Virginia Nurses Today - August 2020

www.VirginiaNurses.com | Virginia Nurses Today August, September, October 2020 | Page 3
President's Message
COVID-19 Response: A Leadership Perspective
Pandemics have occurred throughout history
with each bringing their own challenges as a “new”
disease with unknown nuances that must be
identified and addressed. COVID-19 is no different.
From the initial onset of this pandemic, people
around the globe have watched with anticipation
and anxiety as the numbers related to COVID-19
grew worldwide. We faced significant challenges
relating to how to prepare for the pandemic
given ongoing changes in CDC guidance and
best practices. These large scale issues created
apprehension among medical communities as they
attempted to prepare for their first PUI (persons
under investigation) and positive COVID-19 cases.
Recently, nursing leaders from across Virginia
shared their challenges and successes in
preparing for the first phase of the pandemic in the
commonwealth through VNA’s COVID-19 Weekly
Updates webinar series. They also provided updates
on the ongoing operational changes established
to protect and engage patients, patient families,
and nursing personnel as well as their plans
for a second wave. These individuals included
Deb Zimmermann, DNP, RN, NEA-BC, FAAN,
Chief Nurse Executive with VCU Health; Melody
Dickerson, MSN, RN, CPHQ, Chief Nursing Officer
with Virginia Hospital Center, and Linda Shepherd,
MBA, BSN, RN, Chief Nursing Officer with Ballad
Health Johnston Memorial Hospital.
The overwhelming challenge out of the gate
for each leader centered around dealing with
the unknown. As command centers were put
into operation, no one truly knew what to expect
relative to: anticipated volumes since other patient
populations would still require care; how swiftly
surges would occur once PUIs / positive COVID-19
patients were identified; what the human resource
demands would look like; if the required PPE would
be available and accessible; what community
support would be required; how the acute care
facilities could partner with other entities to provide
a more comprehensive approach to the pandemic;
and what treatments would prove to be effective for
this patient population; among other questions.
Resoundingly, the leaders and their organizations
turned to their colleagues on the west coast to gain
insight into their successes and challenges since,
at the time, these entities were dealing with the
pandemic first-hand. Many of these conversations
began in January 2020 and continued as the
leaders and their teams were challenged to establish
plans for their respective organizations.
Learning the lessons shared by medical
communities in the midst of COVID-19 and utilizing
the principles of emergency management helped
the leadership teams to begin preparing for the
inevitable while basing decisions on worst case
scenarios and engaging in staff innovation. Each
leader shared how their organization designated
and expanded bed capacity, including negative
pressure room availability, to house anticipated
PUIs and positive cases. Others pulled from the
lessons they learned during Ebola and created
hot and cold zones adjacent to COVID-designated
rooms. Innovation also took the forefront as
these organizations worked to establish drivethrough
testing sites to alleviate emergency room
overcrowding and conserve some PPE elements
while trying to actively identify PUIs and positive
patients. In-house testing was also established at
several of the organizations to provide expeditious
identification of PUI / positive cases, a transition
from receiving results in days to mere hours.
Nurses also utilized extension tubing which allowed
IV pumps to be managed outside PUI/ positive
patient rooms and bunded care to minimize
exposure of other team members and conserve
PPE. Spotters were also put into place to monitor
donning and doffing of PPE to protect staff and
patients. As PPE usage increased and the ability
to replenish supplies in some parts of the state
declined, the reprocessing and sterilization of N95
masks was investigated and initiated once there was
an established comfort level among nursing staff
in utilizing these items. Other initiatives included
further partnering with the health department and
community and organizational leaders in prisons,
public housing, and other peripheral entities as
a means to create targeted strategies to leverage
resources to address and possibly minimize
community spread.
Sufficient human resources also were, and
continue to be, an ongoing need to source additional
bed capacity and allow for creative nursing models,
which provide safe, high quality care to the patient.
To expand the need for nurses, most facilities
engaged in multiple strategies including the use
of contract labor and redeployment of nursing
personnel from areas experiencing lower volumes
or where services were suspended as a result of the
pandemic. Redeployed nurses were assigned to areas
of previous competency as appropriate, providing
Bachelor of Science
in Nursing (RN to BSN)
[6
For practicing RNs who
wish to obtain their BSN
Finish in 5 semesters
part-time
Financial aid available
for those who qualify
Among the state's
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them with abbreviated
classes and time on the
unit/s, allowing these
nurses to acclimate to
their designated areas in
advance of deployment.
Other strategies included:
Linda Shepherd,
MBA, BSN, RN
the establishment of internal float pools made up
of redeployed nurse resources, use of clinical ladder
nurses where the ladder aligned with skill set
designations, and the utilization of multiple forms of
President’s Message continued on page 6
Clinical Nurse
Leader (MSN)
For RNs with their BSN who wish
to become advanced practitioners
✓
Accreditations & Certifications:
Two starts per year
(Jan., Aug.)
Online format with
two clinical courses
Part-time curriculum
for busy RNs
Certified by SCH EV to operate in Virginia,
accredited by ABHES & approved by NC-SARA.