Category: Business

Nursing Facilities Must Be A Priority in Fight Against COVID-19: Testing is Key to Prevention

A nurse checks a patient

As the COVID-19 pandemic hit the state, particularly southeast Michigan, it became clear that this virus is most severe to our senior citizens. A shocking 69% of all of Michigan’s confirmed COVID-19 deaths were people over the age of 70. The average resident in our nursing facilities is 82 years old, often with multiple medical conditions. Therefore, it is no surprise that these individuals are particularly vulnerable once the virus enters a facility.

Through June, 46% of the state’s nursing facilities have reported no COVID-19 cases, and a significant number have reported fewer than 10 cases. This raises the question of what causes the spread in some nursing facilities but not others. The answer to that question will help determine proper policy going forward to prevent and curtail the spread among this highly vulnerable population in this highly vulnerable setting.

Melissa Samuel, president/CEO, Health Care Association of Michigan

Melissa Samuel, president/CEO, Health Care Association of Michigan

Research recently released by Harvard Medical School and the University of Chicago has important findings related to COVID-19 in nursing facilities that not only help explain the primary factors causing the spread, but also what does not cause it. The studies conclude that the prevalence of COVID-19 in a community is the main predictor of the virus entering a nursing facility, with larger facility size also being a factor. It further shows that no correlation exists between significant COVID-19 outbreaks in nursing facilities and various measures of overall nursing facility quality, such as the national Five Star rating system that rates all nursing facilities based on surveys, staffing levels and quality measures.

According to David Grabowski, professor of health care policy at Harvard Medical School, “COVID-19 cases in nursing homes are related to facility location and size, not traditional quality metrics such as 5-star rating and prior infection control citations.”

Tamara Konetzka, professor of health services research at the University of Chicago, found “no meaningful relationship between nursing home quality and COVID cases or deaths.” Another study recently published in the Journal of the American Geriatrics Society reached the same conclusions.

Researchers from Genesis HealthCare, Brown University and Florida Atlantic University found that COVID-19 prevalence in the surrounding community and higher number of beds were the most significant and consistent predictors of large outbreaks and mortality rates among nursing facility residents — not a facility’s Five-Star Quality Rating or infection control citations.

At the onset of the pandemic, nursing facilities were not a top priority at either the federal or state level for adequate staffing, personal protection equipment (PPE) and testing. Attempts to control the outbreak and spread of COVID-19 in nursing facilities instead focused on identifying individuals who exhibited symptoms of COVID-19 and prohibiting their contact with residents and staff in nursing facilities. However, data from the Centers for Disease Control and Prevention (CDC) now show that individuals without symptoms — “asymptomatic” and “pre-symptomatic” individuals — infect multiple people without ever showing signs of the virus themselves.

Given that the virus is often spread by individuals who are asymptomatic, the research notes that if a community has a high prevalence of COVID-19, there is simply a greater risk of new nursing facility residents or staff serving as infection sources. Larger facilities accept more admissions and have more employees, thus they encounter more movement of people to and from the community.

This research tells us that the best way to prevent and curtail the spread of COVID-19 in nursing facilities is to do whatever possible to prevent it from getting a foothold from the larger community in the first place. Providing sufficient PPE for staff and conducting more testing with immediate results are critical to this effort. Only through broad and aggressive testing that delivers immediate results can facilities identify those infected — staff and residents — and quickly take appropriate measures.

Although the state of Michigan has recently implemented short- and long-term strategies to establish universal baseline testing and ongoing testing of all nursing facility residents and staff — a measure which we support — it still takes too long to receive the results. A new testing instrument to be distributed soon by the U.S. Department of Health and Human Services (HHS) promises to deliver results in minutes. If this works as suggested, it will give nursing facilities the capability to screen and test both residents and staff and provide the means to swiftly mitigate the spread of the virus.

Testing with quick results is also important to allow residents to visit with friends and family in person once again. Current restrictions have proven difficult for residents, families and staff. For visits to occur in a safe manner, adequate supplies of PPE and proper testing are essential.

We didn’t create this pandemic or choose to have it come upon us. There is no blame or finger pointing. We can make an enormous difference in the outcome of the COVID-19 battle in Michigan nursing facilities with the support from the state and our healthcare partners if we focus on the correct, research-driven solutions.

