As the COVID-19 situation grows more serious, Keck Medicine of USC is working extremely hard to respond to these rapidly changing circumstances. This ongoing series of stories will share the experiences of faculty and staff and their responses to the ongoing crisis.

Impressions from the frontlines: Keck Medical Center nursing

Efforts on the ground have been intense, with nurses across the health system pitching in to adapt, advocate and safely care for COVID and non-COVID patients alike.

Nurses in COVID-19 units are adjusting to new equipment and protocols every day. They’ve recently trained in how to safely reuse goggles and to extend the use of the N95 masks. They now have dedicated rooms for donning and removing their protective gear, which also includes special smocks and face shields.

They’re also working hard to find the best ways to communicate with patients who are feeling frightened. Maria Flores, RN, and Sylvia Rodriguez, RN and BSN said in a group statement: “The challenge comes in the form of trying to explain to patients that despite what is out in the media, we do not have enough tests to meet the demand and must limit to those that are high risk. The rewards are from answering patient questions regarding symptoms, self-care and caring for elderly family or family members who are high risk or being able to reassure patients on the course of illness.”

Steve Adams, RN, who works in phone triage, speaks with many people trying to get a same-day primary care appointment. For him and his colleagues, directing people to the proper type of in-person care has taken on a new complication.

“One of my challenges is when I am triaging somebody who is not having respiratory symptoms but has an acute situation, like injuries from a fall or a motor vehicle accident, people just do not want to go to the emergency room,” he said.

Innovations from leadership to protect those delivering care

Annette Sy, DNP, RN, chief nursing officer of Keck Medical Center, has been leading the effort to help prepare and protect the nursing staff from a new “command center,” where leaders from different departments across the health system are coordinating efforts to make sure policy communications are timely and everyone has what they need, when they need it.

“A typical day involves the command center remaining open 24/7,” Sy said. “Normal administrative business is halted. Our focus is to ensure that we have the staff and supplies that are needed.”

She added that protocols are in place to help leadership keep the nursing staff updated in real time as new policies and best practices develop.

Through all of this, the California Nurses Association (CNA) is kept fully in the loop. Tveen Kirkpatrick, RN, is chair of the Professional Practice Committee (PPC), composed of RN leaders within the CNA. She works at Keck Hospital in the 4th floor PACU.

“I can speak for CNA when I say nursing and hospital administration have been working very hard to develop safe structures to care for our COVID population, while keeping in mind how to best protect our health care professionals in reducing their risk for transmitting the virus.”

Facing the future together

At every level, the nursing team has been bolstered by the generosity and teamwork surrounding them. According to Flores and Rodriguez, “It has been wonderful to see the willingness of all Keck Medicine employees to adjust current roles to meet the needs of our patients and keep everyone safe.”

“This crisis has shown how well our providers, clinicians and staff can come together as a team in a time of crisis to focus on providing superb care to each other and outpatients,” added Rachel Park, WHNP-BC.

The incoming support even includes donations and offers of help from alumni and other USC schools.

“As far as our protective equipment, I’ve never been as blessed as I am today to be part of the USC family,” Sy explained. “Many of our alumni are reaching out, wanting to make donations or to help us in obtaining the protective equipment that we need. We’re also working with our USC Viterbi School of Engineering, who are using 3D printers to produce masks and face shields. And they have also developed a UV box for us to sanitize our N95 masks.”

These collaborative efforts have done much to inspire hope in an uncertain, even frightening situation.

“We have appreciated this collaboration and look forward to being of more support during this challenging time,” Kirkpatrick said. “Fight on Trojans, we got this!”

— Kate Faye