Jones-Harrison infection preventionist: ‘We’re in a very stressful state of 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

There’s definitely more activity. We had our first COVID positive patient come to us from a hospital. On her second day here, she spiked a temperature. Fortunately, we have a rapid antigen test on site that showed her positive. We got the results in 15 minutes. But the machine is only good in a very short window of opportunity when patients are newly symptomatic. It is not as accurate as the laboratory testing we’ve been doing all along. 

There’s still a big question mark about people who’ve had the disease before and test positive again later. We’ve had two asymptomatic repeat COVID cases that we’ve dealt with, but I’m not sure if those patients were contagious or not. Over the late summer and fall, we also had a slow trickle of staff test positive — maybe one every other week.  

We’ve been very, very stable up until recently. The risk of our health care workers getting COVID in the community and bringing it in has gone up with the positivity rate. About three weeks ago, I had five employees test positive at once. Two had no symptoms, one had mild symptoms and one had severe symptoms. It’s all still quite a mystery, but it was a wakeup call that this isn’t gone yet and what we do is important. We shook off the dust, tightened our processes and have been trying to prevent it from coming to our residents.  

All of our staff are now testing twice a week instead of once a week. The hardest part of that is our laboratory was giving us results after five to seven days, which is too long. The whole state is now doing twice weekly testing. I’ve thought, “How does this make sense to give them twice as many specimens if we can’t figure out a quicker turnaround time?” It’s hard to do contact tracking five to seven days later. It’s a lot of work — a lot of work — but it’s the right thing to do to try to identify where this virus has gone. 

We have been testing the residents weekly, and so far, knock on wood, we have not had a translation from employee to resident, which means the PPE is working, the protocols are working. But it’s kind of like a little Band-Aid on a wound. If you don’t pay attention, the wound will get bigger than the Band-Aid.  

Before last week, the governing bodies were saying, “Open up, open up, open up. Allow visitors, allow more contact.” And a big fear of ours is that by opening up, it’s going to come through our doors and cause more harm. It’s not only about the residents but it’s also about the staff who show up every day and have families of their own. It’s not just about disconnected families but — like the butterfly effect — you really can’t predict what it will mean for others. 

When COVID enters the facility, we shut down our face-to-face indoor visits and only allow essential and compassionate caregivers. We’re in that stage now, with most visits held virtually through our therapeutic recreation department — video chats, FaceTime and Zoom. 

For the summer, we had the luxury of really good weather and a lot of families coming into our courtyards and visiting with the residents. They weren’t demanding to come in to see their loved ones. They were enjoying seeing their loved ones and we all felt a sigh of relief.

Now we have the holidays to deal with and families knocking on our door asking if they can take their loved ones home. The answer for Thanksgiving is, “No, it’s not the right thing to do.” It doesn’t look good for Christmas either, but we’re not going to cross that bridge until we absolutely have to. We can have hope.  Hope keeps us going.

At my house, we are not hosting Thanksgiving this year. It’s just going to be me and my husband, because the risk is too great. I have a daughter who’s a registered nurse at Fairview, and their hospitals are filling up. Not only do we have to protect ourselves as an older generation, we also need to protect her as a health care worker and protect my other daughter, who is a behavior specialist for autistic children. It’s affecting us all; not just the geriatric community. 

What I really wish for our nation to understand is that we’re better together than we are divided. I can do everything I can to reduce the transmission, but if my neighbor doesn’t participate, it goes nowhere and we’re in the same boat we were in March — or somewhere worse. That’s been the hardest part of this election and the politicizing of this germ. The argument of “I don’t have to do it because it’s my choice” is not just about them. We’ve gotten away from love thy neighbor. Walk a mile in our shoes and then you’ll know, and your perspective will change.

I think the governor’s closing of bars, restaurants and gyms today is a good decision. We have to close our doors because of the winter weather. It’s unfortunate for business, but if I at a nursing home had to figure it out and schools were forced to figure it out, then it’s not unreasonable for businesses to have to figure it out as well. 

At Jones-Harrison, we’re better positioned to contain an outbreak now than we were at the beginning of the summer, but it’s still slippery and we may have to weather another storm. If it does come into the facility again, there may be a time when the hospitals won’t have the capacity to take our residents. We are talking with our medical director and gearing up to think about what we could do on site. We don’t have a lab or physician here.  

We would do the best we can, but we are limited in the way our nursing home runs versus the hospital model. We can do IV hydration, use medications to help with symptoms and help get rid of mucus in the lungs. We’re open to learning new ways. Hopefully, by doing twice weekly testing we’re flattening the curve of COVID exposure for our residents. Can we handle one or two COVID patients? Yes. Can we handle 100 COVID patients? No.  

We’re hopeful about the vaccine. The trials we’re seeing have greater than 90% effectiveness. The United States, as one of the wealthier nations, will secure the vaccine in the quantities we’ll need and I believe geriatric facilities will get it first. We are signed up through the agency that will dispense the vaccines. But I feel bad for the countries that may be left out, so it’s bittersweet.  

My health has taken a hit, and I discovered my blood pressure is running high.  I also had a fall that contributed to unnecessary pain. The numbers trending up or down gives us a feeling that contributes to the stress we carry on the inside of our body that nobody sees.

One of my TV shows, “Grey’s Anatomy,” is back on now, and it caught me off guard. I found it very hard to watch the first episode because it was triggering my emotional instability. It was taking me back to when it was bad — the frustration and the people dying and the helplessness of the health care workers. 

COVID is affecting not just healthy people with this illness. It’s affecting the whole health care continuum. I can’t get my 96-year-old uncle to his audiologist so he can have hearing aids to contribute to the quality of his life during the last stages of his life. Life is more difficult these days, doing simple things we all take for granted. 

We’re in a very stressful state of being, and I want the rest of the world to know that. I want your understanding. Do the right thing. Stay at home. Wear a mask. Socially distance. Wash your hands frequently. Don’t have your holiday gatherings. You can make a sacrifice as well as we can.


VOICES FROM THE PANDEMIC

 You can read all of the stories here.