Please click HERE for further details on the research referenced above.

 

Melissa Samuel
President/CEO
Health Care Association of Michigan

Michigan coffee company’s future focused on 100% farm-direct sourcing

When Bob Fish, the co-founder of Michigan-based Biggby Coffee, talks about the future of the business, some might be shocked to hear his assessment that “coffee as a product is unsustainable.”

But that’s exactly what Fish says and why Biggby is trying to change the equation.

And it starts with the goal and benefits of farm-direct sourcing 50% of Biggby’s 2 million pounds of coffee purchased each year by 2023. After that accomplishment, Biggby will set its eyes on buying 100% of its product from farmers with whom Biggby has a lasting relationship.

Here’s why that’s important and what it means both for Biggby and its farm partners:

There are more than 200 labor hours to produce a single cup of coffee, Fish explains. It includes a supply chain that involves farms, workers who are often mistreated, brokers, roasters and more middle layers that seemingly work against each other.

“Between climate change and traders driving the price down, farmers simply cannot economically survive,” Fish said. “So, what happens? The farms can’t make it and are being abandoned. This puts the whole supply chain at risk.

“We believe businesses are here to solve problems, not create problems, but that’s what’s happening in coffee, and it’s why we are focused on doing business directly with farmers that treat the planet right and treat their people right.”

The straight line from farmer to Biggby involves extensive research and travel to confirm that the grower has the same passion for social responsibility and community investment, Fish said. As part of the evaluation, Biggby requires:

  • Farmers who pay workers above the national average and employ no child labor.
  • Farms that employ sustainable and organic practices.
  • Farmers who engage others with strong and local social missions.

Fish and his wife, Michelle, visit farms and stay for days at a time, and at different times – during the growing, harvesting and off-seasons – to assess the commitment, he said. Biggby can be a stabilizing force for the growers, providing a premium payment by eliminating the broker/middleman and granting the farmer financial safety and security for their coffee. That allows for future investment in the farm and the community. It also ensures Biggby a sustainable pipeline of coffee for the future.

Follow the journey: Bob and Michelle Fish blog about farm-direct sourcing and local heroes

Leana Ferrey, left, with her daughter, Miriam Morales, in the African drying beds at the El Recreo Coffee Estate

Leana Ferrey, left, with her daughter, Miriam Morales, in the African drying beds at the El Recreo Coffee Estate

One of Biggby’s farm partners is the El Recreo Cofffee Estate in Nicaragua, the second poorest country in the Western Hemisphere. There, Leanna Ferrey and her family have an established farm that pays its workers fairly, shares a quest for growing a quality product and displays a care for its people that goes above and beyond.

Ferrey established an on-site school for the workers’ children to attend through the fourth grade, and she does not allow youth to work on the farm. Each child earns a scholarship and transportation to attend school in a nearby town through high school. She helps them find a way to go to college, if they choose, Fish said. She’s also helped educate the workers, many of whom were illiterate, provide basic health care and provide certainty that there is food for three meals a day.

“It’s really just amazing what she and her family have done,” Fish said. “And this wasn’t because of us but because it’s what they believed in and how they think people should be treated. She is making a difference now and for future generations.

“It’s exactly what we want, and it fits with our belief that you should feel good about doing business with people. And to take that to the next step, we hope a consumer can feel good about doing business with us because they know what our establishment stands for.”

Biggby has a second relationship with a Zambian farm that supports an orphanage. Fish and his team are cultivating more partnerships that create an impact abroad and reflect the coffee company’s values.

“We could go out and get the cheapest coffee and continue to pressure the fragile coffee economy, but we’d rather put money directly in the hands of the farmers who are doing their best,” Fish said. “We want to be involved with people who care for and are engaged with their community just as we are with ours.”

How you can build new, whether you have lots of time or just a few months

Candie and Dustin Sentz in front of their Eastbrook Homes built home

Having searched a while for a larger home to meet the needs of their newly blended family, Dustin and Candie Sentz know it isn’t easy in this market to find just the right house in just the right place. That’s why the Jenison couple ended up building a new home in Lowing Woods.

