PEGGY MOSSHOLDER is typically a triage nurse at Hospice Savannah, but since the outbreak of COVID-19, she’s transitioned to the “COVID nurse.” That means she’s able to care for patients who have tested positive for COVID-19 without interrupting the care of the community.
This is her Quarantine Chronicle.
What has it been like to transition into being the COVID nurse? Is that scary for you?Not so much. I’ve been a nurse for a long time, so I think back to when AIDS was an epidemic and the death rate was 100%. COVID is, what, 3% maybe. It doesn’t scare me so much.
The key here is proper PPE. That’s been the big issue. When the coronavirus epidemic began, we really weren’t prepared. Nobody was prepared. PPE was limited. So in order to be safe, I can use full PPE, the cap, the gloves, the gown, the booties, the mask, all that, whereas to see our standard patients, they can wear a mask and gloves and be safe.
When you’re limited on materials, to have one nurse that can see these patients and be able to have the PPE that I needed was easy for Hospice Savannah to provide. Now we have adequate materials and supplies so that we can open up Hospice House again and have one wing for patients and another wing for specific COVID-19 patients, or patients we suspect could have COVID-19. It’s all a matter of having the materials that are needed. But there was such a limitation that taking a nurse who didn’t have a patient caseload to see them was outfitting one person vs. outfitting everybody.
How many nurses are in rotation at Hospice Savannah that would need PPE?Let’s say there are 10 homecare nurses, but each one has 16 patients. Sometimes we’ll go see a patient in the morning and then they start having complications in the afternoon, so you might see them more than once. Unlike in the hospital, where you’re in an isolated area, we would be protected when we go in the home. It’s not just the number of nurses we have, it’s the frequency of visits.
I think Hospice was wise in coming up with this plan. I think [CEO Dr.] Kathleen Benton and our leadership team did a really good job, and they made it so where we could provide for the community the way we should.
I’m sure that makes you feel really secure to know you’re going into work prepared.And I was. Any PPE I needed, I got. Some nurses were upset—I don’t mean just Hospice nurses, but nurses in general—because they didn’t have the materials they needed or they didn’t feel they had what they needed. But by dividing out things according to who needs what, Hospice Savannah was able to keep us as safe as they could.
Besides the PPE, are there any extra precautions you’re taking?Oh, yeah. I’ve done a lot of things. Mostly I follow the CDC as far as protecting yourself when you see your patients, taking all the garb off as you leave. I’m fortunate in that I have a vehicle that only I was using, so I could wipe it down before anyone else would use it.
I come home and it’s the joke: just because you see your neighbor strip down, don’t judge, she’s a nurse. I have a robe in the garage, so I strip down there, put on my robe, throw my clothes in the laundry as I walk in the door, take a shower before I talk to anybody, and I come out of my private bathroom feeling clean. My hair’s been washed more in the last month than it has in a year, but that’s okay.
How are your patients feeling about this virus, if they’re cognizant of it?The few COVID-19 patients I’ve cared for weren’t really cognizant; they were very short-term, which fits into what COVID is doing. But the interesting thing is that I’m also a triage nurse, so I take in referrals on the weekends after hours. The community as a whole, they’re smart. They ask good questions and are like, “How do I know that nursing won’t make my mom sick? Do you take care of COVID patients?” I tell them we have a specific nurse—I don’t always tell them it’s me—that takes care of the COVID patients, so since your mother or significant other is not a COVID-19 patient, that nurse will not be seeing her.
That seems to give them a sense of relief because we tell our patients, going into the hospital probably isn’t the best thing right now.
We as hospice workers know the importance of having family with you when you’re terminally ill. In the hospitals, they’re not allowing families to be with the patients because that’s their safety mechanism. But we have this vulnerable population that sometimes, those rules are not the same.
I think it makes a big difference how Hospice Savannah handles COVID-19 vs. the rest of the healthcare service, and I think it’s important that the community knows that we are trying to keep them safe, but we’re also in a unique situation to allow family to be with their loved ones and protect them.
I know we can’t have all 92 family members in the room, because we would run out of PPE really fast! But if you put a balancing act in there, we do have the ability to do some things that acute care settings can’t do. And that makes me very proud to work for the organization I work for.
What else should people know?The amount of PPE needed is important for people to understand. Going overboard doesn’t necessarily make you safer, but it may reduce the supplies for people that do need those materials.
What equipment do people really need?A mask. And not even an N95. A cloth mask that you can wash by hand. Some material shrinks, so keep that in mind.
It’s an airborne virus. If you wear a mask and don’t touch your face—this is all the stuff they’re saying on the news. It’s not novel or new, and I’m not a genius because I know it.
Gloves may actually cause you to spread it more, because it’s a false protection. If you put them on and touch anything, you’ve touched things with potentially contaminated gloves. The gloves don’t protect you nearly as much as just wearing a mask, distancing, and the boredom of staying home.
The idea of healthcare workers reusing materials is frightening to me. I can see reusing a mask when it’s still clean and everything, but when I put on full garb and go in a home, my mask is drenching wet when I’m done. It’s not reusable.
How long are you typically in a home?Because of the care I give, I can be in there anywhere from an hour to two or three hours. To put [a mask] on and take it off, you don’t have a protected side anymore. It’s all exposed. So I keep hearing about reusing masks, and there are safe ways to do it, but if you wear it for a prolonged period of time, it becomes an infectious host. I think you have to use your knowledge and common sense.
There’s these things you have to do to get through this epidemic. When I go out, I wear a cloth mask and I use it when I do normal people things. But when I’m Peggy the COVID nurse, I use different protection because I know for sure what I’m exposing myself to.
The good news is, I’ve only had a few patients. The bad news is that I don’t suspect it will stay that way. I think if the count starts going down, people will think that it’s over too soon, and that scares me.
The other thing people need to do is take care of themselves. If you’re healthy, if you do get exposed, you can beat it. I guess there are four things you can do: wear a mask, distance yourself, stay home, and the biggest thing is to take care of yourself so you’re healthy enough that should you get exposed, you can beat it.