Caring for the terminally ill and dying takes a special person. Add the protocol required as the coronavirus pandemic lingers on, and the already-taxing job of a visiting caregiver is made even more difficult.
Abby Campbell, a registered nurse with Lutheran Senior Life VNA, said the six to eight people she normally visits in houses, nursing homes and hospitals across five counties and parts of four others, do not get the important physical contact that is normally a part of her job.
“You just want to give them a hug,” Campbell said of her terminal patients and their families. “I'm getting my job done, but it's putting a wall up in the care that we provide.”
She said since the virus reared its ugly head in Pennsylvania, visiting caregivers wear protective gear like masks, protective glasses or goggles and face shields into every home.
Face shields and glasses are cleaned between each patient.
“I doubly clean my stuff sometimes,” Campbell said.
Regarding masks, Campbell said the N95 variety are in short supply.
A construction worker donated a box of N95 masks to Campbell's coworker, who shares them with nurses caring for those diagnosed with COVID-19 or patients with symptoms of the virus.
Other nurses wear surgical masks or cloth versions that have been handmade, Campbell said. Sometimes patients donate the paper surgical masks they received at their doctors' offices or that come with their IV kits.
Campbell explained that surgical masks include a filter, but cloth masks must have double or triple layers of fabric.
“If you're wearing one of those, then you have to wear the full face shield because there is no filter,” she said.
In addition to the daily patient assessment, basic nursing, wound care, chemotherapy pump care or other tasks required in a visiting nurse's job, more blood work and other tasks normally done outside the home must be completed during a visit.
One particularly difficult situation faced recently by Campbell was a pediatric hospice case. She said she had to maintain social distancing and could not come into contact with the young patient.
“This virus is affecting our palliative patients, but it is affecting our role in hospice,” she said. “I think it's affecting a lot of us.”
Visiting terminal patients in nursing homes is also difficult, Campbell said, because patients face the end of their lives without their loved ones at their bedsides.
“That weighs on that family,” Campbell said. “We are calling the families after each visit.”
She also feels for families who cannot hold a traditional funeral for their loved ones.
“Families need that final goodbye, Campbell said. “I feel like a lot of people will be sad or angry about that.”
She said many of her patients and their families have questions for her about COVID-19.
Nurses must ask patients a series of questions before they visit, such as whether they have symptoms or were exposed to the virus.
While Campbell is prohibited by law from divulging whether she is visiting any patients with COVID-19, she has experience with the virus on a personal level.
Campbell was related to one of Butler County's first COVID-19 deaths.
“It's terrible, because the first thing I wanted to do is go and give his kids hugs,” she said. “It's awful.”
Like everyone and maybe more so, Campbell can't wait for the virus to be gone so her job will return to the normal, nurturing tasks she enjoys. “The emotional part of it feels like there is a wall up and it's interfering,” she said.