Behind the Badge: Keeping Patients and Families Connected During COVID-19

On any given day, Elizabeth Mover, RN, BSN, attending nurse in the Blake 7 Medical Intensive Care Unit (MICU), can be found in the midst of the tasks she has become accustomed to in her 15 years at Massachusetts General Hospital: organizing daily multidisciplinary rounds and participating in bedside rounds, speaking with families and patients to identify needs, organizing family meetings and teaching courses, including basic life support and advanced cardiac life support and continuous venovenous hemofiltration. COVID-19, however, changed all of that.

“Working in a MICU can be stressful on a good day, let alone during a pandemic,” says Mover. When it became clear the typical interactions between patients, their loved ones and care providers would not be possible, she quickly took action.

With support of unit leadership, Mover collaborated with colleagues in IT to bring iPads to patients in the MICU to make communication in the room safer. She also worked with colleagues in Mass General's Social Service Department to enable Zoom calls as a virtual visit option for family members who were unable to visit due to increased infection control measures. “Coordinating daily Zoom calls with families was very important because on top of being seriously ill, the stress of being scared and alone was a concern in helping patients get better,” says Mover.

While technology helped boost interpersonal connections, however, it also posed challenges. “Having difficult end-of-life conversations via Zoom was incredibly challenging for families and staff. Many of our patients were unable to speak to us and, with their families unable to be physically present, we had difficulty getting to know them beyond their medical record; and with layers of personal protective equipment between us, patients were unable to get to know their health care team.”

To help address this issue, Mover worked with the social work team to fill out “Get to Know Me Posters,” which included personal details about each patient, including nicknames, favorite TV shows and music and areas of concern that might produce more stress. “Families would email us the answers and include pictures of their loved one. I filled in their answers and hung the posters in the patient’s room. It really helped us get to know our patients and connect with them. We truly explored every avenue we possibly could in helping patients feel connected to those of us caring for them.”

While it was a stressful time, Mover says, “The teamwork in the MICU and the relationships with our respiratory therapy colleagues really grew and shined. We all came together to take care of some of the sickest patients Mass General treated during the height of the COVID-19 surge. Because families weren’t able to visit, we took very seriously our role as the eyes, ears and link between our patients and their families.”

Despite the uncertainty of the pandemic, the unit made sure to recognize any positive milestone. “We celebrated when patients were able to be extubated or decannulated from extracorporeal membrane oxygenation treatments. And, of course, the biggest celebration for us was when patients recovered enough to be transferred out of the MICU to a general care unit—a moment that made us all realize the importance of being in this together.”