Jones-Harrison infection preventionist: ‘The benefit [of visits] is to their psychosocial well-being and the risk is to their physical well-being’

The Southwest Journal is documenting the coronavirus pandemic by recording the personal stories of Minneapolis residents and workers whose daily lives are in a state of flux. As the outbreak evolves, we will be checking in with the participants regularly. Read all of the stories here.

All interviews are conducted over the phone, and conversations are edited for length and clarity.

Barb Joyce, infection preventionist, Jones-Harrison senior living 

We finished the three rounds of weekly all-resident and all-staff National Guard tests on June 9, and we found them to be very beneficial. We only have two residents left in our COVID unit, and they’re ready to come out. As soon as we get their test results back, our COVID unit will be empty. That feels really good. I think we have put the breaks on that runaway train. 

My all-clear would be no new cases for 21 days. The state gives us guidance suggesting continued testing until you get two rounds of negative. I can’t see us ever getting to a zero with the staff getting exposed in the community, especially if the community is opening up. We’ll play it by ear. If we see it pop up in the future, we might just do unit testing and not necessarily the full house — unless we see it move from unit to unit. It’s a quirky germ, so I’m grateful we have full-facility testing in our back pocket. 

In addition to testing, the KN95 filter masks have also provided a higher level of prevention. We’ve been able to provide them to everyone who shares space with our residents for the last three weeks. They’re one size fits most, but we use an ear protector designed by a 12-year-old Boy Scout. One of our IT guys with a 3D printer made us some to help create a seal for the masks. It’s a little tool that’s really saved a lot of people’s ears from pressure injuries. 

I feel like people who haven’t experienced the illness yet don’t understand how tricky this can be. We’re stronger and more knowledgeable because we’ve gone through this and will be better able to nip it in the bud sooner versus later in the future.

One of our residents tested positive in May and spent 21 days in our COVID unit before finally testing negative on May 27, after which we moved them back to their unit. Yesterday, the resident tested positive again with no symptoms. The resident’s a little younger than our general population. This isn’t bad, it isn’t good, it’s just interesting. There’s no rhyme or reason to it. The resident didn’t have a caregiver who was positive or an outing to see strangers. So we’re trying to decipher what this actually means. 

We’ve had very few people take their family members out of Jones-Harrison. One was a hospice patient whose family wanted to be with her. We tested her before she left and she was positive. She had hospice services at home and has since passed. Another patient was in assisted living and her family readmitted her after about a month because they realized the COVID pandemic was not going to be just a month long. 

We’re very excited about the drug dexamethasone that’s a treatment for COVID. In the very beginning, some of our patients had a very sudden decline — you’d see them go from “I have a bit of a fever” to respiratory distress in one to two days. I think those people would benefit from this drug. Recently, we haven’t seen patients devolve as quickly, and we’re not sure why. It’s a mystery why this affects one person mildly and another person severely.

We’re in conversations about starting visitations for families. We want to do them outside versus people coming into our environment and being asymptomatic carriers. We have a few wrought iron gates that we’ll attach plexiglass to. This will separate their faces, but underneath the plexiglass, they’ll be able to put their hands through the gate and hold hands or rub the knees of their mom or dad. The setup is kind of bank-teller style. 

Right now people are healthy and the weather is good. With the community opening up, it would be nice to get at least one visit per family. Maybe that will help them if we get into a second wave. There are risks and benefits. The benefit is to their psychosocial well-being and the risk is to their physical well-being. And we’re trying to balance that out for both patients and their families.

Personally, I’m in a funk — no extreme highs, no extreme lows. I feel like I’m in this holding pattern. I need to break through this. I think I need a vacation. I need to let go of some of this so I don’t have to deal with it every day of my life. But when I have one or two still testing positive, that grabs a hold of me, saying, “You’d better pay attention.”


VOICES FROM THE PANDEMIC

 You can read all of the stories here.