Name & Degree Program:
Meagen Driskill - doctor of nursing practice degree. TCU's first Walker Graduate Fellow.
My life as an COVID-ICU nurse battling COVID-19
Meagen Driskill: Baylor Scott White Medical Center Grapevine
Tell us about your role and how you’ve experienced COVID-19 in your profession.
I'm the director of nursing and for critical care services here at the hospital. That means I'm one of four nursing directors and each of us have kind of our scope that we're over and critical care, of course, is what's been most impacted by this healthcare crisis and which means I'm over the emergency department, the intensive care unit, ICU, as well as our EMS and rapid response team. Those are all the main areas that are most impacted by this and a lot of what my work has been over the last several weeks, is to prepare my areas for the influx of patients that we have had and that we anticipate over the coming weeks.
The emergency department that we have, has 27 beds and we see about an average of 50,000 patients per year. As we look across the country in some of the areas that have already experienced the surge or influx of these patients. We know that our emergency department volume can triple perhaps just depending on how this takes off in our area. So we have converted half of our emergency department to where we can put these patients that are infected and we put those in a particular type of airborne isolation.
So there was a lot of modifications to the existing emergency department rooms treatment rooms. We also added an overflow area using a back hallway and an unused office space to accommodate an additional 40 patients. On top of that, we also put up a tent that's adjacent to the emergency department in case we get an influx of 40 to 60 patients over our norm, then we can start putting patients in that tent. So increasing our capacity to take more patients has been one of the first things that we've done and we have through the last two weeks started to see a pretty consistent spike in the number of patients seeking treatment for COVID-19.
On the other side of that we see across the country and even in Europe that for these patients, ICU beds are critical. It's a critical need to care for these patients, and so the existing ICU I have, is 20 beds and we've doubled that capacity. So we've created an ICU overflow for COVID patients as well as established another ICU for just regular ICU patients, meaning medical surgical and trauma patients that would normally or typically be in an ICU to segregate them from the COVID patients.
So a lot of planning and preparing. In addition to staffing resources and figuring out how many nurses we’ll need as you've also heard across the country. The availability of healthcare personnel is a dire, dire need and there's not enough nurses, particularly critical care nurses to care for these sick patients as we're seeing them.
Nurses are considered essential and they've got to be here to take care of patients. So a lot of my nurses, first and foremost, have been terrified and I have had 20-something-year-old nurses look at me with tears in their eyes and say, ‘I don't want to die. I'm scared. I'm scared to take care of these patients, but I know it's what I signed up for. I know, that's why I am a nurse.’ Then there's others who have small children who have husbands or elderly family members that they care for there's just been a variety of circumstances and as a nursing leader, working with each of those individuals to the best of our abilities to provide them resources. So nurses have come together to share childcare resources and some of our community have offered hotel rooms and other accommodations so that our nurses and physicians don't have to go home and potentially expose their own family because they've been taking care of patients. Just a lot of innovative thinking and ways to be able to keep our team safe, so they can continue to care for our patients.
Did you get much preparation time for all these changes?
No, we did not. I think all of us through our media and, you know, heard about Washington state being one of the first in a country to be significantly impacted through the healthcare community as far as our colleagues and professional organizations, we started hearing about this, but you know, it was just like a roller coaster train coming out. It's just as quickly and there was very little time to say, ‘What do we do, and how do we prepare?’ Unfortunately, I think you know as healthcare professionals, we have shared those lessons learned and that's been our preparation, but nothing as a nurse as a nurse leader and critical care, has prepared us to endure or be ready for what we have seen happening across the country. And what we may very well be experiencing here in the near or in the next few days or weeks.
One of the concerns we’ve seen across the country is healthcare professionals having a shortage of protective equipment. Do you have everything you need?
Yeah, it's definitely a very real consideration, I think. Fortunately, being part of Baylor Scott and White Health, it's a robust large organization with a wealth of resources. So our health system has been very well in tune to helping us ensure we have the personal protection equipment that we need gowns, masks, things of that nature. We are on a conservation program where we are assigned a certain number of masks and those masks are sanitized and reused a certain number of times, according to what the CDC recommends and other experts. We are definitely just like everybody else in the country very conscientious and conserving the use of our PPE, but yet at the same time still obviously protecting our team, first and foremost, no one's had to go without the protection that they need.
