Protective steps Long days

In the back of the Samaritan Clinic on Pioneer in Moses Lake, past the plastic sheet blocking off a hallway to the rest of the clinic, a number of nurses, medical assistants and other staff are suited up for a long day at the Respiratory Virus Evaluation Center.

Open only since Wednesday, the center is pivotal in allowing medical workers to separate and evaluate patients showing symptoms that may be from the novel coronavirus, also known as COVID-19. In its first day, 40 patients were seen, 16 of whom had COVID-19 tests taken.

Patients coming into the clinic can be screened for respiratory infections, including for coronavirus, but only after calling the 24-hour nurse hotline at 509-764-3331 to evaluate their symptoms. If they don’t need to be seen in the specialty clinic, they’re turned away — the last thing staffers want is for someone to get exposed by patients who need to be there.

“The real problem is that it’s a highly contagious virus, and we really want to keep people who are potential coronavirus patients out of the general population,” said Dr. Andrea Carter, the chief medical officer at Samaritan.

“The way most clinics and hospitals are set up, when you come in, everyone comes in through the same doors,” Carter continued. “So setting up like this, we can dedicate those services for patients who need them and keep them away from the well patients who may come through the clinic.”

Patients walking in are asked to stand six-feet back from staff and to use plenty of hand sanitizer. Sometimes the smaller patients are less than cooperative.

“Thank goodness we haven’t had too many kids yet, but that may change,” said Registered Nurse Penny Mayo. “I think one of the biggest frustrations with kids and for us is, you want to follow protocol, but little kids don’t always want to keep their masks on.”

“For some kids, we’ve been triaging them and then seeing them in the car,” added Nicole Tabert, also an RN at Samaritan. “So we’re taking every precaution we can so we can protect everyone we can.”

They’re asked a series of questions by registered nurses, whose voices are muffled by their facemasks, screened for other respiratory viruses, checked one last time to ensure that they’re there only if they need to be, and their vital signs are taken.

The nurses handling this process, like all staff in the center, are decked head to toe in protective gear.

“Coronavirus is airborne, and we still have a flu in season right now, so this helps protect us from contacting that,” Tabert said. “We have wipes to wipe down between patients, we change our gloves between patients. Most important is to keep our patients safe and ourselves.”

Once patients are finished checking in, they’re brought into a side room, which has been split up with curtains into a waiting area and four small rooms for patients. If those rooms are full, patients are seated at least six feet away from each other, and high-risk patients are asked to wait in their cars.

Along with its own air handling system, sealed off from the rest of the clinic with oversized plastic wrap, this area is a negative pressure room, which allows air to enter but not to escape to other areas of the hospital. Staffers track who has been triaged and work their way through patients one-by-one.

When it’s time, if a COVID-19 test is to be administered, a medical assistant walks up with an uncomfortably long swab. While not quite a “brain biopsy,” as urgent care provider Bob Ebel jokes, the test, consisting of that swab being shoved very far up the nasal passage, isn’t a particularly comfortable one.

“Most people do pretty good, but some sneeze, some cough, some gag,” said Sabrina Weber, a medical assistant at Samaritan.

Those testing kits, once difficult to find, have become significantly more plentiful in recent days and are expected to continue to become more available, Carter said.

“We never ran out, and we never had to compromise testing of our most sick or high-risk patients, but in the last couple of days we’ve had an improvement in our supply,” Carter said.

There’s still plenty that Samaritan and other health care providers will need more of in coming weeks, particularly ventilators, hospital beds and more staff, Carter adds.

Right now, Carter said she supports the dramatic steps being taken by local, state and federal governments to slow the spread of the virus. While older and immunocompromised patients are the most likely to experience severe symptoms or die, anyone can get the disease, Carter said, and anyone with the disease can spread it to others.

“I would never discount the impact of having to close businesses and close schools, I would never want to minimize that,” Carter said. “But having said that, it’s not me that’s going to get sick, probably. But what if I bring it home to my pregnant daughter? What if I bring it home to my mom?”

After a long first day at the clinic, staff shed their protective gear, sanitize their stations, and prepare to head home. And, when the day is done, serious steps are also taken to keep the disease away from the families of staff.

“I strip in the garage and run naked,” Tabert said, laughing.

“The teenage daughters love it,” Mayo interjects.

“Yeah, ‘turn around!’,” Tabert yells, cracking up. “It’s very serious though, I definitely try to take everything off right away and get it into the laundry, make sure that I don’t bring anything home. I clean the car, clean everything.”

Noting how much the constant hand-washing is wearing down their hands, Tabert pats her pocket where she keeps a bottle of lotion. Despite maintaining their sense of humor, the day has been a hard one, and there are more hard days ahead.

“I am kind of emotionally exhausted,” Mayo said, speaking through her mask. “And breathing through this, you know it dries fairly quickly when you take it off but it becomes harder to breathe when you keep them on because of the moisture.”

“You can get a little claustrophobic at times,” Tabert added.

But Samaritan is doing what it can to support its workers through the long days, Weber said.

“We have a great management here, a great system at Samaritan, so they’ve been making sure to relieve us or make sure that we have coffee or food, and anything that we need,” Weber said. “They’re making sure that we’re well taken care of.”