TMC PULSE

22 t m c n e w s . o r g " A patient may not be a COVID-19 patient one day, but you come back the next day and the patient is a PUI. That was the problem. " KWAME BENNAM, RCP, RRT, is a respiratory therapist at Memorial Hermann- Texas Medical Center. He spoke with TMC Pulse on April 15, 2020. I'm the guy they call on if there's any respiratory issue. I am the clinical practice leader that is in charge of the neuroscience service line. We have all these service lines, and I am the advanced practice person that is the liaison between the doctors and the bedside therapist. Any high level, advanced vent settings that a regular therapist usually is struggling with, I'm the guy they contact. We go into the patient's room when they are a person under investigation [PUI] for COVID-19, then we swab them and walk the whole sample to the lab. It's been challenging—I'll be frank. There was so much uncertainty surrounding COVID-19. The reason is, when it came out, we all didn't know what we would be dealing with. Everybody's like, 'It's not going to be in Texas. Everything is going to blow over.' When we found out that the respiratory team was going to be the one actually doing the testing, I thought, 'Whoa, wait a minute. We're going to be put on the front line?' ➟ Spotlight on COVID-19 COLLEEN KIMBALL, APRN, FNP-C, a family nurse practitioner, manages the Hogg Clinic, one of 10 clinics in the Memorial Hermann Health Centers for Schools program. She spoke with TMC Pulse on April 13, 2020. Our clinic, located at Hogg Middle School in the Heights, is designed to be a comprehensive medi- cal home for uninsured and underinsured children. We're a super small team: I'm the nurse prac- titioner and the clinic manager, and then we have Celia Ramos, a licensed vocational nurse; Janet Morales, our office assistant; Ecenthia Burnett, who is our social worker; and Adabelle Franco, our navigator and also a dietitian. That's it! We're a little portable unit and we have a full pharmacy where I can give over-the-counter medications, antibiotics, vaccines—everything free to the families. We also have our own on-site lab. It's been challenging with the Stay-at -Home Order. A lot of our patients think we're closed because HISD [Houston Independent School District] is closed, and we also have a large num- ber of patients who are immigrants. We found out that there has been a lot of fear spread throughout that community. People were being told that if they were caught out during the Stay-at-Home Order, or if they were found to have COVID-19, they were at risk for being deported. It's awful. Our numbers dropped significantly because of fear. But we knew they needed us, so we thought: How can we let them know we're here? We started calling them until they would pick up, and our office assistant would explain to them that the rumors were not true and that even people who are here illegally have a right to free care. Then we thought: What else can we do? We were following the HISD food sites that kept clos- ing and our social worker had the idea that maybe we could supplement that for our families who might need it. We do a food insecurity evaluation on all of our patients and families, and that basi- cally tells us if they are at risk. We pulled that list and decided to go from there. We started out with 10 families and what we found is that if you tell people you have toilet paper and paper towels and food, they will come. We went to the Houston Food Bank's website and found the closest distributor, a little church around the corner called St. Joseph's Catholic Church in the Sixth Ward. When we went over there, we found a little note on the door, and so we called the phone number and the ladies there said absolutely they'd help. There are literally two women doing all this work—they are operating on donations and running out and still helping us. They made 10 big bags for us with things like fro- zen chicken, orange juice and nonperishables, and then we pooled our own money and supplemented and got all kinds of stuff. When our resources ran low, our medical director at the Hogg Clinic, Dr. Steven Alley, helped us purchase the remainder of what we needed, and he plans to continue that contribution each week as needed. We called the families and they came one by one—separated by time slots. We screened everyone over the phone first for any symptoms of COVID-19, and then every single person who shows up at our door has to be screened with a series of questions and also has their temperature taken. We're also wearing masks and gloves all day. We were able to do an intake on each family and go through their kids' charts and see what they needed and if they had any illnesses. I also gave them a little bit of a COVID-19 education, and our social worker was able to do the consent form for telehealth because we just so happened to pull people that also had kids who were engaging in some sort of mental health services. We were also able to schedule appointments the following week for anything else they might need, like immuni- zations or other kinds of health care issues. They could just see that it was safe, that we're here if they need us, and that we're not closed, which is so essential. If we're not serving those uninsured or underinsured people, then they're going to go to the ER and then the ER is going to be overcrowded. I will say that the biggest blessing for me is that from the time I was small, I wanted to do some type of mission work. And my life took a huge turn. I went from being an opera singer and then working as a school nurse and then working in cancer, and I feel like I've come back full circle and I'm doing mission work right here in my own community. How lucky am I? —Colleen Kimball, APRN, FNP-C, as told to TMC Pulse senior writer Alexandra Becker " We knew they needed us, so we thought: How can we let them know we're here? "

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