When California and subsequent states went into lockdown last year to prevent the COVID-19 virus from spreading, my advanced provider colleagues and I were expecting an intense period of work—perhaps several weeks, and at most two months—spent helping to treat moderately to critically ill patients and educating our local community on practical tips to avoid contagion. Little did I know the pandemic would still be raging a year later, and that my skills and resources would be tested like at no other time in my career.
Not only that, but my operational and logistical acumen would also be utilized and put to the test in a complex effort to help lead skilled nursing facility (SNF) outreach support teams across Riverside County in Southern California. These “SOS teams,” as they came to be called, gave me a chance to use my entire skill set as an advanced provider to serve my community at such a time of need.
Protecting Our Most Vulnerable Post-Acute Patients
SNFs are a critical piece of the American healthcare system, often serving patients who don’t need long-term care but are impacted in their day-to-day movement and functionality, such as post-surgery rehabilitation. However, most SNFs in Riverside County also include long-term nursing home residents. When the pandemic first struck, these patients were considered especially vulnerable due to close living quarters and elderly population.
My Vituity colleague, Michael Mesisca, DO, came to me with a proposal in April, shortly after one SNF in our region was forced to evacuate 80 patients in a matter of hours. Several of their colleagues had recently contracted COVID-19, and the rest of the staff was afraid of passing along the disease to their families and friends. Dr. Mesisca asked that I join him in an ambitious multi-agency county effort to support and educate the staffs of SNFs, assisted living facilities, and behavioral health facilities across Riverside County as they fought the pandemic.
Advanced Providers Leading the Charge
Our challenge was daunting, with many issues to be addressed. How could we effectively support and educate SNF teams without encroaching on their well-established routines and expert roles as care providers? The concern of interfering with routines also applied to the nursing home residents, who might be frightened by new and unknown people in their bubble environment. This dilemma called for a form of organizational “soft power.” Instead of charging into these facilities with the aim of fixing perceived shortcomings and then departing as new challenges arose, we needed to collaborate with staff members to make them feel comfortable and set them up for success in what could and indeed would be a long road ahead during a pandemic with no end in sight.