The neighborhood of gorgeous new homes west of Grand Rapids not only is the ideal location for the Sentz family, it’s also a great place for any family as it features a community swimming pool, playground, walking trails and winding streets lined with trees and sidewalks.

Plus, because Lowing Woods is an Eastbrook Homes community, Dustin and Candie could build their new home exactly how they wanted.

“We toured some of the houses in here and liked the workmanship and quality of it,” said Dustin, a former builder. “We liked the ability to go on Eastbrook’s web site and look through their plans.

“We went with a lot of the upgrades they offered and we’re thankful we built it the way we wanted because we’re going to be here a long time.”

Dustin and Candie Sentz

Candie and Dustin Sentz chose a Ready-to-Build option that offered complete personalization of the interior and exterior of their new home in Lowing Woods, an Eastbrook Homes community west of Grand Rapids. Eastbrook also partners with clients on building Move-in-Ready and YourCanvas homes.

Dustin and Candie knew they wanted a main-floor master bedroom, so they filtered through the plans on the Eastbrook site and narrowed the options down to a handful. They also wanted a large basement so they could have a sizeable living space on that level of the house, too.

After browsing photographs of existing Eastbrook homes in dozens of communities around the state, Dustin and Candie ended up choosing a plan with an exterior look that’s unique to their new neighborhood. And they were able to partner with Eastbrook to accommodate personal touches such as custom handrails and a lower-level bar.

The couple chose paint colors, fixtures, trim and other features with the help of Eastbrook’s Home Creations Studio. They also selected certain upgrades including a larger garage.

“We were on that web site daily,” Candie said. “For me, it was fun. I had every plan printed out with all the different elevations and brought them to our families and said ‘What do you think about this?’ It was very organized.”

Dustin and Candie chose a Ready-to-Build Home, which is one of three great ways to partner with Eastbrook on building the home of your dreams:

Ready-to-Build

  • offers complete personalization of the exterior and interior of your home
  • takes 7 to 9 months with assistance from Eastbrook’s Home Creation Studio
  • benefits from the streamlined building process Eastbrook has honed over the past 50 years

Check out plans for Ready-to-Build homes and read what it’s like to build with Eastbrook.

Move-in-Ready

  • brand new homes already built and ready for you to move in as soon as 30 days after closing
  • perfect if you need a home right now, or if you’re sick of bidding wars on existing homes
  • beautiful, energy-efficient homes that come with new home warranties

Take a look at Eastbrook’s Move-in-Ready homes and read about how easy it is to get into a new home fast.

YourCanvas

  • homes are partially built with the foundation, structural and exterior selections already finalized
  • you get to choose and personalize interior features and finishes including paint colors, countertops, trim, lighting, fixtures, wall details and more
  • takes about 90 days from start of construction and is ideal for getting into your new home quickly with a flexible budget

RELATED: Want to build a new home in around 90 days from start of construction? Here’s how

Dustin and Candie visited their new home in Lowing Woods almost daily while it was being built. Just as it was fun to look through Eastbrook’s home plans, it was fun to pop in and see the progress on their own custom home.

Then, after closing on the home in summer 2019, the couple popped the cork on some champagne to celebrate. They moved in last July, hosted family for the holidays and this Fourth of July enjoyed a golf cart parade through their new neighborhood.

“We were attracted to the community feel they have here and thought it would be a great place to raise a family,” Dustin said. “We’d do it all over again. We’re just so happy with the house.”

Find our more about partnering with Eastbrook Homes in the video below:

 

Temp workers going from unemployment to frontline ‘hero’ in battle against COVID-19

Thank you sign in front of MediLodge

COVID-19 cost Rachel Schwartz her job. Now, she’s working to keep the coronavirus from costing other people their lives.

Several weeks ago, the 25-year-old Sterling Heights native was working for the U.S. Peace Corps in Africa. Then she and thousands of other volunteers were evacuated as the pandemic spread.

Back home in Michigan and ineligible for unemployment compensation, Schwartz decided to look for a job. What she found has given her a first-hand experience of Michigan’s essential medical heroes responding to COVID-19.

