For Kimmy Miller, a registered nurse at UW Medical Center – Montlake, working on a floor designated for patients with COVID-19 means finding creative ways to make a personal connection.
“Patients are in isolation, and we have to try and spend as little time in their rooms as possible,” says Miller.
She explains that reducing time in patient rooms helps minimize risk of exposure for nurses but also makes it challenging to connect with patients, especially when personal protective equipment (PPE) masks nonverbal communication.
Miller strives to create a sense of familiarity for her patients by asking about their families and interests. Even though they can’t see her face and expressions, she wants to connect with them so that she is someone they recognize — a small comfort in unpredictable times.
A time of uncertainty
Miller says that before COVID-19, she walked into work with a sense of certainty, but now there is an air of anxiety and nervousness.
“Every day you don’t know what it’s going to be like,” says Miller. “But we are nurses, we have dealt with uncertainty before, and we become stronger for it.”
The floor Miller works on admits patients who have tested positive for COVID-19 and are stable enough to breathe without a ventilator but are often dealing with other chronic conditions. Many patients on her floor have requested not to be resuscitated (DNR) or intubated (DNI) as part of their advanced care plan.
“That’s the most difficult,” says Miller. “Watching over our comfort care patients.”
Before COVID-19, when a patient was nearing end-of-life, nurses would check-in on their patient every 10 to 15 minutes, and most patients had their extended family bedside. Now, due to safety protocols, nurses can’t physically check-in on patients as frequently and visitor policies reduce the number of family members that can visit per day, but the nurses do their best to keep end-of-life patients as comfortable as possible.
“Every day for every patient, you are making a difference,” says Miller.
And that’s what keeps her going.
Your greatest asset is your team
Miller calls her coworkers her greatest assets.
“We talk about what is going on and ask how everyone is doing emotionally,” says Miller.
Her nursing floor has started working in teams of two. Together, the nurses see about five patients a shift. One nurse works in the room with the patient and the other supports from outside by retrieving items that their partner might need for patient care.
Miller says it makes her feel supported and cultivates a sense of teamwork. As much as patients need to know they are not alone in this, so do care team members.
The tools for the job
The habits she has built inside the hospital transfer to her own self-care practices. Miller tries to keep a sense of routine and familiarity for herself the same way she does for her patients.
“I run 3.5 miles to the same spot every day,” says Miller. “You push yourself; you focus on your breathing and your steps and it takes away everything else that was on your mind.”
Miller acknowledges that the emotional burden and physical toll of her work is heavy, but she has the tools and support to do this job.
“We do our jobs every day, even when there isn’t a pandemic,” says Miller. “This work is always going to be physically or emotionally exhausting.”
And it’s worth it for her, especially when she gets to see patients go home to their families.