When patients infected with coronavirus first made an appearance on Kristina McGuirk’s case load, it was hard not to be concerned.
As a nurse with Home Healthcare, Hospice and Community Services, McGuirk’s job is to go into people’s homes to provide care for those dealing with a variety of conditions and medical concerns. But the addition of COVID-19 brought on that question of “what if?”
“You have to assume everyone has it and that’s really the best way,” McGuirk said. “I obviously don’t know what I was expecting. It’s something we’ve never seen before.”
She’s worried about being infected herself or bringing it home to her fiance. For those on her weekly caseload who had contracted coronavirus, her visits have so far come after the patient returned home from hospitalization.
“The acute phase has already passed,” McGuirk said. She said that some patients’ symptoms still remain like a cough and shortness of breath.
“Little things like holding a conversation can be difficult,” she said. “They’re feeling shortness of breath just talking.”
But as the weeks have gone by, McGuirk said she has seen progress from those patients who tested positive for the disease, like being able to walk up stairs and go outside.
“It’s been really nice to see the recovery phase,” she said. “But the weekly progress I’ve seen was pretty gradual.”
Each trip into someone’s home that has been diagnosed with COVID-19 – as well as everyone else – comes with a heightened sense of precaution. For patients who have tested positive for the virus, that means an N95 mask with a secondary cloth mask on top, double gloves, gowns and extra sterilization of the equipment.
“Sure you think about it when you’re at work and on the way to their house for a visit,” she said.
McGuirk said that HCS was unable to supply her with booties or a hair covering due to shortages, but that if they were available, she would wear those too.
Prior to a visit, HCS conducts screening calls, McGuirk said, and a lot of what she has done since the pandemic changed the way of life in New Hampshire has been to answer questions and educate.
“Just doing our best relaying the information,” McGuirk said.
While there is concern, McGuirk knows she has a job to do and can’t let fear or reluctance creep in.
“I’m a nurse and I like helping regardless of their diagnosis,” McGuirk said. “At the end of the day they’re still a patient and need care.”
McGuirk said early on the nurses at HCS were asked if and when they got patients with COVID-19 who would be willing to add them to their case loads.
“I volunteered because they’re patients that need a nurse, they need care,” she said.
She did so because she considers herself young and healthy at the age of 27, and knows there are some older nurses on staff that have conditions or are immunocompromised.
When McGuirk goes home for the day, she changes into clothes she leaves in the garage before heading out for her shift, uses hand sanitizer, and washes her hands thoroughly once inside.
Branden Howe spends two or three days a week going into homes in his role as residential supervisor for Monadnock Worksource. He used to conduct in home visits every day before transitioning into a managerial role.
While the threat of COVID-19 is on Howe’s mind, he’s more concerned with the individuals he and the staff work with on a weekly basis. After the pandemic, Monadnock Worksource reduced the number of hours it spends with individuals, which ranges from 11 to 30 hours each week, executive director Janis King said.
They put a stop to transportation because “we can’t provide that safe distance,” King said, and a number of the places where individuals held jobs or volunteered were suspended for the time being. And that kind of disruption to the routine is concerning for Howe – even more so than the looming threat of coronavirus.
But at the top of his priority list is making sure he takes the proper precautions to keep from getting sick.
“I’m doing everything I can to maintain my health,” Howe said. “Because keeping myself healthy is part of this.”
Howe said in certain instances they would use PPE during in home care, but now it is used with every visit.
“It’s been working, but every day is different and has challenges,” Howe said.
But for Howe, it’s just the nature of the job.
“Our job is challenging, but people who do direct care are really invested in the individuals they support,” Howe said.