The Impact Of COVID-19 On Nurse Communication With Patients And Families

From the moment a person enters nursing school, they’re trained to work in tandem with patients, family members, and loved ones. A patient’s recovery is always a team effort.

Yet the coronavirus pandemic threw a curveball at the way nurses must handle communication with patients and their loved ones. Gone are the days when nurses and doctors could stand in the same room as a patient and their visitors to relay health information. With physical distancing measures, visitor restrictions, and PPE requirements, in-person communication is almost nonexistent.

At Rush Copley Medical Center, Rush University Medical Center, and Rush Oak Park Hospital, technology has filled the gap.

“At the hospital, we’re used to having visitors and families at the bedside,” said Mary Applequist, BSN, RN, CNML, Clinical Manager at Rush Copley. “Sitting at the bedside has stopped, and we’ve minimized time spent with patients. Face-to-face interaction has turned to relying on different devices like iPads®, video conferencing, and phone calls.”

Even physicians and consults are using phone calls and video conferencing to communicate important care details to patients and their families.

“COVID-19 has put a wrench into how we care for patients,” said Mary Heitschmidt, PhD, APRN, CCRN-K, Director of Clinical Research at Rush University Medical Center. “Research shows families being a part of patient care improves patient outcomes — and our nurses are the glue between patients and families. But recently, we’ve really had to adjust.”

Necessary But Hard Circumstances
Throughout various Rush locations and units, daily rounds include phone calls to family members to provide updates. iPads are placed on stands next to patient beds, where family members can appear via video conferencing and spend time “next to” the patient, as if they are at the bedside. Families also use video conferencing to meet the medical team, ask questions, and in the ICU, say final goodbyes to loved ones.

“Especially for palliative patients, when family members have to say goodbye over the phone, it’s really tough on the families and the nurses,” said Blaine Stringer, MSN, RN, CEN, NE-BC, Unit Director of the Medical Intensive Care Unit (ICU) at Rush University Medical Center. “The nurses facilitate the calls, and it takes a real emotional toll on everyone.”

But if not for the technology, family members would have no way to say farewell.

In the labor and delivery unit, mothers diagnosed with COVID-19 are immediately separated from their newborns after birth. Nurses help new moms use iPad video conferencing programs during the infant’s hospitalization. And while seeing their babies on a screen is better than no contact at all, it’s not the same.

“Nurses are used to facilitating bonding between mothers and infants, but this physical separation makes that difficult,” said Louise Fazio, MSN, RNC-NIC, CNML, Clinical Manager of the NICU at Rush Copley. “The use of iPads does help, but it still takes a toll on mothers and nurses.”

Maintaining a Focus on Wellness
Recognizing the emotional and mental toll these new communication methods have on staff, Rush has implemented a number of wellness measures for its nurses. A few offerings include:
  • Rooms to decompress and relax
  • Pastoral care
  • A wellness cart that goes around the units with treats every Wednesday
  • Counseling provided to all staff
  • Bereavement representatives on hand

The Human Resources department also recognized the huge burden of lack of childcare for nurses during the COVID-19 pandemic. The department formed contracts with area childcare providers so nurses could work knowing their children are being cared for.

Thank-yous to medical staff in the form of cards and free meals have been pouring in from the beginning of the pandemic. Every department — from the COVID-19 unit at Rush Copley to the NICU and the ICU — have felt the love from nearby communities.

“We’re really hopeful that a coronavirus surge won’t happen again, but if it does, Rush is prepared,” said Mary Heitschmidt. “Our senior leadership helped us carry out a vision to prepare for this pandemic, and we’ll continue it moving forward.”

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Posted by Holly E Carpenter, RN, BSN on Sep 1, 2020 1:56 PM America/Chicago

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