The Pandemic’s Impact on Patient Isolation
Technology will never fully replace the value of human touch in patient care. But as COVID surges again, the power of technology to ease patient loneliness simply can’t be dismissed.
Like roughly 70 million other people in the US, I work a side gig – mine as a PRN bedside registered nurse at a local hospital. The weekend shifts I work each month give me personal – and frankly, increasingly painful – insight into what hospital patients face as COVID numbers once again surge.
Our unit is designated as a telemetry observation unit, but since the beginning of August, we have operated as a COVID positive unit. This is the second stint as a COVID positive unit for our floor since the pandemic began; we had no COVID patients from March to late July. The Delta variant changed all that very quickly.
The challenges to communication with an isolated patient
Working in a COVID unit is challenging for the nursing and medical teams. We must don fresh PPE (personal protective equipment) before going into a patient’s room – what I call my spacesuit: N95 respirator mask, face shield, gown, and gloves. Being covered literally head to toe with plastic does not make for easy communication, but it is part of standard precautions. My colleagues and I often struggle to communicate with one another when in full personal protection equipment, even when in a quiet environment.
Communicating with isolated patients is even more challenging. It can be especially frightening and challenging for our patients. Many struggle to get their breath. Many are dealing with a high fever. They are surrounded by loud machines and noises, like the large fans pulling air out of the rooms to maintain negative pressure due to the special isolation precaution.
The facial expressions and words of a nurse are muffled behind our masks and face shields, and even non-verbal communication is muffled. It is a lonely, frightening and isolated experience for those patients in protective isolation.
The realities of a patient in isolation
Never have patients been so isolated and so alone.
Because of their diagnosis, patients cannot have visitors. The isolation protocol even in non-COVID units, patient visitation is limited or prohibited in many hospitals as they struggle to reign in infection rates. Patient room doors must remain shut to maintain negative pressure and, of course, patient safety.
Patients can no longer even count on regular interruptions by hospital staff. Because of the need for full PPE, the once frequent interactions with nursing staff are limited as nurses bundle patient care to minimize the need for new PPE. When a staff member does enter the patient’s room, the experience is complicated by the noise of oxygen delivery, negative pressure fans and the layers of PPE.
Communication to the world beyond the closed doors of these isolated rooms is not easy in this COVID world. The negative pressure fan makes it difficult to communicate via the pillow speaker or room microphones. Nurse call interactions are frustrating for the patients and staff. I often get a request to visit a room because the patient’s request over the pillow speaker was not understandable. When I go into the isolation room, the patient might simply have needed more water or ice. Imagine repeating that process many times per 12-hour shift.
Combating patient isolation: We’re in this together
As intentional and focused as I am on giving the best care to my patients, I also know there will be frustration when I cannot understand them when they call. There will be anxiety when I fail to be there when needed at some point during the day. And patients will continue to feel intense anxiety from their isolation and loneliness. It’s a challenging time for staff, family members and especially our patients.
My hospital is not alone. Sadly, the patient isolation that I see is replicated in hospital units across the US. As busy as we are, it’s time we push pause for a moment and really focus on how we can make each patient’s experience less lonely, less frightening, less isolated but at the same time still prioritize patient safety. Even long after COVID, the answers to those questions will continue to change the experience our patients expect from a hospital stay.
What is your hospital doing to bridge the communication gap and decrease patient isolation?
About the author:
Mark Heyward Johnson is the business development manager for the Sentrics E3 Division serving acute care and skilled nursing facilities. A board-certified informatics nurse and health IT professional with 25 years of nursing experience. He has served in the healthcare software industry since 2007. As a practicing bedside nurse in acute care, he is an impassioned advocate for promoting patient engagement through the integration of technology and human touch.