Nursing experts in councilwoman’s webinar tell of coronavirus’s impact on the medical front lines

Four nursing experts described their experiences on the front lines of the coronavirus pandemic as San Diego City Council President Pro Tem Barbara Bry presented the third installment of her “House Calls” public webinar series April 20.

During the 45-minute session, delivered via Facebook Live and Zoom, Katie Moss, a clinical nurse with UC San Diego Health, said she and her colleagues are “keeping up with the changes, learning as we go and making sure we stay up to date” on patient care standards.

Education is also important for Dr. Heather Warlan, assistant director of nursing quality, education, development and research at UCSD Health, who said navigating the COVID-19 crisis “has been challenging, with a lot of planning to ensure our hospital is prepared to care for a surge of COVID patients. What that means is we have a staffing model for a higher volume of patients, that we have educated our staff and expanded opportunities to support our employees, knowing it’s not just our work that’s changed, but also their home life. They really need a lot of support.”

“It’s emotional support,” Warlan added. “Nurses are worried about the risks and how their jobs will change. In addition, when you go home, there are other stresses with significant others or children. People’s bandwidth to deal with stress is challenged right now. We’re looking at expanding all our support programs to meet their needs.”

Moss agreed, saying “nursing is in general a difficult job, and with social distancing, our normal coping strategies aren’t there: movies, dinners with friends, massages. Community support is so appreciated.”

Bry said it’s “important you’re acknowledging the whole person and that it affects their lives outside of the hospital.”

When asked about the supply of personal protective equipment, Moss said San Diego County “has done a wonderful job with stay-at-home orders. We are in a really good spot with the numbers of PPE and mechanical ventilators we have right now.”

Warlan said contaminated PPE is “bagged and disposed of in accordance with very strict handling guidelines, whether it’s COVID-related or not.”

Warlan said there are enough coronavirus tests for patients and health care workers at UCSD.

“If you have a cough, fever, loss of taste or smell, your primary care provider might recommend you get a test at one of our drive-up testing centers,” she said. “For our own health care workers, they can be tested if they feel they’ve been exposed, either professionally or within the community.”

Moss said the intensive care unit at UCSD Medical Center in Hillcrest is conducting a trial of the antiviral drug remdesivir for its potential as a treatment for the coronavirus. Similar trials are being conducted elsewhere.

“It’s still new, but seems it’s working well for the patients we’ve administered it to. I look forward to seeing what other trials are going on,” Moss said.

Dr. Karen Macauley, associate dean of advanced practice programs at the University of San Diego, said nursing students have been impressive in their output of care.

“The impact on our graduate students is truly remarkable,” Macauley said. “The majority of my students are working on the front lines. Many are parents, or caring for parents, and balancing all these new responsibilities with being a student and learning remotely.”

Dr. Kathy Marsh, associate dean at USD’s Hahn School of Nursing, said: “I see new nurses in pre-licensure ready to get out into the workforce. They have learned so much, and they have learned about health policy up close and personal. More students are interested in public health than ever before.”

Macauley and Marsh said they haven’t experienced a change in the number of nursing school applicants.

“People going into nursing are not deterred by what’s happening,” Marsh said. “They want to contribute to making their community a better place.”

Macauley was asked about nurses’ roles in contact tracing, a process in which public health staff works with patients to help them recall everyone they have had close contact with while they may have been infectious and warns those people of their potential exposure and encourages them to stay home for 14 days after their last exposure.

“It is nurses who provide tracking and surveillance of communicable disease,” Macauley said. “The uptick in public health nursing is really what we will need in the county in terms of tracking COVID-19.”

She also expressed worry about the residual effect of post-COVID-19 stresses in the health care community. “Nursing is in crisis mode. In addition to medical care, nurses are playing the part of family. The toll of the compassion and empathy required, you carry with you. It impacts your care for the rest of your life, and hospitals and schools need to provide support as we move forward.”

Bry thanked the participants, saying, “We are all very appreciative of what you’re doing. You are truly our front-line heroes.”

Previous “House Calls” webinars addressed the science behind the coronavirus and the economic impact of the outbreak. The next in the series will be at 5 p.m. Monday, April 27, and is free and open to the public. For information, email mgaynor@sandiego.gov

Prior online discussions and future ones can be viewed at Bry’s District 1 City Council Facebook page: facebook.com/BarbaraBryD1