In 2019, I accepted the role of care manager in a Victorian residential aged care facility in Melbourne’s north-eastern suburbs. The role was going to be for six months. Then there was COVID. My six months became two-and-a-half years.
The early days of the pandemic were ones of loneliness and a feeling of isolation. The doctors were reluctant to visit the residents in person and pathology services did not want to enter the building. Government instructions changed on an almost daily basis. And all we were hearing was bad press about the poor care being provided to residents in residential aged care facilities.
How we cared for residents changed. All staff were instructed on the intricacies of infection control and the correct way to don and doff PPE. The poor residents had to adjust to their carers wearing masks, making it difficult to hear and read the mood of those attending them. I personally had to complete the infection prevention and control course in record time over the Christmas and summer period. I felt frustrated as much of the information in that first course seemed irrelevant and was not specific to the aged care environment. We wrote a COVID outbreak plan and continually reviewed and updated it. We felt prepared for an outbreak.
An outbreak did not occur in our facility until October 2021. It was the Delta variant. It hit us hard but was over quickly. On day zero, three residents in one of our five separate households woke feeling unwell. They were tested using rapid antigen tests and initially all received negative results. All staff on duty in the household of thirty residents were also tested and three returned positive tests. By the afternoon, residents were returning positive results, including the three who had first tested negative. COVID had taken hold and was spreading swiftly throughout the household.
We had learnt what was important from other facilities and had the support of a team from the local public health unit. They were contactable at any time and their advice proved to be extremely helpful.
We quickly enacted our outbreak plan to the best of our ability. As a first step, we isolated all the residents with COVID in one wing. With the support of the local public health unit, we then decided the best approach was to keep life as normal as possible for our residents. The sick residents were encouraged to sit in the lounge and eat in the dining room, while we encouraged the five well residents to stay in their rooms.
I believe this life-as-usual approach assisted with our high rates of resident recovery. Very sadly, one gentleman passed away within the first week, but all others survived and were cared for within the home.
It is the positivity and the comradeship of staff and the bravery of the residents that shines through from this time. The memory of the adrenaline we lived on to keep our residents and staff safe diminishes over time, but this overall memory remains clear. During my last meeting with the public health team, I made the comment that the whole experience was positive overall. They told me it was the first time they had heard this.
Why was it positive? The staff were united in the goal of caring for our residents. They all went the extra mile. Board members met daily and did what they could, including providing food for the staff. One board member in particular, a registered nurse, came each evening and helped with the endless round of assessing the health of our residents. The CEO worked in the laundry. I have some other favourite memories. Watching a carer massaging the hands of the female residents and giving them manicures. Care staff showering residents and making sure they felt comfortable. Residents sitting in an open-air internal courtyard drinking their cups of tea.
Communication with families was important and we made daily phone calls to give them updates. We used FaceTime so family members could see their loved ones as they spoke with them. If a resident became particularly unwell, usually day three of the infection, we would encourage their family to gown up and sit with them because we didn’t want any resident to die without their family by their side.
Some things were not so positive. Staff within the facility who were not in the infected household did not know what was happening, so we started to send them daily news reports. Meetings, which were probably necessary, seemed endless and time-consuming—and frustrating because we were reporting the same information over and over. Keeping abreast of the changes made by the health department on an almost daily basis was challenging. And the mountain of rubbish from all the PPE we were using was hard to manage. Thankfully, we’d identified this as an issue in our COVID outbreak plan and so our rubbish removal contractor gave us extra wheelie bins and provided rubbish pickups every second day.
Now COVID is a normal part of our lives. Outbreaks will probably never be the same as in the early days of the Delta variant. From my own experience, I believe that aged care nurses and staff do amazing work, often while they are receiving negative press reports.
Along with all nurses and healthcare workers, they need to be applauded for the work they do, because COVID has taught us that nurses are a resilient bunch who go beyond the call of duty over and over again.