Because of the pandemic, all elective surgeries were cancelled and the ambulatory surgery unit where perioperative nurse Valentina Ward, BSN, RN, MPS, CPPS, worked was closed. “As a result,” she says, “I received an accelerated course and was reassigned where I was needed the most. … Serving veterans during the global crisis means so much to me. Despite all that is going on, and the challenges that exist, I have never been prouder to be a frontline nurse.”
The Importance of Maintaining ‘Normal’
COVID-19 seems to subsume everything around it, but there are still health care needs that have nothing to do with the virus. What happens to those patients and their care?
Melissa Varela-Manso, MSN, RN, CRRN, is an inpatient nurse case manager who works with a dedicated team to coordinate admissions and discharges for veterans on the acute Spinal Cord Injury (SCI) unit. “During this pandemic,” she says, “our veterans continue to have non-COVID medical conditions that warrant attention and hospitalization. Therefore, we are following the SCI veterans with non-COVID health issues on the inpatient unit. We also follow our SCI veterans on other units who are being ruled out for COVID and those who have tested positive. We are working diligently to guarantee each veteran gets the quality care they need and deserve while following the evolving guidelines.”
One of the ways VA health care teams have kept things stable for patients, while also ensuring their safety, is through telehealth. VA introduced telehealth in 2003 and is now the nation’s largest telehealth provider. In 2019, > 900,000 veterans received care through telehealth. But it took something like COVID-19 to really show the strengths and utility of being able to care for patients electronically. At the beginning of March, VA conducted about 2,500 telehealth video sessions daily. By June, that had jumped to nearly 25,000—a 1,000% increase.
Sherry Clement, BSN, RN, CFCN, CWCN, CCCN, is the VA Coordinated Transitional Care (C-TraC) Program case manager assigned to the COVID Outpatient Call Team, managing COVID-positive outpatients via telephone and VA video connect. “Working with the call team has been a great collaboration between primary care, telehealth, palliative care, infection control, and occupational health,” she says. “It is amazing to see how fast and efficient our team came together to create contact protocols, consults, notes, and a working plan to organize and oversee the needs of our COVID positive veterans ."
Increased usage of telehealth also has meant community-based outpatient clinics continue to be operational, says Karen Boenig, MSN, APRN, ANP-BC, a primary care nurse manager. “Nurses and providers are conducting routine and urgent visits via VA Video Connect and telephone.… At the Framingham clinic, I am working with the Tele-Flu Clinic, which assesses veterans virtually who have symptoms of COVID-19. By utilizing virtual care visits, we can continue providing health care services to our veterans, which minimizes patient and provider exposure and supports social distancing.”
Florence Would be Proud
It seems fitting that 2020 is also the International Year of the Nurse, in celebration of Florence Nightingale’s 200th birthday. That passionate reformer would appreciate NOVA’s mission: “Shaping and Influencing healthcare in the Department of Veterans Affairs.”