Nurses are usually running from the moment they step foot in their clinics. So, how did they factor in the extra workload required by a pandemic?
In the words of Leah Malazdrewicz, primary care nurse at Highwood Health in High River, “We flexed.”
Looking back, she reflects that, “it was unbelievable what we responded to this year – Cargill, then testing at Hutterite colonies, then onto First Nation reserves.”
She says, “We found ourselves doing lots of phone calls. In October , Alberta Health Services told the public that they were too stretched to make follow-up calls to everyone who had tested positive. At CRPCN, everyone on the list got a phone call. We would support attachment to a family doctor, provide referrals for resources to isolate, and answer questions about contact tracing, and isolation using AHS guidelines.”
Staying on top of our diabetes patients
An unexpected side effect of the pandemic, and an add-on to our nurses’ workloads, has been assisting with diabetes patients and their case management. In the Foothills area, AHS diabetes educators haven’t been able to see patients in person for about a year.
Foot care for diabetic patients also wasn’t happening regularly, so CRPCN nurses offered foot screening, and provided referrals to either the CRPCN foot care nurse, or to more specialized care, depending on the severity.
Patients’ eating habits have also suffered. People were stress eating, recreation facilities were closed – and over a cold winter especially, there was less opportunity for activity.
COVID made it harder for families to see each other. Prior to COVID, a family member would have likely been the person to notice that their senior parent was showing signs of incapacity. When isolation made that impossible, there became a waitlist for capacity assessment teams of nurses, doctors, therapists, etc., who had to assess patients and advise whether they could continue looking after themselves or whether they should be under guardianship.
Leah has noticed that a lot of seniors who had declining mental health and dementia prior to the pandemic were definitely impacted by the toll COVID took on their support systems. They receive so much less stimulation and socialization.
The difference it has made to primary care nurses is an increased number of cognitive assessments and referrals, such as to geriatric mental health - trying to get people with cognition and memory problems the right help.
And through it all, maintaining sanity
Nurses took more time during appointments to check in on their patients’ mental health. Leah definitely noticed that, “people are chattier.”
Couples and families had lots of time together, which can be great, but the downside is that people weren’t getting a breather of time apart. They didn’t have their usual outlets, and often, both partners were working from home, a bit on top of each other.
Add that to differing roles and expectations – maybe the person who usually cooks is working out of the house so the other spouse is cooking, or the husband is now buying groceries, but doesn’t buy what’s on the list, which irritates the wife. Are you nodding your head in sympathy?
What’s great about our mental health support is that the CRPCN’s social workers and mental health workers removed their geographical boundaries, and also accepted referrals for issues they might not have ordinarily.