Nurse: Despite coronavirus pandemic, hospital patients need their loved ones at their side
Hospitals can make it safe for patients to have their loved ones with them. It is too much to ask patients give birth, face surgery, or die alone.
It was 11:30 at night, but I answered the phone when I saw my friend’s number light up the screen. She was sitting in her car outside the hospital sobbing. Her husband has a life-threatening heart condition. They have two small children. He was defibrillated twice by his internal device. When they called his cardiologist, the doctor didn’t hesitate: Get him to the emergency room right now.
But when she tried to accompany her husband into the hospital, she was stopped at the door. She had to give him a hug and a kiss in the parking lot. She called me because I’m an intensive care nurse with over 12 years of experience and now had no idea if her husband was okay.
Across the country, because of COVID-19, family members, spouses, and friends are being told they may not enter the hospital with their loved ones. Fathers are being told they may not be present for the birth of their children. Family members are told they will not be able to hold the hand of their loved one as they die. We are now being barred from being present for the two most sacred moments in a person’s life — birth and death. But separating patients from their loved ones while they are in the hospital is always a mistake. During this time of crisis, the practice is causing devastating harm.
Family — our patients' eyes and ears
I work in the cardiovascular intensive care unit at a major children’s hospital in California. My hospital serves pediatric patients as well as adults in a community of 4 million people. But we do not bar entry to our patients’ identified support people. Instead, we follow stringent protocols and take every precaution to make sure no one gets exposed to COVID-19. Even with COVID-19 in our community, we have been successful with no hospital-acquired infections.
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It’s a little-known fact that at the hospital, doctors and nurses rely on the patients’ loved ones to be their extra eyes, ears and hands. They advocate for their loved ones. They are present when medical decisions are being made because many of these patients are in vulnerable positions due to compromised health. Having a vigilant loved one at a patient’s bedside helps the patient receive the very best care.
The truth is both nurses and doctors rely on family members. We need them to help us turn patients by holding the multiple types of catheter tubing. We need them to motivate their loved ones through illnesses. They feed them, help with sips of fluid, help change patients, and do dozens of other general activities of daily care which ultimately help keep our patients safe.
This is especially true on busy days when we nurses are caring for multiple critical patients. Loved ones will even double check medication and dosing. It annoys nurses — of course — but we also work 12-hour shifts and, ultimately, we are grateful, knowing that even the most experienced RN can make medical mistakes. Our mistakes can have catastrophic consequences: Iatrogenic (health professional-induced) mistakes are the third leading cause of death in America by some measures.
But due to the lack of preparedness from hospital administrators and health departments, doctors and nurses are overworked and overwhelmed, especially in New York and New Jersey. This can lead to patient neglect. My colleagues report that in some hospitals only a single nurse, with a nursing assistant to help, is in charge of four ventilated patients.
Overstretched medical staff
An intubated patient is sedated and paralyzed. You must move them every two hours in order to preserve their skin integrity. If you don’t, the patient can develop major pressure sores that can become infected and even deadly. The fluid in their lungs can settle and make it even more difficult to ventilate. To safely move an intubated person, you need three or four people. Without appropriate help, it becomes very dangerous for the staff and patient. I can tell you from personal experience that it is impossible for just one intensive care unit nurse and a nursing assistant to provide adequate care to four patients at a time.
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At my hospital, we allow a partner in care at bedside for our non-COVID hospitalized patients. We require temperature and symptom checks at the front entrance. The hospital staff is given the authority to ask partners-in-care to leave if symptoms are noticed while the loved ones are at the patient’s bedside. We practice strict hand washing guidelines and wear masks and gloves when caring for patients.
We have COVID-19 in our community: Our families are exposed, our staff is exposed, and our patients are exposed within the community. But our hospital’s outstanding outcomes prove that people can safely be in the hospital with their loved ones without having or increasing hospital-acquired infections.
Two days after she kissed her husband goodbye in the hospital parking lot, my friend was told to pick him up. She had had zero communication from the hospital. Not once had a staff member returned her call. The uncertainty was devastating. In all the time her husband has been battling a heart condition, being separated from him was the worst thing she ever had to go through. But she is lucky. Her husband is still alive.
Tawny Buettner works in San Diego, California. She has worked as an intensive care unit nurse for over 12 years. These views are hers and do not reflect the opinions of her employer.