By Maria Arellano
Throughout history, world events have impacted society and significantly altered our daily life. World War II, for example, created an opportunity for women to work in factories and other traditionally male jobs and broke down long standing barriers out of dire need. When the war ended, it never really “went back to normal.” More recently, 9/11 significantly changed how the world travels and created new security protocols that have become second nature to us now. This too is not likely to ever return to “normal.”
The global health emergency we all know as the COVID-19 pandemic 
certainly fits into this discussion and its impact on our society clearly was more of a smack in the face. Society implemented the necessary changes very quickly out of desperate need to prevent the spread of this mysterious virus, with the idea and hope that it would be short-lived and soon we’d get back to normal.
Getting back to “normal” is a common theme in the many video chats I’ve had with people over the last 4 months. But with the COVID cases falling and rising again, the anxiety and fear we all are experiencing are real and delays the return to “normal” anytime soon. I miss traveling, seeing my friends in person and hugging them when they’re down. I miss being able to get in the car and just go. Now it takes planning and careful evaluation whether it’s an essential trip or not.
This pandemic has also created some horrific experiences, including lost jobs or the loss of a loved one who died alone in the ICU or nursing facility. Both things that no one would ever want to go through.
Seeking Out Silver Linings
One approach to dealing with this situation has been to seek out all the silver linings and positive adaptations folks have made to address our current “normal.” Personally, my backyard and garden have never looked so beautiful. It’s amazing what a little effort does to nurture my flowers and vegetables into magazine quality beauty and farmer’s market-like produce! Women’s groups are sewing masks for those who might not be able to afford one and we’ve held parades and drive by parties to celebrate life changes and successes.
Professionally, I have been so impressed with innovations caregivers have made in the face of incredible shortages of PPE and staff, changing regulatory requirements and fierce media scrutiny. There are so many stories being told of the creative activities conducted in the hallways and in residents’ rooms, window visits to cheer up family members, and outdoor booths being built to allow for visits and hand holding, all while still maintaining precautions. Zoom care conferences and virtual visits with family keep the connections intact and allay the fears of many family members. We see signs of “Heroes Work Here,” and social media praises of the heroic and compassionate acts made by staff (#SNFStrong).
True Definition of “Essential” Emerging
The true definition of essential workers is emerging and sheds new light on what is important and what deserves our priority. One of those groups of essential workers is healthcare workers, all of them – all disciplines, all departments, all settings. But I want to single out those who keep our nation’s long-term care facilities operating daily, as they deserve our respect and praise and OUR priority. Finally, we’re seeing their worth and contributions recognized in the media.
Power of Collaboratives
We’ve also seen the value that provider collaboratives established prior to COVID afford communities. These collaborations had a leg up on fighting this pandemic because they had pre-established communication and practice systems that supported a much more effective community response.
So, while we’re dreaming about the day we all return to “normal,” I’d like to start a list of things I’d like to see as the “new and improved normal” in our industry.
My SNF Wish List for the New Normal
Wild innovation
Let’s keep problem solving or brainstorming as if our lives depended on it. Some of the most creative ideas for care delivery and activities during this crisis have come out of new ways of thinking. Thinking that isn’t held back by norms and regulations. Stay wildly creative then worry about the details later.
Recognition of essential workers
Now that we can clearly see who truly provides those essential services to our communities, let’s treat them accordingly. Let’s evaluate how we can provide them with adequate equipment to do their job. Show them that we recognize their value by paying adequate salaries so they don’t have to work two jobs to cover basic needs. Anyone notice that professional athletes and Hollywood stars, while entertaining, haven’t surfaced as “essential” in any way?
Care delivery system changes
Although efforts were already in the works to ensure the right care at the right setting, further exploration of creative staffing approaches and deeper integration of telehealth services must continue. In addition to helping manage during the quarantine, telehealth offers greater access to specialty providers, reduces potentially traumatic office visits outside the facility for frail residents or those with dementia and reduces the cost of transportation and staff time. I would also love to see the 3-day hospital stay requirement eliminated permanently. We tried this in the 1990’s, but it’s time to do it for real.
More community care collaboratives
Further break down the silos by care setting and build collaboratives across providers. Hospitals and PACs can work together to build a community team that works together to improve the quality of care, holds each other accountable, shares best practices and resources, and communicates effectively. We’ve seen them do amazing things during this pandemic.
Family connections through technology
We’ve had the technology for a while, so why did it take so long to implement virtual care conferences? So many working families can’t attend care conference routinely due to work commitments. A quick 15-20-minute video conference call can easily be incorporated into the workday. Long distance family members also can visit with their loved one using video conferencing. These connections add so much to the quality of life the resident’s experience. I know it has added to mine. I have monthly Zoom calls with my dear friend across the country. It’s become our normal and we’ll keep it up for sure!
Creative celebrations
Keep the yard signs and the drive by parades going! Let’s continue to howl at the same time every night or applaud healthcare workers at shift change and play music from our balconies to encourage those who may need an emotional lift. What a fun way to get the community involved to rally around its elders and the staff who care for them.
What would YOU like to see become the new normal?
Share your thoughts on what the new normal should look like.
More Resources from Maria Arellano for Skilled Nursing and Post-Acute Professionals:
- SNF Infection Control Practices: The Pressure Is On
- Managing Risks in Your Network of SNFs Amidst COVID-19
- COVID-19: Policy Updates and Care Considerations
Author:
Maria Arellano, MS, RN, RAC-CT
Senior Healthcare Specialist, PointRight
Maria has over 35 years’ experience as a registered nurse in the post-acute industry. Maria has served in a variety of roles directly in or supporting the long-term post-acute care sector including staff development, director of nursing and corporate consultant where she demonstrated regulatory excellence and exemplary quality outcomes. Previously she was a nursing home quality specialist with a quality improvement organization (QIO) and worked to enhance the quality of care for residents. Maria participated on CMS Technical Expert Panels as well as various committees and advisory boards throughout her career. She is focused on quality improvement, which fuels her passion for transforming data into knowledge and actionable insights.
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