Since the beginning of the battle against COVID-19, we have heard how many people tested positive each day and how many of them require hospitalization.
But what happens to the people who aren’t hospitalized? Do they just go home and get back to normal in a few days? The truth is many of them have their health linger in limbo for weeks that turn into months. They live an isolated life in their home, worried about what every new symptom means while simultaneously wondering how they’ll pay their bills and who will bring them medicine and groceries.
That’s where JPS Health Network steps in with a team of case managers, nurses and social workers who not only monitor the health of patients remotely and guide them along the road back to health. They also serve as a friend, advocate and sounding board for people who are filled with anxiety and fear by a virus that clouds their future.
“We’re talking with patients daily to monitor their symptoms,” said Devon Armstrong, Director of Outpatient Case Management at JPS. “What we’re finding is that patients are really afraid. They have a new self-diagnosis every time they turn on the TV or the radio. Fortunately, we’re able to talk them through their symptoms and make sure their needs are being taken care of. Patients appreciate the contact because they are so scared. They’re going through something that no one really understands. So we try to support them any way they can. How do you get your medication? How do you get your groceries? We’re always working to connect people with resources. Do you just need to talk to someone about your concerns? We can do that.”
JPS currently has 154 people enrolled in its COVID Home Monitoring Program which was created on April 10. The number of patients in the program has tripled in the past two weeks as COVID-19 cases surge across Tarrant County and Texas. While the time patients spend in home monitoring varies widely, Armstrong said the average stay is about 15 days.
Dawn Cunningham spent nine days in the hospital at JPS, isolated from her family that included a very worried daughter and a sister who was also infected.
“I had it and I didn’t feel great,” Cunningham said. “But suddenly it got a lot worse. I went to the hospital and found out I was a lot sicker than I thought I was.”
About halfway through her hospital stay, Cunningham got her appetite back and slowly started to feel better. A need for supplemental oxygen was all that kept her in the hospital.
“They set me up with oxygen so I could leave,” Cunningham said. “They also got my medication set up the very same day, everything I needed, I had right away. Everyone was so wonderful to me.”
Registered Nurse Raven Shelton works with several COVID-19 patients remotely, calling them several times a day to check their oxygen level and other health indicators as well as to just ask them how they’re feeling both physically and mentally. She said it’s a lot of responsibility, especially as the number of patients has begun to mount. But she said she is proud to be part of the community’s response to the virus.
Originally, each nurse had two or three patients to monitor, Shelton said. But as the number of positive patients skyrocketed, so did the workload for caregivers. They had to find new ways to manage the rapidly-expanding case load.
“I don’t think I expected it to just explode the way it has,” Shelton said of COVID-19. “We knew it was coming, but it’s really kept us working to adapt to every change that comes at us. I’m really grateful to be a part of this team. The way we were able to mobilize so quickly is amazing. We’re constantly adjusting to meet the need and I know the patients appreciate us being here for them.”
Cunningham said her three times a day check-in calls were incredibly important to her.
“When you’re dealing with something no one has ever seen before, it’s scary,” Cunningham said. “So it’s a big relief to know someone is looking out for you. They said they were going to keep watch over me and they did, three times a day for six weeks. Never missed a single time.”
While a handful of patients she’s managed have worsened and had to be admitted into the hospital, Shelton said most of them recover and graduate from the program. She said she looks forward to meeting them in person when the pandemic is over.
“People have a lot of questions, and that’s alright because they’re experiencing something that we’ve never seen before,” Shelton said. “I’d rather have them call me 50 times than sit at home and worry about things. We grow pretty close with the patients. I feel like I have known some of them for 40 years. I think it would be great if someday I can meet them in the clinic and see their face after all we’ve been through together.”
Dr. Steven Davis, pulmonary/critical care physician and Senior Physician Executive of Internal Medicine, said at-home healthcare is vital in the response to COVID-19, freeing up much-needed hospital beds for the patients who can’t be treated remotely. While no one imagined what the fight against COVID-19 would look like before it happened, he said case managers, nurses and social workers have been vital to organizing and executing the response.
“These programs can’t exist – and most of what we do both inpatient and outpatient can’t exist or happen – without the efforts of our case management staff providing ongoing care, coordination and assurance to our patients,” Davis said. “The home monitoring programs that we have (ones with oxygen and not, and ones for COVID-19 patients and not) are entirely dependent on the efforts of our case management staff.”
Davis said it took a major, coordinated effort to bring the at-home COVID-19 program together quickly under pressure.
“It’s amazing how quickly and efficiently they were able to put this together to benefit our patients,” Davis said.