Hospital teams lift each other up amid ongoing health crisis

By Maureen Gilmer, IU Health senior journalist, mgilmer1@iuhealth.org

Last year at this time, the cookies, pizza, sidewalk art and good vibes were flowing into our nation’s hospitals daily.

Communities stepped up to show respect and appreciation for medical workers whose spirits were sagging under the weight of a pandemic that showed no mercy.

A year later? That pandemic is still raging, hospitals are still in crisis mode, and the heroes of yesterday seem all but forgotten today by many.

But not by each other.

Riley Hospital for Children has a culture of caring that runs deep. Not just in the way it cares for its patients, but in how team members care for each other.

In the past few months, Riley has experienced a surge in pediatric patients, some due to COVID-19, some due to a common respiratory virus called RSV that can be serious in small children, and some due to an increase in traumatic injuries, including gunshots.

We wanted to give Riley teams a chance to lift each other up and talk about the importance of feeling valued.

EMERGENCY DEPARTMENT SHOUT-OUTS

Perhaps nowhere has the increase in patient numbers been felt more acutely than the Emergency Department. Dr. Cory Showalter, director of the ED, and Nettie Wilson, clinical manager for the ED, pulled together this list of shout-outs that goes beyond their department to other specialties:

Chaplaincy and social work teams: For rounding on families and team members, helping support spiritual and emotional needs during this difficult time.

Case management: For supplying enormous support with COVID test callbacks and coordinating care of Camp Atterbury guests.

Riley leadership and transformation team: For helping to navigate operational logistics for ramping up the surge response and providing support to boost physician and nurse staffing to match the increased patient volume and acuity.

SPA team leadership: For contributing to rounding in the Emergency Department waiting room, helping families as they wait their turn to be seen.

IU Emergency Medicine incident command team: For supporting ED operational needs at the system level, ensuring the team and patients are well cared for.

IUH leadership (Missy Hockaday and Brian Kremer): For visiting the ED, rounding and listening to the team’s needs, then helping to bring needed resources.

Language services and the executive team: For supporting a Spanish interpreter in the evening hours.

Every EVS worker, unit secretary, tech, medic, social worker, nurse and physician who works in the department: For their dedication to patients and each other.

And finally, the families of Indiana: Who trust the health of their children to the ED team.

“A REALLY ROUGH THREE MONTHS”

The pediatric intensive care unit is another area that has been busier than usual, said service line director Dr. Riad Lutfi, who noted that while the winter of 2020-21 was not as bad as feared at Riley, this summer has made up for that.

“We had a low census in the winter. Everyone was masked, and we had strict social distancing,” he said. “Things started opening up in the spring and early summer and that was really a game changer, and then the Delta variant came around.”

The PICU has had nearly double the census from the winter months in July-September, he said.

“It’s been a really rough three months. We had to have an urgent/emergent plan to care for all these children, so we extended our coverage during the day and night.”

IU Health’s pay incentives for nurses in particular has been critical to maintaining adequate levels of staffing, he said.

“It is good to see the system appreciate the need. It is a smart investment.”

And while the extra money is nice, the nurses he knows are also motivated by wanting to help their patients and team members.

“Their heart is in the right place,” he said. “When you feel appreciated for what you do, it only adds to the joy of the work.”

That appreciation extends in other ways too, the critical care physician said, including frequent check-ins and small birthday celebrations.

“They are small things, but I think small things can help,” he said.

Dr. Lutfi understands that after 18 months of the pandemic, people are tired of living under restrictions, but he wants those who are not vaccinated to consider the risk they may pose to children who are unprotected.

Riley, like hospitals around the state and country, is seeing a surge in pediatric patients diagnosed with COVID. Most, not all, do well with treatment, but the virus takes a toll on even the healthiest body.

“It has been tough; everyone is tired for sure. We are wishing we had a little bit of a break, but we’re not sure when,” he said.

And until that respite comes?

“We will continue to support each other and be available for sick children in Indiana.”

“EXTRAORDINARY WORK” IN CVICU

Heart surgeon Dr. Jeremy Herrmann singles out the cardiovascular nurses at Riley (particularly in the ICU) for their “extraordinary” work, especially over the past few months.

“Our CVICU has been full or even over the usual capacity on many occasions,” he said. “Carrie Davison manages the CVICU and has been steadfast throughout all these difficult times. I have seen her come in overnight to help her nursing team on several occasions. She truly leads by example.”

