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.
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.”
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.
‘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.”
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.
‘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
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.
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
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.