Rising to the Call
July 23, 2020
Corinne Sieker, infection preventionist at St. Paul Elder Services in Kaukauna, Wisconsin, heads the long-term care organization's efforts to protect its elderly population from coronavirus infection. When she first spoke to Catholic Health World Associate Editor Julie Minda on June 12, not one of the approximately 300 residents had tested positive for the virus, and there had been no viral spread among the facility's 450 staff members. While this still held true as of mid-July, the danger of contagion remains a constant threat.
Sieker talked about the challenges of infection control when what is known about the transmission of a disease is changing by the day. St. Paul includes long-term care, skilled nursing, assisted living and memory care services on two campuses in and around Green Bay, Wisconsin. It is part of the Franciscan Sisters of Christian Charity Sponsored Ministries health system of Manitowoc, Wisconsin.
In January or February, you started hearing about the virus over in Wuhan and pretty soon after that we had learned there were cases in our country. And, I didn't know anything beyond what was coming from the media, and it was all scary, particularly the news from China and Italy. And I remember thinking — this virus could be very, very bad. While I have been a nurse since 1995, I've only been an infection preventionist for less than three years. I can't tell you how often I worried about what I didn't know about coronavirus transmission. And I worried about personal things too. I have two sons, and I have to keep everybody safe as the caregiver of the family. It was very, very overwhelming.
And, so, you feel the pressure. But then you realize that all of your colleagues are just as worried and doing everything they can. We wouldn't have the results we've had if it wasn't for everyone on our St. Paul team showing up every day, screening honestly, reporting honestly, following the rules honestly, following the policies, bringing problems to attention, and rolling with the changes that happen every day — maybe twice a day.
Every person who walks in a St. Paul building has a temperature taken and is asked screening questions — like do you have a runny nose, stuffy nose, cough, body aches, a headache, a sore throat, all these things. We are not minimizing reported symptoms — not explaining any of them away. If they have one of those symptoms, they are screened out to be further evaluated. (If staff members have one or more symptoms, St. Paul sends them home to work with their health care provider to confirm they are COVID-free before returning to work.) So I think that helps because then it doesn't just slip under your door.
And another factor for our success has been our requirement that all staff and all residents wear masks. And we just started to have social distanced, PPE-protected, in-person visits for families and residents. This has been quite an undertaking. There has been a lot of planning that the team did. Managers are having to pitch in to provide supervision over those visits. All people who come into our buildings, including those now coming in for visits, are screened and get the same questions and have the same expectations as staff. All to get the best possible results: healthy, happy, COVID-free residents.
Following the guidelines from public health agencies has not been easy from the start. Information comes down from the World Health Organization and the Centers for Disease Control and Prevention, then Centers for Medicare and Medicaid Services, then the Department of Public Health and Department of Health Services and the Department of Quality Assurance at the state level, and then it comes down to our county public health offices and sometimes even our city public health offices. And so you get memos (from these different agencies) and none of them match.
"OK, well what is it you want me to do?" We are taking those memos and listening to webinars every day and then actioning them out in terms of what does this mean when it comes to screening our residents and how often do we have to screen them, and what are we screening them for, and what are the symptoms?
My time the first two to three months has been spent trying to keep up with the regulations, trying to stay on top of the daily changes and expectations and communicating it out to all the staff as clear work assignments, and to all the residents, and to all the families who have their own opinions about what we're doing.
Keeping straight all those communications that are being thrown at you while you are just trying to manage day-to-day operations of taking care of people has been the most difficult part.
But then on the flip side, the best part of this role is just being able to stand back and look out at everybody and say look at what we are doing. We have been screening all staff and residents for every little symptom you could possibly have, and while we have had several staff members test positive, not one resident has returned positive for coronavirus.
People are pretty hard on long-term care. But, look at us. We have staff who are going out in the world and having to go home and take care of their kids and go to the store and go to the gas station and be among a lot of people who are not protecting themselves or others. And then these staff come to work here and take care of people. But what we're doing is working to protect patients. It can work if you're doing it right.
Some of our staff share things on Facebook about how proud they are of what we as an organization have been able to do. I'm glad that they feel empowered and that they feel strong enough to say it to the outside world.
Sometimes you just want to stand on the top of the roof and you just want to yell (when the prevailing narrative is so negative), "We are not that bad, we are good and we're caring. We are loving."
View a video St. Paul created to document life on its Kaukauna campus amid the pandemic
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