Today, I reflect upon March 13, 2020 when CMS issued a regulatory memo that essentially restricted all visitors to nursing homes, stopped all communal dining and activities and we were told to get the residents into their rooms for the foreseeable future. This major paradigm shift rocked many of us to our core. For years we have lived with culture change and all that came with it. Freedom of choice for the residents was to be afforded from where to eat, when to eat, which activity to attend and generally they should be able to come and going as they pleased. We were taught, and we believed that the community was their home, and we were visitors in it.
If one steps back and thinks about it, this also happened to us outside of the nursing home. Within the next couple of weeks, in late March 2020, we were mandated to wear masks and we were relegated to mostly home cooked or takeout food. We could not attend social or church activities except those that safely could be held out of doors without crowds, and now we had to essentially “stay in OUR rooms”!
For me, who has travelled now for work, for the past 27 years, this was like taking the morning cup of joe away from a coffee lover! As I flew home on a mostly empty plane on March 16th, I do remember thinking, “when will I travel again”? Then, just when I thought what am I going to do without travel, the virus began its march across the country and into the nursing homes. Calls ensued daily with our staff for a couple months. We never ran out of topics and we used our collective brains to solve problems like no staff, or no PPE, or how to put a plastic barrier up. One call, in April that will always be ingrained in my mind, was the discussion on just how deadly this COVID-19 could be to our residents and staff. My travel schedule was set aside not only due to a “stay at home order” but because I needed to stay abreast of everything day and night. Like many of us whom are nurses, a crisis situation causes us to rally quickly, and to turn on a dime. Those unfortunate communities, who broke the COVID-19 ice early, quickly realized how virulent this virus was. We had no choice but work together to keep our folks alive and “at home.” Discussion, on how to do that, will little guidance, in the beginning from the CDC and CMS, was by, as my mom would say, “the seat of our pants”.
But what did we truly gain from this? Were there lessons to be learned? Was there a silver lining? The initial surprise though, was that our residents accommodated to basically anything we ask them to. Stay in your room, ok. Quarantine alone in your room for 14 days, ok. Take this big old Vit D and Zinc pill, ok. THEIR resilience helped to keep us focused. After all, THEY missed their families, and freedom. We got to go home, this is their home!
My personal growth is probably the # 2 positive outcome for me (the residents’ positive outcomes are # 1). I encourage everyone to take a minute to take stock of any personal silver linings they may have gotten out of this past year. It’s hard, I know, but if the resilience of our residents has taught us anything, it’s that we find ways to keep going forward. I learned to slow down, that I don’t have to run, run, run to be productive. I fell into my new norm. Up at 6 AM (that’s a new one!), coffee and emails until my lady friends arrived at 7 AM for our daily walk. I relearned my neighborhood and neighbors. My community became very small. During that 1 hour walk every am, we all chatted away, sometimes lamenting about a social event we were missing or about the pandemic itself and the restrictions it was imposing on our lives. We debated the mask rule, the restaurant and church closings, and how our families were handling this. Most of all, we missed our freedom to go where we wanted, when we wanted and with whom we wanted. Imagine how our resident’s felt!
Were there bright moments to be found over the course of the year? Of course. Without these woman, I would now be lost. We check in on each person daily, a quick hello to make sure everything is fine. Most of us are back at work now, our families back together and life has returned to some semblance of normal, but this bond brought on by COVID-19 will forever continue.
As I lament of where we were a year ago to where we are today, I ask others about their silver linings, because despite the tragic loss of life to COVID-19, I saw that we, in post-acute care and specifically Mission communities, have the ability to rise to meet seemingly impossible challenges. New obstacles will come our way in 2021, but we now know that nothing is insurmountable. I believe we are all better leaders for it, and that we will continue to use our abilities to care for those who need it most.
Will life ever return to that pre March 13, 2020? Who knows, but can we take with us some of the lessons learned and resulting growth? Absolutely. What are your silver linings?
Karen McDonald, BSN, RN
Chief Clinical Officer, Mission Health