Delivering Care and Compassion to COVID-19 Positive Patients and Their Caregivers

The COVID-19 pandemic has created a once-in-a-lifetime global crisis—and in times of crisis, the Visiting Nurse Service of New York is quick to mobilize to protect society’s most vulnerable. This includes our courageous VNSNY Home Care teams, who are delivering recovery care to COVID-19 positive patients in the place they most want to be: their homes.

“I’m so happy that COVID-19 patients are coming home,” says Ruth Caballero, a nurse who works in Manhattan Branch 7 and has been with VNSNY for 19 years. “I can’t imagine how isolating it has been, not to see their families and with medical staff in the hospitals limiting time with patients. Our visit may be the longest amount of time that a healthcare worker has spent with them. We’re committed to doing whatever we can to help patients return to the community, and ultimately return to their optimal level of health and wellness.”

Over the last few weeks, VNSNY nurses, joined by other clinicians when warranted, have been caring for COVID-positive patients returning from the hospital. To ensure this care is delivered safely, they follow a strict protocol: Before the visit even takes place, the nurse conducts a screening by phone to ensure that only the patient and one family caregiver will be present for the visit, and that both have masks on. The home or apartment should be well-ventilated, and all paperwork must be completed in a room separate from the patient.

Once the nurse arrives, dressed in full personal protective equipment (PPE) from head to toe, social distancing is observed wherever possible, excluding the physical examination. The clinical equipment used during the visit—a stethoscope, thermometer and blood pressure cuff—remains with the patient. Following the visit, the nurse removes and disposes of all PPE, also according to strict protocols, washes his or her hands, and wipes all contacted surfaces with disinfectant.

Through all these precautions, VNSNY nurses continue to deliver care with skill and compassion. Debbie Starace of Nassau Branch 1 has been a nurse for 30 years, 20 of them with VNSNY. She cared for patients at the height of the AIDS crisis and was also highly involved in the aftermath of Superstorm Sandy. “But I’ve never experienced anything like this public health challenge,” she says.

Debbie recently visited a COVID-19 patient who had been discharged from the hospital and now lives with her adult son, who is also COVID-19 positive. Debbie pre-poured the woman’s medications for the week and helped the son encourage his mother, who was very weak, to sit up (which reduces pressure on the lungs), breathe, and cough productively to improve her blood oxygenation.

“The level of anxiety in the home was very high, but they found great comfort in the fact that I was there helping them through this,” says Debbie.

One grateful daughter sent a moving email thanking VNSNY for the care coordinated by nurse Sandy Osias of Queens Branch 2 for her COVID-19 positive father. “Visiting Nurse just left. PT and OT are scheduled for next week. I could literally weep,” she wrote. “I’ve been so overwhelmed nearly at my breaking point. Thank you so very much. I feel less alone in handling my father’s care now that VNSNY is engaged!”

Despite people’s gratitude, however, social distancing must be observed, notes John Ramos, a nurse from Manhattan Branch 4. “One caregiver was so thankful that she jumped up and wanted to give me a hug. I had to stop her,” he says, adding that the power of the human touch must now be conveyed through the warmth of the voice and compassion of expression.

Patient education, always a vital part of homecare, has never been more important, with a new virus that spreads rapidly and can cause such havoc. “I’m continually talking to families about COVID-19 precautions,” says Ruth, “such as wearing a mask when nonessential persons are in the home, keeping the room well ventilated, and increasing the patient’s protein and fluid intake to get their strength up because they’re very weak.”

VNSNY Home Care nurses also serve as “eyes and ears” for COVID-19 patients’ physicians, communicating regularly and reporting on any warning signs so the physician can act quickly—for example, by prescribing an antibiotic if necessary.

“We are the voice of the patient in this difficult time,” says Cidric Trinidad, a nurse with Queens Branch 1, where the pandemic has hit especially hard. “We explain everything to them, advocate for them, and are with them every step of the way. That’s what being a nurse truly means.”

To read more VNSNY Heroes of 2020 stories, click here.

You can also see Debbie, Ruth and Cidric in this Who We Are video.