scenario from Day One of their careers,” she mentioned.
Payment strategies range for well being aides. Most insurers cowl residence well being and hospice, though sufferers could have a copay. If the go to isn’t made, the supplier can’t invoice for the service.
Training Temporary Workers
As hospitals gear up for a surge in sufferers, staffing corporations that make use of momentary nurses say they’re seeing an uptick in demand. But having nurses rotate out of varied well being services may improve the an infection danger, mentioned Saskia Popescu, a senior an infection prevention specialist at HonorHealth, a big well being system in Phoenix.
“The more people you are exposed to in the hospital, the higher the risk,” she mentioned.
But she added that the chance is mitigated when hospital staffers be sure that momentary staff observe the hospital’s infection-control guidelines. “When you are using contracted staff, you are dependent on that staff member having the right education and training,” she mentioned.
The downside for providers offering nurses in sufferers’ houses or services utilizing momentary nurses is these staff could not have the identical infection-control coaching as nurses in higher-risk areas, resembling hospital emergency rooms, she mentioned.
“I don’t feel like we give them as much attention when it comes to infection control,” Popescu mentioned. “And they may not know where the risks are.”
Lynne Gross, president of RNnetwork, a nursing temp company based mostly in Boca Raton, Florida, mentioned her nurses must fill out a survey and attest that they’re in good well being and haven’t knowingly been uncovered to the coronavirus earlier than beginning a brand new project.
“If they have any flu-like symptoms, they have to wait out a two-week quarantine period,” Gross mentioned.
Personal aides who assist sufferers at residence with nonmedical wants, resembling getting ready meals and dressing, are additionally taking new precautions.
“Our staff is doing a lot more cleaning and wiping down of surfaces in homes, with disinfectant,” mentioned Lawrence Meigs, CEO of Visiting Angels, a Bryn Mawr, Pennsylvania-based firm that gives residence care and has about 600 franchises throughout the nation.
He mentioned the aides are nonetheless making visits.
“We consider our caregivers essential personnel,” he mentioned.