“I instantly sensed the additional burden that COVID-19 was placing amongst the workers and was eager to provide any relief that I could,” said Schwartz, who started working last month as a waiver care aide at MediLodge of Shoreline, a skilled nursing facility in Sterling Heights. “Every individual has been affected by this crisis, but all of these frontline workers are experiencing an intensifying effect.”

The waiver care aide positions are temporary, non-clinical roles that were created by MediLodge’s network of 50 skilled nursing facilities statewide to have extra hands in care centers at a time of need. The jobs, which do not require prior health care experience, are also a response to community residents in the wake of pandemic-related layoffs, furloughs or hour reductions in other industries.

With a background in social work and a desire to help others any way she can, Schwartz was immediately drawn to MediLodge when she came across it during an online career search. She applied for the job and became one of many newly hired team members who are providing facility support in a variety of ways.

The daily to-do list for Schwartz includes making sure all employees are wearing a mask and documenting the results of COVID-19 screenings that employees undergo each day. She also helps residents at mealtime and with their daily hygiene, while also providing emotional support.

Handmade masks donated to MediLodge

From sewing homemade face masks to joining the MediLodge team as an employee, there are many ways to support skilled nursing care during the COVID-19 pandemic.

After a few weeks on the job, Schwartz has alligator-skin hands from constant handwashing and also a new appreciation for nurses who have readily adapted to an environment of COVID precautions including visitor restrictions and personal protective equipment.

“I am both amazed and appreciative of the strength and commitment that I witness within my new co-workers,” she said. “They continue to maintain positive attitudes, to support one another and to provide optimal service.

 

“We are strong, we are dedicated, and we are constantly adapting. We are the service workers and we are all in this together.”

Of course, support isn’t only coming from within MediLodge skilled nursing facilities these days. Across the state there are stories of heroic acts by family members of residents and the community at large who have rallied around MediLodge facilities to affirm and support the quality nursing care happening inside.

The list of examples is endless:

 

How can you support your local skilled nursing facility during the COVID-19 pandemic? By donating lunch? Delivering snacks or treats? Sewing masks? Sending cards of encouragement or putting signs in the lawn?

Or maybe by joining the team at a MediLodge facility as Schwartz did. MediLodge logoTemporary job opportunities are available across the state under 30-, 60- and 90-day contracts for positions in activities, dietary and facility support, as well as for certified and licensed staff such as CNAs, LPNs, and RNs. People who’ve lost their jobs or had their hours reduced, retirees and college students home from school are all among the workers hired in recent weeks.

Some new hires are even turning their temporary jobs into launching pads for a new career, even if they’ve never thought about working in long term care before. For example, Amanda Macias was working in childcare when the spreading coronavirus shuttered her workplace and forced her to be laid off. She applied at MediLodge of East Lansing for a job as a temporary waiver care aide, doing things such as taking employee temperatures at the door, sanitizing surfaces and wiping down wheelchairs.

About an hour into her first shift, Macias was asked by a resident for some assistance. But because she’s not a certified nursing assistant, she had to find another staff member to help.

Macias realized right then that she wanted to pursue her CNA certification. She’s looking forward to taking the certification class, at MediLodge’s expense, and becoming a permanent part of the team. She’s even planning to pursue a nursing license and will start taking classes in the fall.

“I love it so much!” Macias said. “It is physically demanding, but so rewarding to know when I leave work that I made a difference in someone’s life.”

How coffee is a ‘note of optimism’ in returning to normal from pandemic

Masked Biggby barista hands out coffee carrier

Since founding Biggby Coffee in 1995 and building the Michigan-based business into the fastest-growing coffee chain in the U.S., Bob Fish has taken pride in its hands-on, next-to-you interaction with customers in store lobbies and drive-thru lanes. Biggby coffee location

The COVID-19 pandemic has challenged, but not broken that spirit.

“Now, it’s more than twice arms-length to get the same job done,” Fish said while recording a podcast with MLive’s Eric Hultgren. “Biggby has always been a place where you go to get a smile and a cup of coffee, and we can’t ignore the fact that people are getting a dopamine rush because they’re seeing people…who are smiling, engaging, happy and excited to see you.

“Our values remain grounded in supporting people and building a life they love. We have to keep a positive attitude regardless of what we’re doing (while dealing with the virus).”