The level of dedication and professionalism shown by the nursing team continues to impress him.

“Everyone has stepped up. Considering that so many hospitals are losing nurses for various reasons, the fact that they retain so many, especially veteran nurses, speaks to the culture of that ICU.”

From a surgeon’s standpoint, Dr. Herrmann said, the critical care nurse is irreplaceable.

“You sleep better at night knowing there are good nurses looking after your patient.”

PUTTING PEOPLE FIRST

Carrie Davison, whom Dr. Herrmann mentioned above, is clinical manager of the CVICU and leads a team of nearly 80 nurses, six patient care assistants and a unit secretary.

For her, being a leader means putting people first.

“I encourage work-life balance,” she said. “I’ve always viewed my job as taking good care of my people so they will in turn do a good job taking care of our patients.

“When we have good work-life balance, that allows the joy to come out at work and that’s what our families pick up on. They see a team of caregivers here who love their jobs, who are committed to being here.”

While COVID hasn’t impacted the unit too much, Riley’s reputation as a top pediatric cardiology program (No. 5 in the nation and No. 1 in the region) means business is booming.

August marked the highest average daily census in the unit’s history, Davison said.

And, of course, COVID is not just a challenge in the workplace. It adds stressors on the home front, whether that be concerns for at-risk family members, navigating school openings and closings, quarantining or lack of adequate childcare.

“It has added another layer of complexity to life. We’re all human, and so that impacts us here at work,” she said. “And it’s been going on for so long that it’s starting to wear some of us a little thin.”

But they encourage and count on each other.

“We have a tremendous team approach on the cardiac ICU, and that goes from our physicians to our secretary to our patient care techs to the nursing team and to our surgeons,” Davison said.

“We all count on each other to deliver excellent care to these patients. I think that when you have that vested interest in each other, it’s natural to care and be compassionate toward each other. It’s natural to try to lift each other up, but it’s also natural to try to have fun and enjoy your time together.”

Davison is proud of her team’s hard work, sacrifices and professionalism. They know their patients need them, and they need each other. But they’re also needed at home.

“Because we have that strong team and that compassion for each other, it makes us sad when we can’t be here,” Davison said. “And that wears on us. Those stresses and responsibilities outside of work are real, and that causes internal conflict.”

GIVE GRACE TO ONE ANOTHER

Amy Haskamp, clinical nurse specialist for palliative care and hematology/oncology, believes paying attention to self-care is extremely important, as is asking for help and support when you need it.

“For me, spending time with a young patient who is doing well and laughing certainly does my heart good.”

Her colleague, nurse practitioner Amy Hatton, said the hospital can be overwhelming these days.

“I don’t know that I have any insightful tips, other than to give grace to our colleagues and families navigating scary things and assume everyone is doing the very best they are capable of in this time.”

Erica Branam, a nurse on 8 West, wants to spotlight respiratory therapists as everyday heroes.

“As pulmonary nurses, we see how vital RTs are,” she said. “In a code or rapid response, THEY are who I want in there over anyone else. Especially with COVID, they are the real front line.”

The Indianapolis Indians agree. The team recognized those in the profession as Hometown Heroes during a recent baseball game at Victory Field. The event raised money for the Indiana Society of Respiratory Care, of which Beth Summitt, director of respiratory care at Riley, serves as a chapter director.

“I appreciate the opportunity to highlight the amazing work they do and the significant contribution they make in the lives of our patients and families,” Summitt said.

“WEAR A MASK AND GET VACCINATED”

Dr. Jeffrey Raskin, a board-certified pediatric neurosurgeon and director of the movement disorder and surgical epilepsy programs at Riley, acknowledges a tremendous sense of exhaustion among medical providers today.

“Beneath the exhaustion, behind the bleary eyes, under the stratified PPE, are still professional medical providers from all credentials doing their level best to deliver high-quality care,” he said.

“Therapists, nurses, hospital workers, doctors and administrators all trying to respond to the most impactful public health crisis in decades. To single out one individual would be disingenuous, because everyone is really working together right now to just not lose our collective minds.”

What can the public do for him and his colleagues right now?

His answer is simple. “Wear a mask and get vaccinated.”

If you want to give a shout out to an individual or a department, email mgilmer1@iuhealth.org and use the subject line "Team Shoutout."

Photos submitted and by Mike Dickbernd, IU Health visual journalist, mdickbernd@iuhealth.org