As one of ten hospitals around the country designated by the U.S. government as a special regional center to treat biothreats and infectious diseases, Massachusetts General Hospital’s Biothreat and emergency preparedness teams have been practicing for a potential outbreak for about a decade. But like health systems around the world, the recent coronavirus outbreak is still hitting them hard. The hospital has been trying to increase their testing capacity per day, and the nurse-run phone bank they set up to answer questions from the community and to screen for symptoms has been receiving more than 3,000 calls a day.
Hiyam Nadel, a Johnson & Johnson Nurse Innovation Fellow and founding member of the Society of Nurse Innovators, Scientists, Entrepreneurs and Leaders (SONSIEL), confirms that the situation is challenging, but that innovation is being ignited, and hospitals are coming together like never before. The Johnson & Johnson Notes on Nursing team recently spoke with Hiyam to learn more about the challenges her team is facing amid the pandemic and how they are constantly innovating to respond to these challenges.
J&J:
How is Massachusetts General Hospital working to support nurses on the frontlines?
Hiyam:
The most important thing we have done has been to improve communication with staff. We’ve shut down all internal emails except for updates about the coronavirus so they don’t miss anything important since this situation is evolving. We’ve also created a central website where our staff can go for up-to-date information.
My colleagues at Mass General and I are partnering with other hospitals, providers, the government, communities, manufacturers, Harvard, MIT and others in a rapid innovation platform, a consortium that is breaking down barriers so more people can share insights into treatments, clinical trials and medications. We’re also thinking through how to help our sister communities and health systems by sharing information and donations of food and equipment. Mass General is also teaming up with organizations to help test those who are experiencing homelessness in our community.
I’d also say the culture has really centered around how best we can support everyone. The hospital leadership has shared videos thanking everyone for their efforts and we’re all trying to start meetings with kindness and gratitude.
My colleagues at Mass General and I are partnering with other hospitals, providers, the government, communities, manufacturers, Harvard, MIT and others in a rapid innovation platform, a consortium that is breaking down barriers so more people can share insights into treatments, clinical trials and medications. We’re also thinking through how to help our sister communities and health systems by sharing information and donations of food and equipment. Mass General is also teaming up with organizations to help test those who are experiencing homelessness in our community.
I’d also say the culture has really centered around how best we can support everyone. The hospital leadership has shared videos thanking everyone for their efforts and we’re all trying to start meetings with kindness and gratitude.
J&J:
What are some of the challenges you have faced in combatting the coronavirus?
Hiyam:
Addressing people’s fears is probably the hardest thing. Nurses are also worried about contracting the virus themselves and infecting their families. They are anxious about getting tested if they have symptoms. We’re worried about potential staffing shortages. Our Knight center, a professional development center for staff, is doing massive training and proper education around specific personal protective equipment (PPE).
Most of us are feeling stressed and tired. Officials are predicting a surge over the next few weeks, and yet there is still so much to learn about this virus. Information about this virus is changing by the hour, so we’re thinking through how best to communicate new information to everyone. All day long, planning is taking place around surge capacity and the need for proper education. We’re trying to be as nimble and preventive as we can.
Most of us are feeling stressed and tired. Officials are predicting a surge over the next few weeks, and yet there is still so much to learn about this virus. Information about this virus is changing by the hour, so we’re thinking through how best to communicate new information to everyone. All day long, planning is taking place around surge capacity and the need for proper education. We’re trying to be as nimble and preventive as we can.
J&J:
How does this compare to anything else you’ve experienced in your nursing career?
Hiyam:
This isn’t like anything we have experienced before, but we listen to the source of truth and rely on our experts and science. There is lingering worry that we are running out of supplies, but massive efforts are taking place to prevent that.
As one of the leading biothreat hospitals in the country, we’ve been preparing for a moment like this for over ten years. We’ve practiced surge capacity and gone through exercises with the entire city. But with this outbreak there are new questions arising every day, not just relating to patient care but also with remote working, childcare, deliveries and parking. We’ve been able to put some plans into place quickly, but we’re continuing to pivot as we learn more. Everyone is working hard to understand it quickly and we’re grateful for learnings from other countries.
As one of the leading biothreat hospitals in the country, we’ve been preparing for a moment like this for over ten years. We’ve practiced surge capacity and gone through exercises with the entire city. But with this outbreak there are new questions arising every day, not just relating to patient care but also with remote working, childcare, deliveries and parking. We’ve been able to put some plans into place quickly, but we’re continuing to pivot as we learn more. Everyone is working hard to understand it quickly and we’re grateful for learnings from other countries.
J&J:
How have you and your team been finding ways to innovate during this time of crisis?
