Nurses who are well supported are flexible and more open to changing roles quickly in times of crisis. As the World Health Assembly has named 2020 the Year of the Nurse and Midwife, we'd like to celebrate one of our biggest triumphs in nursing this spring.
We've learned so much from training and developing the skills of both existing and new non-critical caregivers in the face of disaster. With a surge of critically ill COVID-19 patients in February, we knew we had to act fast. We rallied our teams across Research, Practice, and Education under the Providence Nursing Institute and worked together to support our clinicians through this crisis.
As part of our disaster preparedness, we created playbooks, staffing tools, and training plans with centralized clinical nursing strategies to help our caregivers quickly change roles and operate in new care environments. We rapidly shifted from a primary care model to a team-based model. We shared our learnings and resources through the Clinical Academy.
Through this process, Providence learned how to anticipate not just future waves of COVID-19, but also how to stabilize for any disaster that happens in the future.
Step 1. Understand & Identify Your Nursing Team, Measure and Assess Their Clinical Skills
It can be challenging to train staff when you aren’t sure of what you need. It’s important to first identify any gaps in your clinical practice. What skills does your team have? Are they clinical or non-clinical? This can help you determine who needs to be on your Critical Care team and then identify which skills are needed to perform the tasks at hand.
Step 2. Incorporate Learning Resources and Simulation into Training
If you need to redeploy people, how do you help them get the skills they need to care in environments that are overflowing with patients? Early on, we didn't know the exact right treatments for COVID-19.
Over time, we've improved our treatments and seen a decrease in mortality based on research and best practices. For example, moving a COVID-19 patient into a prone position can eliminate or reduce their need for a ventilator. We began teaching our nurses how to prone and looked for other types of PPE and supplies, such as different proning devices, to help train staff quickly on how to do this appropriately. We found simulation to be especially helpful, as training could be conducted virtually or in-person.
Step 3. Utilize Data and Technology in Response to Surge Planning
Part of our disaster preparedness was to identify areas where clinical care was inundated and in dire need of staff. We implemented our ShareCare staffing tool for approximately 50 acute care facilities. The ShareCare tool is designed to track labor in the labor pools; we were able to break down our data by region and quickly match staff to areas in need. ShareCare helped us to obtain more aggregated data around the health of our caregivers, identifying who had symptoms of COVID-19 and needed to quarantine. This saved our system time, money, and resources by giving us data. Additionally, we relied on the Clinical Staff Projection Calculator to monitor the availability of our beds and staff so that we could prepare for an influx of COVID-19 patients.
Step 4. Continue to Iterate on Best Practices and Educate to Fill the Gap
In a time of disaster, you must pull your team together to be nimble and innovate. Give them the tools they need to be successful with succinct and focused education aids and learning resources. Prepare them for all outcomes, including palliative and hospice care.
Step 5. Enable an Environment of Support
Many of our teams have a closing huddle at the end of their shift. They share something that could have gone better and something that went well. As a team, they listen, learn, and support one another. It can be therapeutic to create a structure for “letting go before you go.”
The most important skills your staff can have during a crisis are adaptability and humility. At Providence, we have a commitment to support our caregivers. We also promote a culture of connecting, allowing anyone to speak up when they need help. When your staff works together as a team, you can better manage a standard crisis of care.