Michigan’s stay-at-home order transitioned Biggby’s business to carry-out and drive-thru service only effective March 17. Some of the 200-plus stores temporarily closed while others changed hours. All the owner-operators are eagerly awaiting the ability to re-engage with comfortable spaces in coffeehouses and breaking out the patio furniture and allowing people to talk, celebrate friendships and share a cup of coffee.

The priority is to keep the health and safety of staff and customers at the forefront, said Fish, Biggby’s co-CEO. Masked Biggby barista working drive thru

“Biggby has been at the leading edge of doing everything proper from a safety and sanitation standpoint,” Fish said, noting that new protocols with everything from masks to social distancing in stores have been instituted and followed.

Despite the differences in daily routines, Biggby has bucked national trends by increasing its overall sales and hiring staff rather than reducing its workforce. The coffeeshops have been a bellwether of the economy and Michigan’s overall mood.

“I think Biggby is just a note of optimism in what returning to normal looks like,” Fish said. “The fact that sales are back to normal already and we’re in a hiring mode is pretty cool.”

The other shift that Biggby leaders have observed during the pandemic is the care and concern customers have had for staff during uncertain times. People are being “hyper-generous” with tipping baristas and expressing appreciation, Fish said.

Fish also shared how scheduling daily walks has helped keep him remain centered under different life circumstances. He recommends scheduling time for yourself outdoors to all.

“Something really special happens out there,” he said. “You can start sorting through things in your head and getting aligned. Listen to nature, the wind, the trees, the animals, the birds, all that has a really positive impact on your mind and mindspace.”

Coffee as cocktail?

Fish also virtually visited with MLive’s Amy Sherman to talk about coffee-based cocktails and to share his signature recipe for a creamy Tiramisu Latte that is a cool pick-me-up as Michigan enters the summer season. Biggby tiramisu drink

The ingredients are below, but watch the video with Amy and Bob for more tips, including why to make your coffee stronger and how to properly prepare the drink.

“This one is an absolute winner,” Fish said. “It’s magic.”

Bob Fish’s Tiramisu Latte

  • 4 oz Biggby coffee, brewed, and chilled
  • 2 oz Jagermeister Cold Brew liquor
  • 4 oz whole milk
  • 1 oz brandy
  • 1 oz Godiva chocolate liquor
  • coffee ice cubes
  • softly whipped cream, sweetened if you like
  • cocoa powder

Find a Biggby near you to grab a coffee or ingredients for a cocktail.

No visitors, but still lots of fun: How MediLodge is making residents smile

A wheelchair decorating contest is one of several activities keeping residents at MediLodge of Clare happy and safe in an era of social distancing. Residents there also have fished for rubber duckies, tried their aim in a hallway Nerf gun shooting contest and exchanged long-distance hugs.

In some ways, skilled nursing facilities look a lot different during the COVID-19 pandemic. To mitigate spread of the coronavirus, no visitors are allowed, dining halls are empty and certain social activities have been cancelled.

But in other ways, things look just the same. After all, residents and their caretakers and non-clinical staff in housekeeping, maintenance and other areas are still making each other smile each day.

Meow! Mask-wearing staff members dress up as cats to entertain residents at MediLodge of Livingston in Howell.

Meow! Mask-wearing staff members dress up as cats to entertain residents at MediLodge of Livingston in Howell.

Sure, this pandemic is a trying time for everyone, and for families of loved ones in nursing care it can even be heartbreaking. Yet, for every story of a resident being sick without family by their side, there are countless more examples of residents smiling – despite the current reality of visitor restrictions and social distancing guidelines.

Sometimes it’s the little things that make the biggest difference in a person’s day, from employees dressing up in goofy costumes to residents making paper airplanes to special, door-to-door deliveries of ice cream floats.

“Due to COVID 19, our residents have had to stay in their rooms, so we have brought the fun to them!” said Laura Decker, activities director at MediLodge of St. Clair.

Go ahead and take a break from the daily roll call of coronavirus headlines, and take a look at these beautiful scenes from MediLodge skilled nursing facilities across Michigan:

Meet some of Michigan’s ‘guardian angels’ in COVID-19 pandemic

MediLodge Staff holding signs, "MediLodge Strong"

Madison Walat’s training didn’t involve FaceTime. Yet, there she was at the end of a 12-hour shift in the COVID unit at MediLodge of Alpena, holding an iPad so family members of a resident dying with the coronavirus could say their last goodbyes.

