Healthcare: Meet a Clinic Nurse in Seattle, WA

Could you tell us about yourself and your occupation? How does your occupation impact the local community?

I am a registered nurse working at a community health center in the Seattle area. My responsibilities include providing patient health education, phone and walk-in triage, standard out-patient nursing care procedures such as dressing changes, suture removal, and medication administration etc. I work with a multi-disciplinary team in caring for chronic disease patients such as patients with diabetes, hypertension, hyperlipidemia, heart disease, lung disease, kidney disease etc. I also help coordinate care between clinic providers and referral specialty providers.

In terms of how it impacts the local community -- nurses play a big role in patient education and health promotion. We assist patients, especially the elderly, with understanding diagnoses and treatment plans, and check in on patients to make sure they are taking their medications as prescribed and following up with their provider when appropriate.

How has COVID-19 affected these chronic disease patients?

Even though we prohibit people from visiting public places and the pace of life has slowed down for most of us, people with chronic disease cannot wish away their illness. We still need to manage their disease. To ensure our patients’ health, we have been offering audio/video calls. It is far more challenging to see patients over video. For one, we cannot do some physical exams remotely. However, remote visits are the best choice for some of our patients, especially those that are elderly and thus high-risk.

Some medication is able to be delivered, rather than obtained by patients in-person. If someone desperately needs to come in—for example, to complete a blood test—we minimize the time they spend in the clinic as well as who they come in contact with.

I also heard that testing tents are being set up in Seattle; is this something your clinic is doing to help with COVID-19?

Yes, we do provide COVID-19 drive-through testing for the broader community. This means that we are offering services to non-clinic patients as well as for our patients. We’ve had to be on high alert for all calls. Patients will call us to say that they wish to be tested and nurses will do phone triage to ask a series of questions. If they meet a delineated set of criteria, they can be scheduled for drive-through testing at the clinic.

We’ve set up tents outside of the clinic to prevent needless exposure. Patients need not come out of their cars; they simply roll down the window, and a nurse or provider will perform the specimen collection for COVID-19 testing. Everyone working at the drive-through clinic wears PPE (Personal Protective Equipment) such as gown, cap, face shield, mask, and gloves.

"Everyone working ... wears PPE (Personal Protective Equipment)."

If you are willing to share, how has COVID-19 affected you individually and your family?

My biggest worry is potentially exposing my family to COVID-19. In order to reduce risk, I have to take extra precautions when coming home after work. For example, I wipe down everything before going into the house and change into fresh clothes before meeting with anyone else. Counters in my home are routinely cleaned, and all of my belongings that make contact with the outside are stored in the garage.

What do you believe others can do to help ease problems encountered by your organization?

I would say that the biggest thing is to follow public health recommendations. Things like washing hands frequently, cleaning all “high-touch” surfaces every day, following social distancing guidelines, etc. may seem small, but are extremely important! People should wear masks in public, because you never know if you or others you meet might have COVID-19 but are asymptomatic.

For essential businesses that are still open, if they are able to do symptom checks and screen the temperature of staff members/employees and customers regularly that would be good too. This is something we do every day at our clinic. We have a screening station set outside the main door to ask questions about symptoms and also use thermometers to check temperature for everyone (staff, patients, including delivery personnel) before they can enter the clinic. Everyone is also required to stand 6 feet apart while in line.

What is the greatest lesson we can learn from this outbreak?

Through this outbreak, we have seen how important it is to follow public health guidelines. Some people don’t take them seriously. “It’s too stressful to think about all these steps!” is something I commonly hear. In my opinion, this is likely because people don’t understand the reasons for the recommendations and/or the seriousness of the disease. A good public education is essential. People think the outbreak is just like a flu and that they’ll be okay but this is very different from the flu. People should also realize that scientists don’t know everything about COVID-19 yet. Until we have a vaccine for COVID-19, we ought to do everything in our power to prevent contracting and spreading it.

"A good public education is essential."

Are there any other comments you would like to share?

In addition to general disease management, I think we should pay more attention to the psychological effects of this pandemic. Things like feeling lonely, depression, etc. are often seen as blips in the radar compared to “physical issues.” This is a mindset I hope to revise. For one, think about the elderly in nursing homes. Due to restrictions, they can’t receive visitors right now; those that once had regular family visits no longer have that social interaction. Thus, if at all possible, family members and friends should consider calling them regularly to talk or check in! Lastly, one more thing I’ve noticed is an increase in communal spirit. I think we’ve all realized that we need to work together to fight this.