Jason Bauer: Walnut Acres

“I actually took this job four weeks ago. A week into it, all of this happened. It’s been a great learning curve for me to learn some of these things and it’s been a challenge. We’re a county-owned nursing home here in Freeport.

“We knew COVID-19 was out there, but it was still in China. You’re trying to keep read up on everything and educate yourself about COVID. It’s a lot more contagious [than SARS or H1N1], but as far as the facts, I think that’s still the big unknown is that we don’t really know what’s going to happen to people who have had this disease until 10 years from now. The hype around the other ones never used to be as high as it is on this one. It’s so different. There’s no playbook on this stuff.

“You start to see anxiety in the residents. They’re watching the news every night. They know their loved ones can’t come see them. And we’ve had some where their spouse or kids would come every day for the last five years, and now they can’t come. We had to cancel all group activities.

“At work, we have no visitors. We really don’t even have any vendors anymore – short of critical ‘we need them in here’ vendors – so it’s really just the staff. Staff every day have to check in at the front desk, get their temperature taken, fill out a second form saying they have not experienced any fever or coughs, the routine things.

“Another precaution we’re taking is daily respiratory assessments, vital signs, pulse-oxes on all the residents – that’s not something we do every day normally in extended care. We started doing that just to keep an eye on all the respiratory statuses in case something were to change where you can get ahead of it and identify it early, so we’re trying to be very proactive in that.

“We have stopped all communal dining. We used to have everyone meet in the dining room to have breakfast, lunch and dinner and now two-thirds of them are eating in their rooms. We serve about a third of them that need to be monitored more consistently, so we set them six feet apart from everyone else in the dining room. It’s new for them. That’s where they get their socialization and see their friends.

“I say leadership is shown in a crisis. How innovative can you be when the system is under stress? We identified a way where we have a closed-circuit television channel where we now do bingo over the TV on channel 2 in the rooms. When [residents] win bingo, they put their call light on, and we go respond to it. We just figured out a different way of doing it.

“This change has forced us to change. It’s created opportunities that we wouldn’t have done otherwise. We set up window visits where [friends or family] can come to the window. Kids in the community have made cards and pictures to put on everyone’s doors. We started our own email account where we’re just communicating with families and offering times for window visits. We’ve been trying to get the residents as involved as we can. They’re part of this team, too. I tell them, ‘What you do affects everybody else as well, so how do we work together?’

“All the staff wear masks in the facility now. That’s pretty standard now. Which also creates a problem because of the PPE shortages. We have worked hard to get to where we have four days on hand. If our supplier says we’re ordering more than we should, they’ll cancel our order. The health department and emergency management office has been helping us and sending us stuff when they get it from the strategic supply.

“The state was very unprepared for this PPE shortage. And it really is a state issue on this. Where’s their stockpile? I don’t see it. Even the health departments don’t have a lot to give you. Having a clear messaging of where we’re at with things is the biggest thing that would help. But with supplies, I think everyone was caught off guard with this and identified a gap in the system.

“You have to find the silver lining in all this. There’s a lot of bad stuff happening, but what I’ve seen from our staff and the way they’ve responded to rally around protecting the residents in this facility is amazing. I thank them so much for being so adaptable to these great times of change. New standards can change the rules within a day. Not one person has complained or refused to come in on the weekends to lend an extra set of hands.”

Jason Bauer
Nursing home administrator, Walnut Acres, formerly Stephenson Nursing Center
Freeport, Illinois