By Melinda Young

Case managers, social workers, and nurses from other areas of the hospital have been the back-up support to critical care nurses during the COVID-19 crisis.

Many underwent training to assist frontline staff during COVID-19 critical care peaks. They provided help with restocking personal protective equipment (PPE), and offered emotional and mental health support.

“Nurses without critical care experience can support critical care nurses with a variety of tasks,” says Michelle Sanchez, MSN, RN, Beacon Program manager with the American Association of Critical-Care Nurses.

Support nurses assisted critical care nurses with doffing, refilling coffee and water bottles, and cleaning equipment and high-touch areas, says Gaila Palo, MN, ARNP-CNS, AGCNS, CWON-AP, travel wound nurse at Kindred Hospital in Seattle. In addition to their new tasks, nurses provide emotional support to the professionals on the frontlines, she adds.

“They give smiles and words of encouragement to nurses, as soon as they come out of a room, checking in with staff and being available to lend an ear,” Palo says. “As one colleague from labor and delivery said, ‘I’m a nurse for the nurses. I know how to do that.’”

There are many creative ways case managers and other hospital staff can provide support to one another, including these examples:

• Care closet. “One unit designated an old supply room as the care closet, where nurses can go to escape for a few minutes if they need an emotional break,” Palo says. “The helping nurses keep this room stocked with chocolate, tissues, and notes of appreciation and empathy on the walls.”

Anyone using the care closet can write an anonymous note about their feelings on a sticky note and post it to the wall. Other staff draw a heart or star on the note to show they feel it, too.

“It’s sort of like giving a love symbol to a post on social media,” Palo says. “Many of the activities for emotional support have been spearheaded by the spiritual care/chaplain departments.”

Another unit held a Secret Santa-style exchange in which staff left one another notes, treats, and little surprises for two weeks, Palo says.

• Healthy competition. Nurses in an eight-story facility held a stair-climbing competition for the COVID-19 unit, Palo says.

“The nurses were bemoaning their gyms being closed, so they decided to time each other running up the stairs and back during their breaks,” Palo explains. “They even had a little trophy for the Stairmaster of the Week.”

This is an example of team-building and a healthy activity in which hospital staff can have fun and camaraderie, she adds.

• Sitcom parties. “There’s a general theme of staff avoiding many sources of negativity because of the emotional burden of life right now,” Palo says. “They are reaching out for light in a dark space, and being more contentious about not letting more darkness in. One unit has some of its nurses holding watch parties for sitcoms.”

Some hospital professionals stopped telling people to “Stay safe,” and instead say “Be well” in emails.

“It has the broader connotation of wishing someone health and wellness in all areas — not just around COVID,” Palo says. “It’s a subtle difference, but I believe in the power of language. We have to use every tool we can to support each other during this time.”

• Community support. Hospitals have experienced public support and appreciation. In one hospital, a cellist played a concert in the parking garage as staff were coming out from their night shift, Palo recalls.

“The community bangs pots and pans, and yells and claps all over Seattle every night at 8 p.m. to thank the healthcare workers,” she says. “People with apartments facing a hospital put up banners of support and thank-you signs in their windows for staff to see during patient care.”

All these things help, but they are not enough to prevent emotional distress among hospital staff during the pandemic, Palo notes.

“Nothing can make this OK or safe or peaceful, but it does make it tolerable for another day,” she says. “It makes it survivable in the hard moments, and it reminds us that it is worth the cost, that our sacrifices — though never fully understood — are appreciated.”

Managers can send staff weekly tips on mindfulness and other ways to protect their emotional and physical health, says Maureen Brogan, LPC, ACS, DRCC, statewide program manager of Traumatic Loss Coalitions for Youth at Rutgers University Behavioral Health Care.

Virtual support meetings also can help, Brogan says.

“There are always good things going on, and sometimes people are not sharing the good things because we’re inundated with so many negative things,” she says. “We can’t fix everything, but we can validate and support each other.”