Tuesday, May 4, 2021
It started with a challenge. Patients recovering from COVID-19 preparing to be discharged from VCU Medical Center were frequently busy — getting treatment, sleeping, eating breakfast, talking to family on the phone or via video call. Nurses and social workers wanted to make sure they weren’t interrupting patients at these inopportune times. And students, who in non-pandemic times might have been on clinical rotations in the hospital, were missing out on critical opportunities to educate patients on what they needed to know before leaving the hospital.
The solution: A phone call from a Virginia Commonwealth University nursing student to prepare the patient for their long-awaited return home.
The students reached out to patients as part of the COVID-19 Patient Education Initiative, a call center that gave students at the VCU School of Nursing the opportunity to interact over the phone with more than 100 patients over the course of several months.
“I’ve been using the analogy, ‘We’re building the plane as we fly it,’ and we’ve learned a lot, but we were able to make some really great contact with patients and support our care coordination team,” said Shelly Smith, DNP, director of the doctor of nursing practice program and a clinical associate professor, who led the creation of the call center.
Smith noticed the challenge of reaching COVID-19 patients at the right times in the hospital while working in post-acute services and care coordination at VCU Health, where she is on the clinical team. Team members wanted patients to get the information they needed in a timely manner so they could return home sooner, but it proved difficult to find the right time to get in touch with them while going about other duties that were critical to the care of patients.
“So I said, ‘Why don’t we let the nursing students do that? They’re super great at talking to patients.’ It’s one of the things students are really good at, because for them it’s exciting and new, and it’s a skill they’re comfortable with,” Smith said.
Smith worked with Irene Zolotorofe, director of care coordination at VCU Medical Center, to get the program off the ground. Faculty and students at the VCU School of Nursing formed the twice-weekly call center in just 10 days, with students manning the phones under faculty supervision. It was an endeavor that stood to benefit students as much as it did nurses and patients.
“With COVID-19, not just our health system but health systems in general had to put a hold on clinical learning so that they could comply with social distancing mandates the best that they could in acute or tertiary care settings,” Smith said. “It impacted clinical learning for students.”
Tamana Fatah, a senior in the traditional B.S. in Nursing program, is one of those students. Fatah hadn’t had an opportunity to practice the skill of discharge teaching on her own until calling patients through the COVID-19 Patient Education Initiative. As she prepares to graduate this month, Fatah said she has gotten a lot of value out of the call center herself but also knows it’s not just busy work: It adds value for patients and nurses too. She said it’s reduced the load of nurses in the hospital, in terms of both teaching and clinical duties.
“For me, this was great because I got some experience with discharge teaching with patients, talking with patients on your own without your nurse there,” Fatah said. “It’s a great feeling to, as a student nurse, be in this role and be helping out and alleviating a lot of the stresses the nurses are feeling right now.”
Fatah and her fellow students carve out about 15 minutes or more for the calls, which include sharing public health information and making sure patients have a safe environment to go home to where they will get the care they need. Students and faculty work to connect patients with social workers and post-care services at VCU Health when necessary to ensure they have the resources needed to make a full recovery long-term.
Fatah noted the benefit to patients she has seen, giving them additional time to ask questions, call back if needed and connect with her and her peers, whom she said are “bright and bubbly” when they speak to patients.
“The experience for COVID patients right now is isolation,” Smith said. “Not only are they socially distanced in their room; they’re socially isolated. So, they appreciate that telephone call.”
Nurses at VCU Health have observed the difference the students have made, said Zolotorofe, the medical center’s director of care coordination.
“I think the students went above and beyond,” she said. “It wasn’t only about COVID. It also helped provide that conversation and emotional support that the patients needed at the same time. It really gave a real great feeling of collaboration between the care coordination team, the students, the professors that were overseeing the students and the nurses, who had the opportunity to make sure that those pieces were taken care of and that they didn’t have to worry about that element as well.”
The collaboration is one of the benefits of being part of an academic medical center, and Zolotorofe said, while this was her unit’s first time working with nursing students in this capacity, the effort has led to interest from her team in continuing to involve nursing students on the unit.
“It really helps the nursing staff and social work staff by decreasing the phone tag, doing the teaching, providing support emotionally for the patients and, importantly with the advent of the electronic health record system, decreasing the amount of charting — that’s a really time intensive thing and it’s a skill that’s really great for students to learn,” Smith said.
Smith said she appreciates all that her fellow faculty members and staff have done to supervise the call center and make this effort happen, especially when many of them have clinical duties at the health system.
“This is something that people want to do because they want to be present in the community and they want to be supportive,” Smith said. “I think that’s really unique, and it’s a good way (for students) to learn at the same time. It aligns with VCU’s mission about contributing to our community and making learning real in real time.”
Fatah knows this experience will benefit her as she prepares for what’s next at the community hospital near her hometown of Woodbridge, Virginia, where she currently works as a licensed practical nurse ahead of earning her bachelor’s degree. She hopes her degree will give her more opportunities to work in an intensive care setting, where she expects to be working with COVID-19 patients and others in need of critical care.
“We’re not able to be in rooms with a COVID-positive patient during our clinical experience right now so the only COVID-positive patients that we have any kind of communication experience with are through this call center,” Fatah said. “I’ve gotten more experience learning about COVID, specifically, itself through the fact sheets (at the call center). We have to continuously update them with whatever new information is coming forward. Now I know more about COVID to be able to teach my patients more, which will help me when I graduate because COVID will still be a problem.”
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