Our small 112-bed hospital at St. Anthony Hospital of Gig Harbor, WA was faced with the challenge of being one of the first hospitals here in Washington to be impacted by COVID-19. Our hospital began to check and adjust to the rapidly changing conditions with consideration for the best staff and patient-centered responses.

On this day, already holding a confirmed COVID-19 patient and multiple other pending rule-outs, our team rose to the challenge. Our team was receiving day to day, and at times, hour to hour updates on proper PPE, proper conservation of PPE, newly recommended staff ratios, how to properly swab a COVID-29 patient, how to defer media questions if approached, how to screen visitors, and every other process being put into place.

We were established as Phase 1 of our hospital’s disaster planning. What did phase 1 mean? It meant that our department would be converted to 16 negative pressure rooms with temporary anterooms being built that day outside the entrance of every room. If patients were still requiring an airborne precautions bed, then it meant having the rest of the department converted and ready to accept COVID-19 rule-out patients as well. Moreover, it meant that we needed to find a way to make our CAPR cart accessible to all these rooms. It meant that we needed to find a way to share 6 CAPR helmets while being mindful of each other. It meant that we would need to rapidly adjust from operating as an observation unit with a staffing ratio of 1 RN to 5 patients to 1 RN to 3 airborne precaution patients. It meant that as soon as the patient’s COVID-19 test came back negative, that we would activate a process to remove that patient from the department and to make space for the next COVID-19 rule-out….over and over again.

How does a team create more nurses when we are already operating at surge capacity? You do what this department at St. Anthony Hospital did. You pull together and persevere through it with teamwork! This team stepped up by staying over on 12-hour shifts to working 16-hour shifts, they also came in early, or they made shifts by picking up partial shifts on days off. Every nurse was checking on the other nurse; it was the perfect example of seeing humanity in action.

They developed systems of how to hand off food trays if a nurse was in a full airborne precautions room, they found ways to communicate and delegate tasks together to prevent donning and doffing of PPE, and they did it like a well-oiled machine.

As a charge nurse, I remember the exact moment that through all the uncertainty in the community, I knew we were doing it right. It was when one of our COVID-19 patients wrote the team a letter wanting me to share it showing his/her appreciation. Here is what it said:

“I’m so grateful for the amazing care and service you’ve provided me. I was on death's doorstep and you prevented the door from being opened. Thank you for being my Guardian Angels. I am praying for you and all your loved ones. My suspicion is that I am the first case of so many to pass through. I hopefully get to go home. But you, like the heroes on 911 who raced heroically into the towers, keep rescuing. Your courage, strength, and faith inspire me to live the best life I can live. Thank you.”

After this letter, even more patient letters continued. Our patients are seeing each and every nurse going into the rooms keeping an optimistic attitude while continuing to provide compassionate care. This team truly is extraordinary. They all deserve to be recognized, not only individually, but acknowledged for how well they worked together.