“It really tore me up,” said Walat, a licensed practical nurse. “That was so hard to sit there and hold the iPad while each family member told stories and cried.

“Automatically, not even thinking, I was holding the resident’s hand the whole time. He could hear the family’s voice and I was just holding his hand so he wouldn’t feel alone.”

From donning full-body personal protective equipment such as N95 masks, gowns and face shields to helping residents and family members communicate at a time when health care facilities are closed to visitors, a lot has changed in the world of nursing as Michigan continues to tackle the COVID-19 pandemic.

Then again, some things stay the same. Nurses are always “essential” workers. And through this trying time of change and uncertainty they remain committed to being what they have always been – caring patient advocates.

“There’s been so many analogies for the health care professionals such as ‘heroes’ or ‘superheroes,’ and I use the analogy of being ‘angels’ because they’re having to be guardians,” said Trissie Farr, chief clinical officer for MediLodge, a network of 50 skilled nursing facilities across Michigan. “They’re having to be caregivers. They’re having to be messengers. They’re having to disinfect iPads and facilitate the opportunity for a family member to be able to use FaceTime or Skype.

“When family can’t be there, it could be that the nurse is the last person that patient or resident ever sees before they leave this world. It’s hard on our staff having to deal with that responsibility, too.”

RELATED: See what a day in the life of a long-term care nurse is like during the COVID-19 pandemic

It’s not just hospital workers on the front lines of the pandemic. It’s also long-term care nurses – LPNs, registered nurses and certified nursing assistants who provide care for recovering COVID patients and also take precautions to prevent the virus from spreading to other residents.

Jamillah Lynn, for one, is thankful. Having battled COVID-19 for more than two weeks including an induced coma and 10 days of intubation to help her breathe, Lynn responded enthusiastically when doctors finally asked her if she was ready to leave the hospital: “Yes!” she almost screamed. After all, Lynn figured she was headed home. Instead, she was transported to a skilled nursing facility for rehabilitation.

In the COVID unit at MediLodge of Frankenmuth, Lynn regained her strength thanks to the caring, compassionate staff. Her nurses were sweet as can be. Her therapists challenged her and treated her with kindness. She was served a delicious variety of food that was safe and easy to swallow. She was given activity books to pass the time.

It was the next best thing to being home.

“The TLC I received upon arrival managed to take the pain away,” Lynn said. “I don’t remember their names, but I most definitely remember their faces and kindness.”

In recognition of National Nurses Month, we’re putting names to just a few of those heroic faces that are helping Michigan through the COVID-19 pandemic:

Walat has only been licensed as a nurse since January, so the pandemic has been a baptism by fire for her. On one hand, she doesn’t know when things will ever go back to normal like they used to be. On the other hand, she’s learning firsthand how nurses have always been guardian angels, no matter the circumstances.

“Every single day I get to make a difference is somebody’s life,” Walat said. “A couple weeks ago I worked many overtime hours. I just didn’t want to leave because I wanted to know what was changing with my patients on my wing. I’m loving seeing them out and getting to walk again.”

Thank you to Madison and all the other MediLodge long-term care nurses for what you do!

MediLodge staff

National Nurses Month: Thank you to all the long-term care nurses on the front lines of the COVID-19 pandemic. ‘Together, the staff at MediLodge of Frankenmuth catered to my every need by creating a home away from home,’ said Jamillah Lynn, who recovered from the coronavirus in the skilled nursing facility’s COVID unit. ‘I was grateful to have been placed in good hands.’

Day in the life of a COVID nurse: Where the ‘dread begins to fade’

MediLodge long-term care nurses

Like many parents during the COVID-19 pandemic, Leanna Watson starts her day by making sure her children are prepared to complete their schoolwork from home. Only she can’t talk to them face to face.MediLodge logo

Watson is a long-term care nurse, an “essential” job that carries no small risk these days in the part of Michigan hit hardest by the coronavirus. To protect her children, Watson sent them to live with their grandmother about an hour away.

