After 30 years of working at Covenant Children’s, Emily Stephens knows that every day can be a trial. As a nurse manager overseeing four units, Stephens sees all kinds of patients with every manner and combination of illness and injury. But in June, Stephens and her staff faced one of the most important challenges of their careers and the hospital’s history when they admitted one of their first patients who was critically ill with COVID-19.
“There has not been one COVID-19 patient that looks like the next,” says Stephens. “Every patient presents differently. We don’t know what to prepare for.”
Few, if any, hospitals were prepared for the novel coronavirus when it first arrived and quickly spread across the country in March. Stephens was tapped to be the nurse manager of a brand-new COVID-19 unit, and she and the staff and administration jumped to convert an entire floor of the building, which had previously been used for extra office space and storage, into a new isolation and intensive care unit. High-flow medical oxygen, suction, and computer network lines were run; new computers, ice machines, refrigerators, and other equipment were installed. Nurses and other staff members pulled from other units were quickly trained on the most up-to-date procedures and treatments.
Covenant Children’s Hospital adapts quickly to help area patients fight COVID-19.
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The staff administered convalescent plasma, collected from other patients who had recovered from COVID-19, and remdesivir, the antiviral medication. They used Tylenol to keep the fever down. Meanwhile, Covenant’s Child Support Services kept the child’s spirits up with video games and BINGO. The patient even celebrated a birthday at the hospital with vanilla cake and ice cream—the patient’s favorite—provided by Covenant.
“Everybody loved this kid,” says Stephens. “The patient always said ‘Yes ma’am’ and ‘Thank you.’ Their family made it so easy for us to care for the patient and they were all so appreciative. Staff would come in on their days off—they wanted to care for the kid.”
"Everyone worked together so well."
"Staff would come in on their days off — they wanted to care for the kid."
Gradually, the fever subsided and the patient’s breathing improved. The caregivers slowly weaned the child from oxygen—the patient never had to use a ventilator. And in about two weeks, their patient was ready to go home.
“We had a parade,” says Stephens. “Anyone available lined the hallways. The family wheeled the kid out. It was fun and celebratory. The staffing nurses have taken such pride in that unit. This was a great success story. The whole thing, the whole unit, has been a success story.”
By the time the first critically ill patient arrived in June, Covenant’s new COVID-19 Unit had been up and running for weeks, having treated several women and children presenting with mild symptoms. But they had seen nothing as severe as what this child was going through. The new patient had a fever, trouble breathing, and lungs filled with fluid. The child also had an underlying cardiac condition that was being exacerbated by the virus.
The caregivers admitted the patient and started high-flow oxygen. They installed two chest tubes to drain fluid from the child’s lungs and whisked the patient safely to and from radiology for x-rays, ensuring that no other patients or staff were unnecessarily exposed.
“These things were tricky,” says Stephens. “But with our team, it went beautifully. Everyone worked together so well. It was nice to watch it happen.”