More than six months into the coronavirus pandemic, Ashley Carey said she sees how it can be easy to take the virus for granted. But she was quick to say that COVID-19 still is out there.
That lesson was reinforced for Mrs. Carey, a nurse at University Hospitals Geauga Medical Center, when she and other clinical staff members assisted the Ohman Family Living Facility at Briar Hill Health Care in Middlefield. In April, the center had 31 patients with COVID-19.
“We covered shifts that some of the nurses had unfortunately fallen sick to COVID-19 couldn’t be there for,” Mrs. Carey said in a phone interview. “So, we’d come in and work 12 hours scheduled, patients needed medications so we’d do med passes. We’d help get patients ready for meals.”
Dr. Sean Cannone, the medical director for Post-Acute Care and director for home health care at UH, said the hospital network has been working with a number of care facilities like Briar Hill to find solutions to the ongoing pandemic even before businesses shut down in March.
“We were working with them ahead of the pandemic to find solutions all over Northeast Ohio, looking for skilled nursing facilities that might be able to take COVID-positive patients from our local hospital in Geauga,” Dr. Cannone said on a phone call. “[We knew] we would have a massive surge of people in the community who would be needing hospital care. Many of those would be older adults.”
Having worked with Briar to set up a new ventilator unit to help with respiratory issues in the weeks prior, Dr. Cannone said the original goal was for UH to work with the home and have some COVID-19 patients recover there. Once they got the call about a positive case at Briar on April 6, the center staff realized they needed help from UH medical workers.
Joshua Wallace, vice president of Growth Strategies at Ohman Family Living, declined to comment.
Dr. Cannone said there had been “other outbreaks in Cuyahoga County that we had just helped to manage at other skilled nursing facilities.
“So we had a little bit of experience under our belt when the call came from Briar,” he said of the care facility in Geauga County.
Dr. Cannone said the UH staff developed an operational playbook that the hospital system used in treating COVID-19 cases at Briar and other facilities.
“Some of what happened here was really innovative at UH,” he said. “The model that we created, collation between hospital facilities and the public health department, was really the model the state ran with.”
Nurses like Mrs. Carey are used to working long shifts, but she said working in a residential facility was a bit different.
“We’d get patients ready for meals,” she said. “You name it, we did it. But it’s more than that. We were a conversation, we were a hand to hold, we were a reassurance to family. Even just a listening ear for a family member that couldn’t be there. And we were a shoulder to lean on for each other, the staff.”
UH Geauga President Dr. Donald DeCarlo said there are both medical and legal logistical challenges when it comes to working with family owned institutions as compared to organizations like UH.
“The first is, is there adequate malpractice coverage? What standardizations and safety protocols are being used?” Dr. DeCarlo explained. “The two nurses we sent certainly knew how to take care of sick patients, but we needed to have them embrace going into a nursing home. It was a different environment.
“Traditionally in an intensive care unit or an emergency department, it’s a high intensity, fast-paced, critical nature. Sometimes post-acute care facilities are on the other end of the spectrum. So, we had to quickly adjust some of our providers that we sent over there, what their traditional roles and responsibilities were, and we had to pivot quickly.”
In addition to having the resources and know-how to deal with the outbreak, Dr. DeCarlo said the hospital understood what type of personal protective equipment works best against COVID-19.
“One of the things that makes COVID-19 more challenging than other viral diseases is there are a large number of people who can carry this virus and be asymptomatic but spread it,” Dr. Cannone said. “That can be difficult when you’re trying to find out who can bring this risk into this particular setting.”
Towards the beginning of the pandemic, when the Ohman cases were first reported, Dr. Cannone said one of the chief difficulties of assessing the situation was testing people in place.
“It’s hard to put into words,” Mrs. Carey said. “I remember how fearful we all were, but our fear got pushed to the side, in a way. That’s where they live every day. It was hard to help them understand what was going on and help them understand why their families couldn’t be there. The people who work there are their family and were their family, continue to be their family. We can’t take things for granted.”
Dr. DeCarlo called this situation and its resolution the “poster child” for how UH collaborates with members of their community.
“We got the go-ahead that they needed help the night before and we developed a contract between the two entities, and by 6 [a.m.] the next morning we had a couple of nurses that started helping out there,” he said.
He added that Geauga County has been on the lower end of the infection spectrum when you compare it to surrounding areas, kept low by the lack of population density and abundance of medical resources that exist within Geauga.
“I’ve worked in five different states in various types of hospitals, and the one thing that really stands out for Geauga compared to the average hospital, we do a tremendous amount of community outreach,” he elaborated.
“We do about 500 events per year,” he said. “We feel that our job in the hospital is not to just wait until you come to the hospital. Our job is to make sure you stay healthy and safe.”
Mrs. Carey said working with the patients at Ohman was life changing. “They taught me to be a better nurse and to have more compassion. We take care of people on their worst days and our bad days aren’t as bad as somebody else’s bad day. They were still optimistic, still hopeful, still staying positive even through their circumstances. It’s a scary thing to have to do but something we were called upon to do.”