“I work in a building where there’s been COVID and I myself have had COVID, so to keep my kids safe they haven’t been home,” said Watson, 39, director of nursing at MediLodge of Southfield, near Detroit. “Even on the holiday we weren’t together. We had to have virtual Easter with a virtual teatime.”

MediLodge infobox

We’re all dealing with changes to our daily routines during the pandemic, adjusting our personal lives to the reality of stay-at-home orders and social distancing. In many cases we’re juggling home-schooling with work. We’re figuring out how to celebrate Mothers’ Day, family birthdays and graduations without endangering each other. We’re bombarded daily with reports of mounting COVID-19 cases and deaths, and we lie awake at night worrying about what the next day might bring.

Long-term care nurses are grappling with all of that, too, in some cases alone and separated from their families. And if that isn’t enough, when they go to work they put themselves on the front lines of the pandemic, often for long hours every day for weeks at a time so our loved ones get the care they need.

Their sacrifice is worth noting during National Skilled Nursing Care Week. It’s also worth celebrating the all-hands-on-deck spirit of skilled nursing staff and the support of their families, the smiles of residents and the gratitude of their families.

“The impact of COVID-19 on our staff is mentally exhausting and it’s physically exhausting,” said Trissie Farr, chief clinical officer for MediLodge, a network of 50 skilled nursing facilities across Michigan. “It’s been a very difficult professional situation, and a very difficult personal situation as well.”

“But together we have resilience in the face of these challenging times.”

Before getting to work

Each morning Sara Tracey feels the same sense of dread that many of us have as she checks her phone and sees the bad news about the pandemic and its effect on people across Michigan and beyond. Listening to the radio on her drive into work, it’s more of the same negativity.

MediLodge resident Barbara D'Anna

‘I’m constantly doing my usual rounds, only now I’m looking at different things,’ said JonAnn Danielson, director of nursing at MediLodge of Shoreline in Sterling Heights, seen here with resident Barbara D’Anna. ‘I’m looking to make sure that any resident in the hall has their mask on properly, that residents and staff are staying six feet apart from each other, and many other COVID-related rules.’

When Tracey gets to work she goes through a new, painstaking routine that involves having her temperature taken and undergoing a COVID-19 screening – Any new onset sore throat? Any new onset cough or shortness of breath? She washes her hands and dons personal protective equipment including

N95 face masks, face shields, gloves and gowns that she’ll wear throughout the day, making her hot and often uncomfortable.

Then, Tracey walks into MediLodge of Alpena.

“As soon as I open the doors, the dread begins to fade,” she said. “I look at the patients and speak with them to see how they are doing that day. Not only do they carry a smile on their face, a little laughter and conversation begins.

“I speak with the staff down the unit, thank each and every one of them for the hard work and dedication they bring to work on a daily basis. Calls are placed to patients’ families. Updates are given. Now all the negativity is gone. The support by our families while talking with them on the phone is all me and my team needs.”

At work

In addition to going about their usual duties of passing meds, changing dressings and caring for the physical needs of residents, long-term care nurses are busy preventing the spread of COVID-19 while still maintaining a homelike environment.

Prior to COVID-19, a normal day at MediLodge had halls full of smiling residents, staff and visitors. The communal dining rooms were active, and it was easy to find friendly games of bingo. Now the halls are occupied by residents and employees with masks covering their smiles. Visitors are not allowed. Face-to-face interactions among residents and between residents and nurses are limited.

Because visitors are not allowed in this new normal, residents are unable to hug or kiss their family members and can only talk to them on the phone or through a window. So, nurses regularly facilitate video chats and window visits.

Brian Grappin a nurse at MediLodge

‘My patients always amaze me the way they keep their sense of humor,’ said Brian Grappin, a nurse in the COVID unit at MediLodge of GTC in Traverse City. ‘They are determined to do their best and I’m glad I can help them.’

Gowned-up in PPE and wearing masks and face shields, nurses now smile with their eyes.

“During these tough times of change and adjustment, one thing has remained strong – the support we provide one another, our residents and their loved ones,” said Jessica Ludlow, an RN at MediLodge of Alpena. “Comforting residents, engaging in meaningful conversations and communicating with their loved ones is more imperative now than it’s ever been.”

