Villa Marie Claire is an inpatient residential hospice facility that is part of Holy Name Medical Center. The Villa is located in northern New Jersey, and our highly trained staff provides care for patients at the end of life.
When the COVID-19 crisis began, our nursing management and administration team worried about the health and well-being of our staff and residents. Holy Name Medical Center was one of the hardest hit hospitals in New Jersey, at the peak of the pandemic with five ICUs. As Villa Marie Claire was temporarily closed to new patients, nurses were deployed to assist in caring for patients at Holy Name.
Our team was stressed, but we all showed up. Villa Marie Claire nurses, home health aides, and team members worked on Holy Name’s medical-surgical units, quickly getting up to speed on the procedures at the hospital and patient care protocols. Our hospice team wanted to make a meaningful impact. This need arose when the burden of all dying patients had reached its peak in March-April 2020. Hospitalists were pronouncing patients at an alarming rate. Physicians and nurses at Holy Name were struggling with the losses. It was heart wrenching.
Our hospice team came together and created a program to alleviate some of the stress and struggles of the staff. We became the pronouncement and post-mortem team, who took on one of the hardest jobs during the pandemic. (In the state of New Jersey, an RN can pronounce patients in an acute-care hospital.)
Our program came together with the assistance of many departments and disciplines. In creating this team, we worked with administration and medical affairs to obtain credentialing to be able to issue a New Jersey Electronic Death Certificate. Information technology staff created an icon in the EHR called “pronouncement team,” which allowed staff to directly send a message to a pager carried by the pronouncement nurse. We collaborated with the nurse managers and nursing education to educate the staff. Infectious disease specialists and nursing set up an expiration checklist and post-mortem procedure to meet the guidelines of the CDC and the NJ Department of Health. IT created pronouncement charting in the EHR, and all of our nurses were able to access the electronic death registry.
Our nurses went to the bedside of every patient who died. After each pronouncement, patients were treated with the utmost reverence and respect. It was the last act of kindness that we could do for so many suffering with the virus. This also alleviated some of the stress experienced by frontline doctors and nurses by allowing them valuable time to spend with patients in need. Our hospice counselors provided emotional support and telephone counseling to the families of the deceased. Our staff assisted families with funeral plans and coordinated with funeral homes.
Hospice provided education and support to the nursing staff. Our hospice nurses rounded on palliative patients. We assisted with interventions to alleviate distressing symptoms. iPads were used to FaceTime and connect families to patients in the most meaningful way. We were present for patients, helped alleviate their fears, and made them comfortable and safe.
The response from nurses and doctors at the hospital was tremendous. They thanked us for providing each patient with the time and care that they deserved. The hospice staff provided dignified post-mortem care to more than 100 patients. We facilitated more than 117 FaceTime calls with patients and families. Our compassionate group provided bereavement support for patients’ families and assisted with all funeral arrangements. It was difficult for everyone; however, this work gave us an enormous sense of purpose.
Thankfully, our pronouncement team is no longer necessary as COVID-19 cases have decreased dramatically at Holy Name Medical Center. We are now trying to regain our resilience and move forward. Our team takes comfort in being able to have had a meaningful impact on patient care and staff support at Holy Name.
Lisa Blumer is a nurse manager at Villa Marie Claire/Holy Name Medical Center in Teaneck, New Jersey.