“Are you doing OK?”

Angela Ochoa, a registered nurse case manager from Hope Hospice, waves through the window to get the attention of her patient, Eddie Zipp, at the Sundance Inn Health Center in New Braunfels.

With nursing home and long-term facilities across the country taking precautions and restricting visitors to curb the spread of COVID-19, Ortega checks up on her patients through windows while using her cell phone. 

“I just wanted to make sure that you were OK,” she tells Zipp.

It’s become standard operating procedure for caring for people at the end of their lives during a pandemic.

“The nurses are really good when I call them and tell them I’m going to do a window visit,” Ochoa said. “They’ll get the patient ready. If they don’t have a window, they’ll put them toward the exit, so I can see them. We try to assess them the best way we can. The nurses here are very understanding. The families are understanding. We’re still coming out here and seeing them as much as we can.”

Seeing the patients inside a facility three times a week before the outbreak to now conducting window visits makes accessing patients more difficult, she said.

“They’re using to seeing us so often,” she said. “I get it. It’s for their safety, but the nurses are great about getting me reports on how my patients are doing. It’s the new nursing-norm at the moment. Every day, things are changing.”

Unfortunately, some patients, especially those with memory issues or Alzheimer’s disease, don’t understand 

what’s going on.

“They don’t understand why we’re not coming in or why their families aren’t coming in,” she said. “It’s just trying to reorient them and let them know that we’re still here. We may be outside the window, but we’re still here. They just want that interaction, and having those extra eyes and extra conversations really help.”

Vicki Guel, director of nursing at Hope Hospice, said coronavirus precautions have affected the way hospice personnel operate.

“With some of the facilities, we’ve had to pull back our visits,” Guel said. “We used to have nurses go in one, two or three times a week. Our (certified nursing assistants) were going in and helping with baths and daily care at least three times a week at most places. We would have a social worker and chaplain going in there also. Now, we’ve had to pull the social worker and the CNAs back, so the nurses are really feeling the pressure to take care of their patients.”

The logistics of continuing to take care of people during the reality of virus restrictions has taken an emotional toll on employees, she said.

“The social workers and chaplains are there to support the families and the patients,” she said. “Now they feel that not only want to support the families and patients, but they also want to support our nurses because they are emotionally drained. Some of them are scared because they don’t know if they’re going to get it and carry it home to their families.”

Telehealth visits, which deliver health care needs remotely through telecommunications or digital technology, have taken the place of face-to-face contact in some cases, she said.

Guel also said the use of personal protection equipment has also become a standing procedure for some visits.

“I think for our staff, getting PPE — masks, gowns and gloves — was difficult in the beginning, but we’ve gotten a handle on that, and everything is starting to come in now,” she said. “But for every day and how it’s affected our staff, we’ve had to rethink how we’re going to take care of our patients.”

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