In some skilled nursing facilities there are designated COVID units where nurses work exclusively with residents who have the coronavirus. Nurses are checking residents’ vital signs much more frequently, taking full sets as often as every four hours to gauge oxygen levels, blood pressure and more. Plus, they’re busy keeping up with the latest government guidelines, which in some cases can be conflicting.

Each day is an emotional roller coaster, as some residents recover from the virus and others die with it. It can feel like losing a family member when a resident dies, and it’s exhilarating when a resident returns to health.

“Working the COVID unit has been physically and emotionally exhausting,” said Stacey Hodges, an RN

Jenna Wieschowski an RN at MediLodge

Each resident needs extra attention these days because of the isolation, says Jenna Wieschowski, RN. ‘I do my best to keep morale up and spirits high for the residents due to the lack of family and even resident-to-resident contact now because of the social distancing rules.’

at MediLodge of Kalamazoo. “The residents are sick. Many times I have been forced to use my past experience in critical care to help them breathe effectively, get their temperature down or bring a blood pressure back up where it belongs.”

“The fear they show during these times is heart breaking, but the smiles they give when they start to heal and feel better is what keeps me going. I think it’s what keeps all of us going.”

Going home after work

After often working well beyond their scheduled shift, the precautions involved in leaving work are just as meticulous as those taken when arriving. Hands cracked and dry from so much washing during the day, many nurses change out of their scrubs before leaving work. Then in a makeshift changing area in their garage or even a camper in the driveway, they take those clothes off before entering their home and march straight into the shower to wash the day’s germs away.

For long-term care nurses who are parents, bypassing children on the way to the shower is a common experience.

“My daughter struggles because she isn’t able to give me a hug like she used to do once I got home,” said Ashley Graves, an LPN in the COVID unit at MediLodge of Cass City.

After getting cleaned up, then it’s time to go over their children’s schoolwork, try to get some quality time with the family and make dinner. Fortunately, many nurses have supportive spouses to help run the household.

Nurses' sock with funny saying

In some ways, many long-term care nurses feel like they are constantly living in survival mode as they go from dealing with family anxieties and concerns to the life-and-death challenges of the workday and back again. ‘We never get a chance to punch out,’ said Rebekah Crothers, an infection control nurse at MediLodge of St. Clair.

“Before I know it, it’s time for baths, bed and prayers that our household remains healthy and safe,” said Jenna Wieschowski, an RN at MediLodge of Green View, in Alpena. “And then repeat it all again the next day. Just normal routine for COVID life.”

In some cases, long-term care nurses haven’t gone home in weeks. They’ve been separated from their loved ones as they isolate themselves during the pandemic.

“I get off the phone with my daughter sometimes and I just want to be there with her, but I don’t want her to get sick,” said Judy Goldberg, an LPN at MediLodge of Cass City. “It’s tough. You hang up the phone and you kinda lose it.”

“But I wouldn’t change what I’m doing. This is what we signed up for as nurses, to help people who can’t help themselves.”

Hope for tomorrow

At the end of March, Leanna Watson was diagnosed with COVID after contracting the virus most likely through her work as a nurse. She lost her taste and smell, suffered bad muscle aches, abdominal pain, diarrhea and shortness of breath with activity.

Watson was off work for two weeks while successfully recovering from the virus at home. When she felt better and returned to her nursing job at MediLodge of Southfield, her family was scared. Her kids didn’t want her to go back to work. But “I signed up to be a nurse,” she said. “I don’t bail when times are hard.”

But even though nurses put on a brave face, that doesn’t mean they’re tough all the time. Watson’s heart melted recently when a long-time resident whom she knew well contracted COVID-19. Prior to his diagnosis, not a day went by that the two of them didn’t talk. Then his symptoms worsened, and he passed away.

“That really hit home for me,” Watson said. “Sometimes I go home and cry.”

Leanna Watson with MediLodge of Southfield resident Monica Foster

Leanna Watson with MediLodge of Southfield resident Monica Foster

But for every sad day, there are good days when nobody is sick or when residents recover. And that

brings hope for tomorrow.

“Those are my happiest days, when it’s feeling like a normal day again,” she said.