By Michelle Lee Hoy

Operations at Southlake Regional Health Centre have seen significant changes in the past few months. With the onset of COVID-19, our frontline nurses, physicians, support staff and leadership have had their days and nights turned upside down. Staff are being redeployed to new roles throughout the hospital to ensure work can continue during a time where many clinics and surgeries have been ramped down. Redeployed staff from all areas of the hospital – clinical and non-clinical – are standing on the frontlines as screeners for all those who enter the hospital to ensure we keep our patients and staff safe. The leadership team, the community, and fellow staff have offered each other support during this time. From free coffee and meal donations to extra attention on staff wellness, everyone has stepped up. During these unprecedented times, the sense of community – of family – is stronger than ever, especially for those on the frontlines who are caring for patients with COVID-19. Now, more than ever, they are coming together as one team, looking out for one another and spreading positivity across the organization.

Two units at Southlake have become the first dedicated units for patients with COVID-19. Medicine 6 (referred to as Med 6), ordinarily an acute medicine unit, was the first to begin receiving COVID-19 patients after they had been swabbed in the ED or the Assessment Centre, so long as they did not require ventilation – those who did were more critical and were cared for in the ICU.

As Southlake began to test more people for COVID-19, Med 6 saw a spike in activity on their floor. At first, there was some anxiety and fear of the unknown. Staff also felt challenged by the learning curve involved with shifting their nursing skills and knowledge over to completely focusing on caring for COVID-19 patients. But now, the staff on Med 6 have quickly settled into their new normal – they have recently transitioned to become a dedicated unit only for patients confirmed positive for the virus.

“There was anxiety coming in and not knowing what the floor would look like when we typically always knew what to expect. It was stressful being the primary care providers for these patients in a time where our usual processes didn’t always apply,” said Danika Dalley, an RPN on Med 6. “It’s nothing that any of us have worked with before, so it has been a big learning curve, but we have worked together to find answers and we have each others’ backs.”

Since becoming a dedicated COVID-19 unit in early March, Med 6 has seen a decrease in activity on their floor, offering them a quieter period they had not experienced in the past. All COVID-19 positive patients require individual rooms and all the semi-private rooms have been made private for now. Some staff from Med 6 have been redeployed to support other clinical areas of the hospital on days when their patient load is lighter. For example, when a patient in the Mental Health Department tested positive for COVID-19, staff from Med 6 went to provide guidance to ensure their colleagues were properly equipped to safely provide care.

Staff are finding other ways to support each other too. “Nurses have opened up their homes to other nurses so they wouldn’t have to expose their families and so we can all be safe together,” said Veronica Wiker, another RPN on Med 6. She added that nurses have been supporting each other and checking in on their team members now more than ever: “We’ve become more of a family unit than we ever have before.”

The opening of the MSK (musculoskeletal), ordinarily an orthopaedic unit, to COVID-19 suspected patients allowed Med 6 to dedicate their efforts to caring for COVID-19 positive patients. Patients who require an inpatient admission and are awaiting their test results are now first admitted to MSK.

The turnover rate for patient flow on MSK is high – patients are swabbed, admitted, test results are received, and then the patients are transferred to another unit in the hospital depending on their test result – all within the span of 24 hours. There is also a learning curve for the MSK staff: learning how to care for patients with symptoms of COVID-19, becoming familiar with the proper donning and doffing techniques for PPE to ensure they can safely do their jobs, and keeping informed on the rapidly changing situation.

“Infection Prevention and Control is doing an amazing job communicating to us, as are the managers and educators, who have done a great job at keeping us up-to-date,” said Heather Ward, charge nurse on MSK. “We are also loving that the Town Halls are seven days a week, and feature timely updates from senior leaders in the Emergency Operations Centre.”

As prepared as the team on MSK feels, they also find it hard to describe how they are being affected by COVID-19: “I listen to the news and try to keep updated, but it is important to take a step back and put things into perspective so you don’t become overwhelmed,” said Helen Poff, RN and discharge planner on MSK. “There is some fear in everyone because of the uncertainty. But we try to be there for each other, and we talk things out a lot on the floor, either during our larger daily huddle or in smaller groups. The world is in a strange place right now.”

One thing that the team has found brings them some joy and puts them in a positive mood is when Helen selects a song from their unit’s request list. All available staff gather at safe distances around the nursing station to hear if she has picked their request. For the next two minutes, they all have a bit of fun singing and dancing along as music streams out of Helen’s phone. When the song is done the team returns to their tasks feeling re-energized.

Poff also notes that the support from the community has been felt and is greatly appreciated: “The community has been amazing, the support from them is heartwarming. We’re all going through this together, but to know we have their support is a nice feeling.”

“Our staff are amazing,” said Dionne Sinclair, director of Southlake’s Medicine program. “They took COVID-19 head on, learned new processes, asked lots of questions, and adapted to the changes in information we have been receiving as the situation evolves, and they are now champions for the organization.”

Clinical teams often work in collaboration to ensure patients receive the best care possible while in the hospital, and the COVID-19 pandemic has been no different. The ICU team worked closely with Med 6 staff as they transferred patients who no longer required critical care. When MSK opened up to receive patients suspected of having COVID-19, they closely shadowed their Med 6 colleagues to ensure the process remained seamless. Med 6 staff continue to offer support to other units throughout the hospital as needed. And when Med 6 was able to discharge their first patient who had come from the ICU, the whole hospital came together to celebrate both the patient and the teams that provided care. Throughout all the changes the organization has faced, there has been one constant everyone at Southlake has been able to rely on – Power of Many.

Michelle Lee Hoy is a communications strategist at  Southlake Regional Health Centre.