Uniting Under Fire

In December 2019 we began to hear about a new and deadly virus that was spreading through China. For a few short weeks, many of us thought that this was something that wouldn’t affect us and, even if it did, we were sure that “some virus” was no match for medicine in the United States.

Of course, that was not the case. As an organization that cares for more than 300 vulnerable elders every day, we tried to prepare when we heard about the first cases in Seattle. We ordered surgical masks, debating about how many we really needed and ending up with 1000, an incredibly insignificant number in the face of all that followed. We trained all of our management staff to be “dining assistants,” a precaution in the event that we were short staffed and needed others to help with meal delivery (our state laws mandate that training). And we waited. And we prayed.

We didn’t have to wait long. In March, a family member came to visit his dad at the nursing home. This visiting son, who happened to also be a physician, was one of the first cases in New York State and served as our “typhoid Mary.”

What was most striking about this pandemic experience was that no one knew anything. There was no information. First, the theory was that it was surface spread and we sprayed the buildings from top to bottom. Then, there were no effective treatments and there were times that an elder would die from COVID before they even showed a symptom. At one point, of our staff of 350 on the nursing home campus, we had more than 100 staff out with COVID!

As a leader, I was operating on instinct. I made a point of being at the buildings every day. When we needed help serving meals, I took trays to patient rooms. I dressed for work, which for me is generally business formal, so that my appearance felt “normal” and I made a point of always being in bright colors, feeling as if it gave the staff (and me) a positive feeling.

I made rounds on all of our units, I put PPE on and I walked the COVID units. Staff would stop me and make sure I had all of my gear. The first time I went into a COVID care area, after we had erected temporary walls, I was gowned and masked. One of our nursing assistants stopped me. “Miss Carol, Miss Carol, you have to put gloves on!” And I did.

Our amazing staff faced this virus head-on. One suggested we bring in negative pressure machines to help prevent the spread into the air handling system. We did. Another researched UV lights that we bought, and used, whenever deep cleaning a room. Our nursing staff, with their deep knowing of our elders, noted the slightest symptom or behavioral change and began whatever medical intervention we had at our disposal. Our dietitian created a special COVID diet, our Rehab staff assisted with turning and re-positioning to help with breathing. Our Respiratory Therapy partner brought in the same oxygen treatments that were being used in the hospital. Our focus was to save lives. And we did.

When an elder graduated from COVID isolation, we had a building-wide celebration. People gathered in the hallway, music was playing and everyone was dancing. Each “graduate” received a certificate, and we celebrated their survival with energy and heart and enthusiasm.

Taking care of our staff was the most vital thing, making sure that they knew we valued them. All meals were provided free of charge and, once a week, we had a special meal sponsored by a donor or board member. Management staff stood behind the serving table for all of those special meals, and I made a point of being there for all of the shifts, wanting staff to feel and know that I cared.

When folks could not get basic grocery supplies, we opened our own “bodega” on each campus and we offered milk, three kinds of bread, eggs, paper towels and the all-important toilet paper. Each item was $1 and staff were thrilled not to have to try and find these critical things in the emptied-out stores.

For a long time, we used PPE jumpsuits that zipped up the front. These disposable coveralls were not the greatest fit, and they were often uncomfortably warm for staff to wear while providing care, but they served a purpose. One day we noticed that folks were decorating these coveralls with their own version of designer logos and slogans. We decided to have a “PPE Fashion Show” and we strutted down our center hall, laughing in the midst of the most stressful of times.

When the vaccine finally became available, we counted the days until our first doses were available. We turned the vaccine clinics into parties, and we had music and decorations and snacks. At one campus, we had big balloon arches to celebrate this vital step forward. We could not mandate the vaccine at that time, but we managed to achieve 100% compliance by talking to every single employee and answering all of their questions.

The second dose clinics were even more of a party atmosphere, and we had T-shirts made for all of our staff. Many of them still wear them with pride.

When I think about a time that solidified our culture as an organization and bonded our team together, this is what I think about. We shared the trauma. We shared anxiety. We shared grief and then we shared hope. Those of us who were here for the crisis have connections that were forged in the COVID crucible and are enduring and unbreakable.

~ Carol Silver Elliot

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