Hiyam:
This health crisis is revealing many gaps in care. It’s a great time for innovation, and I think this time will spur great ideas on how to improve care and reduce waste. We realized that because many patients are in isolation, they were experiencing loneliness. We started adding iPads to the IV poles so nurses can speak more often with their patients.
To help address the anxiety and uncertainty we were hearing from staff, we launched an email box for nurses to send us their questions and suggestions. This will be vital to informing our policies and trainings and will allow us to advocate for resources at a faster pace. We noticed a common theme of nurses being unsure of best practices for PPE, so we orchestrated a rapid response to subdue some of their anxiety with messaging and real-time training. We were able to train over 1,200 staff in one week on how to reuse and extend PPE so our staff could feel more comfortable.
To help address the anxiety and uncertainty we were hearing from staff, we launched an email box for nurses to send us their questions and suggestions. This will be vital to informing our policies and trainings and will allow us to advocate for resources at a faster pace. We noticed a common theme of nurses being unsure of best practices for PPE, so we orchestrated a rapid response to subdue some of their anxiety with messaging and real-time training. We were able to train over 1,200 staff in one week on how to reuse and extend PPE so our staff could feel more comfortable.
J&J:
What do you think some of the long-term effects of this will be on the profession?
Hiyam:
I worry about what the financial impact of this will be, and I worry about long-term mental health effects on nurses and others on the frontline if we don’t address it quickly and rapidly. But I think this dramatic pause in our daily lives is going to make us rethink how we live and how we do things.
This moment is going to forever change our ways of working. For the longest time, we’ve wanted to leverage telehealth, but it’s been very slow. Suddenly, all the barriers such as payment, liability and pre-authorization has disappeared – paving the way to increased telehealth capabilities. Things that have weighed us down, administrative tasks and paperwork, are gone because we can’t handle it right now. I hope that this can be sustained when this is all over and open the door for more innovative thinking and improvements in care delivery.
This moment is going to forever change our ways of working. For the longest time, we’ve wanted to leverage telehealth, but it’s been very slow. Suddenly, all the barriers such as payment, liability and pre-authorization has disappeared – paving the way to increased telehealth capabilities. Things that have weighed us down, administrative tasks and paperwork, are gone because we can’t handle it right now. I hope that this can be sustained when this is all over and open the door for more innovative thinking and improvements in care delivery.
J&J:
What are you doing to stay positive, motivated or inspired during this time?
Hiyam:
To stay positive I’m trying to stay close to other colleagues – either by six feet apart or virtually! We’ve been emailing each other discussing what we are going to do in June or July when this is hopefully all over. There’s going to be an end here, and we’re looking forward to that.
The leadership of my hospital is keeping me motivated. They are on the floors with their staff, and everyone doing their part means a lot to me. And I’ve been incredibly inspired by the resilient nurses both inside my hospital and beyond.
When I’m asking our nurses what I can do to help, they have such amazing smiles on their faces. It makes me happy to be able to deliver the trainings and other resources they need in real time.
The leadership of my hospital is keeping me motivated. They are on the floors with their staff, and everyone doing their part means a lot to me. And I’ve been incredibly inspired by the resilient nurses both inside my hospital and beyond.
When I’m asking our nurses what I can do to help, they have such amazing smiles on their faces. It makes me happy to be able to deliver the trainings and other resources they need in real time.
J&J:
Do you have any advice for nurses across the country during this time?
Hiyam:
If you’re feeling overwhelmed by all the information that’s out there, try to stay calm and go to the source of truth – the Centers for Disease Control and Prevention. If you keep watching television, you’ll think that we are done for, I have faith that before long we’ll be on the other side of this.
In the meantime, I think it’ll be vital to find a way to touch base with fellow nurses and strengthen our communities. Many nurses are feeling isolated in all this. Recently, the Johnson & Johnson Nurse Innovation Fellows were able to get on the phone together and share their experiences, plans and fears regarding the coronavirus. Nurses rarely have the opportunity to come together and share their thoughts, so schedule calls, leverage video chats and use the time to not only touch base but share ideas.
Nurses have a unique opportunity to innovate and lead in this moment.
In the meantime, I think it’ll be vital to find a way to touch base with fellow nurses and strengthen our communities. Many nurses are feeling isolated in all this. Recently, the Johnson & Johnson Nurse Innovation Fellows were able to get on the phone together and share their experiences, plans and fears regarding the coronavirus. Nurses rarely have the opportunity to come together and share their thoughts, so schedule calls, leverage video chats and use the time to not only touch base but share ideas.
Nurses have a unique opportunity to innovate and lead in this moment.