In a bit of irony, the coronavirus pandemic actually resulted in less traffic in Evangelical Community Hospital’s Emergency Department. Anxious about catching the virus, people chose urgent care facilities for minor cuts and sprains, saving the ED for truly emergent care—exactly what it’s for.
“What we saw in the ED was a significant decline in the number of patients,” said Johnette K. Bennage, RN, BSN, CEN, CPEN, director of Emergency Services at Evangelical Community Hospital. “We started to see a more specific use of the ER for things it is really meant to be used for. People who came to the ER really needed to come.”
Heather Stafford, clinical director of Infectious Diseases at UPMC in the Susquehanna Region, coordinated implementation of all COVID safety measures at UPMC campuses and worked alongside the teams providing care to COVID-positive patients.
To safeguard against the virus, patients at UPMC were “immediately triaged and did not sit in the waiting room at all, taken straight back to a negative pressure room,” Stafford said.
The hospital designated four rooms for known COVID-positive patients or those considered Person Under Investigation, Stafford said, and each room designated its own PPE cart for staff. When appropriate, the use of baby monitors provided for two-way conversations with COVID-positive patients so staff do not have to enter the room multiple times.
Especially in the early days of COVID, the Evangelical Emergency Department gave staff members as much support as possible.
“Everybody knew the worst cases were going to come to the ER, and we needed to be available and ready to do what we could,” Bennage said. “Our biggest efforts were put toward trying to keep our staff as safe as we could.”
Dealing with a person who might have the coronavirus can be an isolating experience. At Evangelical, one care worker tends to the patient, drawing labs, putting the patient on a monitor, arranging for IV fluids, etc. The worker must don personal protective equipment that includes a respirator, face shield, impermeable gown and gloves — it’s hard to talk, and it gets very hot.
Evangelical created a response team to support the caregiver by standing just outside the door and helping with the collection of specimens from patients, answering questions and providing an extra set of hands along with emotional support. When the caregiver is finished, the response team helps them out of their PPE safely so they don’t expose themselves to danger.
“We would get them out of PPE and make sure they had an opportunity to go take a break, get some food, get something to drink,” Bennage said.
UPMC provides staff check-off procedures on proper donning and doffing, Stafford said. To keep staff updated, they engage in huddles three times a day to share any changes to PPE expectations or changes related to COVID in a timely manner.
“You have a virus that’s taking over, and you just don’t know what to expect day to day,” Bennage said. “We had the community send in words of encouragement, and we shared that with the staff. We actually had a lot of community members send in food or drinks, anything they thought would be supportive to the staff. These efforts really helped our staff to know they weren’t alone in their efforts, and that they were appreciated greatly.”
Within the hospital, the emergency department received help from other departments.
“There was a very large support of staff from the OR, the ambulatory surgical center, the pre-admission care unit,” Bennage said. “Some of the units that were not working at full capacity volunteered their time to come work in the ED to support us, and that was very, very much appreciated.”
Staff from other departments helped with health screenings and other tasks so the ER staff could focus on caring for the patients.
“This pandemic has challenged us,” Bennage said. “But as a community hospital we have stepped up to the challenge and have been willing and present to address it. And we continue to be prepared and to address it into the future.”