We spent a majority of the first month of COVID-19 creating plans for alternate care sites for the ED to accommodate surges in patient activity. Everybody was learning. The personal protective equipment challenges were top of mind, along with thinking about how to deploy staff. We shut down elective activity; redeployed surgical teams and ambulatory teams to assist with new staffing models to care for COVID-19 patients; and rolled out new strategies, like check-in stations for employee and patient symptomatology, limiting visitors and cross-training teams.
We’ve all drilled for emergency situations, but we’ve never been in a situation where the emergency has lasted this long. Immediately, we recognized that we couldn’t keep the initial section chiefs for the emergency operations center in place for an extended duration. In total, our EOC was up for 97-plus days. We implemented a three-level emergency operations staffing plan, rotating section chiefs and incident commanders and giving people two-week breaks between their roles. That seemed to help a lot, allowing teams to take breathers and new teams to come in fresh.
There was a great deal of intensity surrounding UNM Sandoval Regional Medical Center’s first COVID-19 patient, Harold Rushton. Everything that we were learning about this virus in the beginning was with him. Eventually, we had a lot more patients. Our ICU was almost full, plus half of our fourth floor, but, as we reflect, it was because of him that we were able to implement many of our strategies, and then as more patients got admitted, those strategies became more refined.
Rushton had a fondness for pushup competitions, and his nephew Lee Rushton came up with the idea of doing “pushups to push through” over Zoom. That idea blossomed into people doing pushups around the world to support those dealing with COVID-19. Members of the ICU team did pushups outside Rushton’s room and sent a video to his family. He was a special patient for us, and, unfortunately, he passed away. Our team participated in his drive-through, virtual memorial service. They created a banner that our entire hospital staff and providers signed for the family, expressing our gratitude for trusting us with his care and our sorrow for their loss. It was a very moving time and a hard time. Each of the deaths has had a profound impact on our staff and provider teams, and of course, the families that have had to manage the dying process of their loved one while not being allowed to be present due to visitor restrictions. It has been very challenging and emotional for our team. We’ve been very conscious of ensuring that they have a chance to cry, seek counseling services and take care of themselves.
COVID-19 is going to be with us until we have a vaccine, and right now, we are trying to resume normal operations as best as we can. We have resumed surgeries and ambulatory/outpatient visits; people have gone back to their original roles. We have maintained screening and developed new processes for centralized registration. We’re making sure that we’re keeping our radar up while monitoring shifts in COVID-19 activity, to ensure that our workforce continues to be safe and that we have the resources to provide the very best care for patients.
Jamie Silva-Steele, RN, FACHE, is president/CEO, UNM Sandoval Regional Medical Center Inc., Rio Rancho, N.M. (jsilva@srmc.unm.edu).