While the majority of the attention is on COVID-19 patients, there are patients coming in for other illnesses and injuries as well. How do you manage being able to care for those populations as well?
That's kind of a little bit about what I mentioned earlier. We're definitely co-horting the patients that had COVID-19, whether it's in the ICU or on a medical unit and we're keeping those patients together. We're able to test them, and get those results back so we can discern whether or not it's COVID or whether or not it's the flu or maybe it's somebody who was in an accident. That's a trauma patient and doesn't have COVID. Well, we keep them separate from patients that do have COPD. So there's definitely a lot of intentional processes in place and practices that we've implemented to keep those patients segregated so that we can continue to take care of our normal patients that we take care of on a daily basis.
In terms of people being concerned as to the severity of COVID-19, should everyone who has a perpetual cough get a test?
Absolutely not. I think the individuals that need to come to the hospital are the ones that are sick enough that require care in an emergency room or emergency department and then obviously would be admitted if they needed to be. But I think what individuals need to do, somebody that wakes up with a cough for some of these, you know, mild symptoms, they need to contact their primary care provider and if they don't have one, there's lots of resources out there. Baylor Scott and White health has an app that you can download on your phone and it'll plug you into a primary care provider by telehealth, you know, you answer those questions and then they advise whether or not you need to be tested, whether or not you need to go to the hospital, whether or not you need to see a doctor. So it's kind of a new and innovative way of getting the care you need as a patient through telehealth.
What can the TCU alumni do at home to stay safe?
Yes, wash your hands. Definitely. It just like any other day, regardless if it's now or when we get past this crisis. Absolutely. Wash your hands. It's long standing that that's been the best protection for anybody is to wash their hands, whether it's to prevent COVID or to prevent the flu. The common cold or anything else for that matter, but I think, you know, staying at home, just like our experts are advising us you know every time we turn on the TV or hear any sort of media. You know that message is consistent. We all need to stay home. We need to practice these guidelines. These regulations have been put in place for a reason and they're working and I think the Dallas-Fort Worth area is definitely already ahead of the curve in the sense that we did, implement and these recommendations that the experts had advice to do so ,that we are not hopefully not in a situation like some of our some of the areas in our country are.
What's the one or two things or stories that really surprised you about this, this whole experience?
I think a story that has surprised me is that over the last, gosh, probably three, four weeks, at least, it all seems to be a blur in my role as a healthcare professional just working tirelessly to prepare the my facility my hospital to take care of these patients, and these patients kind of remain to be seen. We obviously have those patients that we're caring for now, but kind of generally speaking of these patients. I received a phone call last week about a family member of mine and has actually been in one of the Baylor Scott and White hospitals for the last two weeks, and he has COVID and he's been in the ICU on a ventilator for 10 days and they can't get him off the ventilator because he's that ill. So the reality of how real this is versus just preparing to take care of the masses of patients that we anticipate to win it, somebody in your family that gets it and that is really just unbelievable. That's definitely an example, I think, of a story or scenario that's resonated with me in all of this. I think the other thing that I would say is that as leaders, I think I've heard this consistently throughout just the healthcare system that community, that as a leader is the time to step up and to lead and to do the right thing by example and to have that impact, whether it's with your family or with the community that you're involved in, whether it's your church school or whomever and that leadership ability to stand up and do what needs to be done during this time of crisis.
On a personal side, how has this impacted your work/life balance? How many days a week are you working?
Definitely, seven days a week. I've always been somewhat on call, so to speak, for whatever is needed, but it has long days long hours, seven days a week. Just because as you asked earlier, did we get a warning or to start preparing for this months ago, or years ago. No, of course not. This is all so new and just in a matter of weeks, we've had to completely rethink, a lot of the way a lot of the things that we do, and the way we do things our processes and practices and so it's definitely been a lot of long hours, and yeah, there's definitely been no days off.