Throughout the coronavirus pandemic, healthcare professionals have been some of the most affected actors in this real-life drama. In terms of their physical health, as well as the emotional stress and strain they’ve experienced, the toll has been a constant.
We reached out to anesthesia providers to better understand what the day-to-day looked like for them during these times, and learn more about the efforts they’ve undertaken on behalf of the safety and care of all involved. This story is from the perspective of Lisa, a CRNA.
Starting the Day
My day starts with my mask. I wear my personal mask from the parking deck to the hospital, where I then swap it for my N95 mask and face shield. Afterward, I proceed to the OR desk where I check and record my temperature, and note that, at least thus far, I have not had a fever, headache, or any other symptoms. Since I’ve been symptom-free, I am allowed to proceed to the OR room.
The first thing I do when I get there is “glove up” and wipe down everything in the room. I clean every surface in my workspace, including the anesthesia machine, monitors, keyboards and cables, flat surfaces and drawers/handles, all with OR-approved solution wipes. I will repeat this process after every surgery to make sure the entire area is sanitized for the next patient.
Next, I set up for my case. I review patient histories and lab work, paying attention to whether or not they have been tested for COVID-19. The majority of our elective surgeries are tested prior to their surgery date. However, emergency cases and in-hospital cases are not likely to have been tested previously. Either way, I wear my gown, gloves, mask, and face shield as if every patient in the OR has COVID-19. This, as part of an involved process, is to make sure I am doing everything I can to protect myself and those around me.
Masks are required in all areas of the hospital. Everyone is encouraged to wash their hands frequently, and sanitizer dispensers are located throughout the OR, in the hallways, and in patient rooms.
For more on COVID-19 updates for anesthesiologists and CRNA’s, click here.
Informing and Comforting the Patients
When we resumed elective surgery in May, patients were dropped off at the hospital entrance for their surgery without family or support. It was a very lonely time for them. From my perspective, these patients seemed scared, especially as the protocols in place further isolated them from human touch, removing a certain level of comfort from the experiences they were familiar with.
When I meet with my patients, I am covered by my gown, gloves, N95 mask, and glasses. I try to convey to them through a muffled voice that I am there to support them and care for them, as if they were my own family. I get less than five minutes to share with each patent that they can trust me and depend on me. I convey to them my confidence in my ability and experience as their anesthesia provider.
I do my best to alleviate their anxiety by letting them know what they can expect as we move to the operating room. I believe my patients’ frame of mind going to sleep will affect their well-being during surgery and postoperatively. I make every effort to convey that they are in great hands, and the surgical and anesthesia team is fully prepared and there for them. It is essential that the patients trust us in order to relinquish control when the anesthesia begins to take effect.
After they wake up in the recovery room and are ready to be discharged, their family comes to pick them up, and we give them the instructions for care after leaving the hospital.
After about a month of outpatient surgeries only, protocols changed to allow more involved procedures that required overnight stays. Patients were allowed to have one support person with them preoperatively, and both the patient and their company were screened, required to wear masks, and interviewed regarding COVID-19 contact. Patient visitation is limited to one person and ends at 6 p.m.
I believe that this alleviated some of the anxiety the patients were experiencing. However, my regimen has not changed, and I still meet the patient in full PPE. I continue to try to alleviate their anxiety by conveying to them how well they will be taken care of and that their family will be updated throughout the entire process.
Another change has been the rise of telemedicine in the anesthesiology sector. To learn more about this development, read our most recent blog!
Anesthesia inductions have always required minimizing aerosolizing particles from patient airways during intubation. In response to COVID-19, a new standard was developed to include full PPE, an N95 mask, an OR mask covering the N95 mask, gloves, gowns, goggles, and face shields. The anesthetic has paralytics that, within 30-45 seconds, provide the muscle relaxation needed to place the endotracheal tube thru the vocal cords, preventing cough and the potential for aerosolizing particles into the air.
Healthcare in the Future
How do I feel about healthcare in the future?
Right now, the industry is ever-changing. We know more today than we did yesterday, last week, last month, and since the start of COVID-19. Continued research and data will give us more insight on how to move forward in making decisions on patient care and protecting essential healthcare workers.
Based on what I have seen, I believe that most people will end up contracting COVID-19, differing in severity based on exposure, strength, and strain. I think the most important thing that anyone can do is stay informed and take action to protect themselves and the people around them.
Wear the mask. Is it inconvenient? Sure. Is it infringing on your rights? Not hardly. Be respectful of others, and be safe.