We got first word of the impending pandemic through the news: China and Italy were experiencing something extreme and it was on its way around the world. We watched as the virus made its way to Canada. By the beginning of March, Alberta saw its first presumptive case. Our immediate response was to meet with residents to explain the pandemic and how it may impact their lives and the delivery of service from staff at Ambrose Place. We didn’t even know what it was or what the future of our service would look like, but we, as frontline workers, had to stay strong. The next step was to secure personal protective equipment (PPE), toilet paper, cleaning supplies and food – before the masses scooped everything up. The news said supplies were depleting from grocery stores and barren shelves confirmed it.
Visitors were no longer permitted at Ambrose Place and our residents were confined to their units when they were home. Medication and food were delivered directly to resident units, which put workers at the forefront of close contact.
At the beginning of the isolation orders, many of us were very scared considering a few residents were in and out despite orders to remain in place and we were making contact with each resident every day. All activities were put on hold, but we continued to smudge the building and pray for our residents, staff and community. The Office of the Chief Medical Officer (OCMO) updates were posted for residents to stay informed, but the updates kept staff informed just as well. The updates made us both more and less scared at the same time; contraction numbers were climbing, but the information available was growing as well.
A consistent communication plan was established with our partners, Alberta Health Services (AHS) Mental Health & Addictions and Homeward Trust, including weekly video calls to provide guidance about the OCMO updates and interruptions. Part of the communication plan included access to PPE inventory, access to additional resources to support residents in place and provide access to funds for additional costs incurred due to COVID-19. Our needs increased throughout the pandemic and our partners were an integral support to the health and safety of everyone at Ambrose Place.
Figure 1 Masks made by Ambrose Place residents to protect against COVID-19
Although we never officially had a case, we were declared an outbreak site as we met the OCMO requisites of two or more residents and staff with matching symptoms. This was often the case as many residents that use substances commonly experience mild cough, runny nose and temperature changes. The clarification of the definition of an outbreak caused us to fall under more stringent rules for reporting, yet staff had to continue business as usual, the new usual. Being placed in the eye of the storm every day is frightening, but our residents are family and their safety is worth the risk.
After being declared an outbreak site, the next step was to establish a new internal protocol to refer each staff and resident symptom to the Lead LPN/Health Manager who then works with the Executive Director. This created a stronger sense of control and confidence in each situation. In hindsight, this support should have been implemented earlier, but we are all learning how to respond to a pandemic of this magnitude.
As of June 1, we began moving to a new sense of normalcy. This includes a new manner of dining in the cafeteria: each floor now dines separately, at half hour intervals, to a maximum of 14 residents per mealtime. The morning smudging ceremony now sees a maximum of seven residents per session, over two sessions daily. Some residents still keep to their units for mealtimes and remain fearful of going out. Our strategies of masking, social distancing and keeping hands and surfaces clean provides a sense of protection at Ambrose Place. We are still nervous about the virus, but we have more control over our facility and a little more confidence in our response. We will be ready for the next one.