Lulette Infante, 46, a long-time nurse and current ambulatory nurse specialist and administrator at Northwell Health, was reading an op-ed for The New York Times written by Dr. Schleien, the Philip Lanzkowsky professor and chair of pediatrics at the Barbara & Donald Zucker School of Medicine of Hofstra/Northwell. Schleine was one of the first COVID-19 patients in Westchester, New York, and wrote extensively about his experience with the disease. The article was heartbreaking, and touched on the loss of his wife of 37 years to cancer seven months prior, needing to live for his two sons, and the 12 days of burning lungs, loss of appetite, and "little gusto for life."
But there was one passage in particular that laid heavily on Infante's heart.
"He wrote about his hospitalization and with complete gratitude to all the front line workers who saved his life, but he said he had no idea who they were," Infante explains to Woman's Day. "They saved his life, but because they were all covered with PPE he didn’t know who they were."
And that's when Infante reached out to fellow nurse and long-time friend Antonella Ferrell, 45, with an idea on how to cut through the layers of personal protective equipment that was protecting frontline workers from contracting COVID-19, but hindering their ability to truly connect with their patients.
"Coming in[to a hospital] ill at any time is very scary — you don’t know what’s going to happen to you," Ferrell tells Woman's Day. "But now, during COVID, you’re walking in and you have everyone all masked with PPE and you can’t see anybody. You just see eyes, if even. You can’t see the smiling face —you can’t see the human behind all that PPE — and I think just in nursing what goes a long way is having the touch; having that smiling, friendly face looking at you telling you you’re going to be OK. And we don’t have that anymore."
Infante's solution? To create and mass print photo badges for the entire clinical staff to wear over their PPE. By making their pre-pandemic faces easy to see, they would be able to once again lift the spirits of their patients and help them feel more comfortable during a time filled with duress and uncertainty.
"You would start to hope that one day you would see their full smiles like that again."
Things moved quickly once Infante and Ferrel presented their idea to the powers that be. "They were very supportive," Ferrel explains. "And within three days turnaround time from presenting the idea, ordering the supplies, and just getting our first batches out — it was great. It happened really quick."
The results of the oversized badges were also immediate, the nurses say, and were felt by both the patients and the frontline health care workers caring for them.
"Being able to see their coworkers faces on the badges, and they’re looking beautiful and well-rested in the picture, you would start to hope that one day you would see their full smiles like that again," Infante says. The badges, she explains, gave those fighting the pandemic something to look forward to — the day when they could see their coworker’s faces again. When they could truly see each other again.
"They would send us their badges in groups, and they would switch names around, give themselves different nicknames, just having fun with each other, and then they’d send in picture with them — with coworkers and teams — just posing and doing funny things," Ferrel says. "So I think it was actually very nice for them; they got to have fun with it on their end. And think it definitely helps with morale and camaraderie, and definitely added a little something to their world right now."
But not only did the oversized badges lift the spirits of those on the frontlines in emergency rooms and over-crowded ICUs, it increased the level of care those frontline healthcare workers were able to deliver to patients, especially during high-stress situations.
"During codes, the staff was actually helped with [the badges]," Ferrel explains. "They were able to identify who was standing in front of them and give them instruction during codes and emergencies, so that was actually very very big on our end. Just helping with the care side of it."
"How do you trust a person coming at you, totally covered?"
Years of working in a pediatric hematology and oncology unit had provided countless, first-hand, and often heartbreaking examples of the importance of establishing a personal connection between patient and caregiver. "When you’re putting a needle in a child’s chest... we’re holding them down. We have to hold them down," Infante explains. "But we can talk to them and we can explain to them, step by step, what’s happening in a way that would give them less of a fear of what’s to come."
But with the barrier of personal protective equipment, that connection — the ability to look into a patient's face and have them see yours in return — has vanished in the era of COVID-19. Instead of seeing an actual person, patients see shields, masks, and other protective equipment that can make a nurse or doctor appear more alien than human.
"How do you trust a person coming at you, totally covered?" Ferrel asks. "How do you trust that? And we're next coming at them with books and toys, we’re coming at them with needles and all these things are being unwrapped and they don’t know who we are. We don’t have the chance to give them that smile, the reassurance, the touch. So it’s got to be ridiculously scary for them."
Knowing all-too-well what a difference it can make in the care of a child, and to the parents of that child, Infante and Ferrel take pride in the fact that even something as small as a large picture of a nurse smiling, or posing with their dog on vacation, can help build back that trust between patient and nurse; a sick person and their physician.
"[The patients] fixate on the pictures," Ferrel explains. "So they’re like, 'Oh, is that your dog?' So it helps." And with the help of a PPE-free photograph large enough for any patient to see, nurses can say, "That’s me, that’s what I look like before I had to put my costume on. "They're like, 'Oh, OK. That’s your costume, and that’s you," Ferrel says. "And I think that’s big.
"We’re happy that it is catching on and that we were able to help other people spread the joy of helping out."
In the beginning stages of the project, Ferrel and Infante would work on printing out badges on weekends and in addition to their full-time jobs. But since partnering with Canon U.S.A., the two nurses have watched as their initial efforts have morphed into a cross-country endeavor.
"Originally launched at Long Island Jewish Medical Center and Cohen Children’s Medical Center and we have guided other Northwell hospitals, including Northern Westchester, Lenox Hill, Staten Island, Huntington," Infante says. "And outside hospitals, including Elmhurst Hospital in Queens and Covenant Health Systems in Alberta, Canada, which employs more than 14,000 staff, physicians and volunteers at 16 facilities."
"This is definitely a real feel good project," Ferrel says. "We were having fun doing it and knowing that we were actually making a small difference in their care and patient’s lives, it really impacted us as well. "
"We’re happy that it is catching on and that we were able to help other people spread the joy of helping out," Infante adds.
And now that 28 states have seen a rise in the number of COVID-19 states in the last two weeks, Infante and Ferrel hope their idea will continue to permeate emergency rooms, ICUs, and other health care facilities as the global pandemic continues. And their efforts, thus far, is something not only they, but their families are proud of.
"Both our families are very proud," Ferrell says. "[Our kids] share our Instagram page with everybody, so it’s really cute. I know, and I think I speak for Lulette as well, thatt her husband is very proud, as is mine."
They're also all too aware of the dangers frontline healthcare workers and their patients are continuing to face. On Wednesday, July 29, 1,4000 Americans died from COVID-19 in a single day. That equates to one person dying every minute from coronavirus in the United States. So to not only find but spread and sustain an easy but effective way to cut through the barriers of necessary PPE and establish that vital connection between patient and caregiver is important to Ferrell and Infante. After all, they know that, like themselves, frontline healthcare workers — the doctors, nurses, hospital cleaners, and extended staff — will continue to show up to save lives, no matter the cost.
"I don't want compare the bravery of soldiers going into war, but that’s exactly what it feels like during COVID," Ferrell says. "You are basically going into the unknown. And when you see soldiers going back to war you think in your head, 'Oh my gosh, they’re crazy. You already did your job, why do you want to go back?' But now I sort of get it. You want to be there."
This is what we’re trained to do," she continues. "This is what we’re supposed to do."
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