When the full narrative of the COVID-19 pandemic is finally written, how it affected the world economy, global health, the environment and society will be a story for the ages. It will also go down in Louisiana history as an unprecedented event with devastating consequences. By August 2020, COVID-19 netted an 11% job loss statewide – double what the state experienced in 2005 after Hurricane Katrina. Hospital systems have been overwhelmed, the school year has been disrupted and business across the state is in upheaval.
But that’s only part of the story. The pandemic narrative will also tell how people worked together to develop effective testing and treatments, outreach, support and critical care while facing a challenge unlike anything they’d experienced before.
“I am proud that our LSU Health New Orleans School of Nursing faculty and students have assumed a position on the front line of COVID-19 response at the LSU Health Sciences Center and within our community,” says Demetrius Porche, DNS, PhD, PCC, ANEF, FACHE, FAANP, FAAN, Dean of the School of Nursing. “They have demonstrated their commitment to conquering this pandemic with examples of compassion, caring, courage and self-sacrifice to ensure that some of our communities’ most vulnerable and diverse populations had access to COVID-19 testing.”
Leading to Address Health Disparities
The COVID-19 pandemic affects everyone – but not equally. Data show that COVID-19 mortality rates are more than twice as high in Black, Latino and Indigenous populations as in white populations. Poverty and inequities in health care access for these populations affect health outcomes. To address these health disparities that specifically challenge minorities and vulnerable populations in Louisiana, Gov. John Bel Edwards created the Louisiana COVID-19 Health Equity Task Force, and the School of Nursing is well represented.
“Early data indicates that the burden of the pandemic has not fallen equitably among Louisianans, with African Americans, seniors and other persons residing in group living disproportionately impacted,” says task force Co-Chair Sandra Brown, DNS, APRN, FNP-BC, CNE, ANEF, FAANP, FAAN (MN ’85, DNS ’94).
Dr. Brown is Southern University and A&M College Dean and Professor of the College of Nursing and Allied Health. She is joined on the committee by Dr. Porche and Leanne Fowler, DNP, MBA, APRN, AGACNP-BC, CNE, Assistant Professor of Clinical Nursing at the School of Nursing.
“The task force has been charged with providing recommendations relative to health inequities affecting communities that are most impacted by the coronavirus and examining opportunities which provide greater access to high-quality medical care and improve health outcomes,” she says.
Another critical aspect of the task force is the inclusion of nurses. “I am grateful to Governor Edwards for ensuring that nurses are represented,” says Dr. Brown. “As such, we have nurses in the forefront who are leading, serving and building a foundation for change.”
Mobilizing for Accessible Testing
Testing is key to managing COVID-19. The School of Nursing collaborated with a number of partners to support area testing efforts. From April through June, the school participated in a mobile testing campaign for COVID-19 across the metro area. The campaign brought accessible, walk-up testing to neighborhoods that were heavily affected by COVID-19, with the goals of identifying early cases and completing 250 tests each day.
“Faculty from the School of Nursing and School of Medicine, medical students, LSU Healthcare Network, New Orleans Department of Health, and LCMC Health nurses and staff provided COVID-19 testing at sites throughout New Orleans, which changed weekly. Testing sites spanned from East Bank to West Bank to Mid-City, including sites in New Orleans East, the Ninth Ward, Marerro, and the Gert Town/Hollygrove area,” says Deborah Garbee, PhD, APRN, ACNS-BC, FCNS, Associate Dean for Professional Practice, Community Service and Advanced Nursing Practice at the School of Nursing. While the school’s participation at the test sites ended in June, the off-site community testing continues.
“No one wanted this pandemic to happen. However, it has provided important opportunities. Our faculty, staff and students have made important contributions to improving our community’s public health. I couldn’t be prouder.”
Demetrius Porche, DNS, PhD, PCC, ANEF, FACHE, FAANP, FAAN, Dean of the School of Nursing
Larry Hollier, MD, FACS, Chancellor of LSU Health Sciences Center, led an initiative to provide COVID-19 antibody tests for faculty, staff and students. “Starting on July 15, COVID-19 antibody testing began at the LSU Healthcare Network clinic one block from the LSUHSC campus,” explains Dr. Garbee. She says that LSU Healthcare Network physicians and medical students provided antibody testing, and the School of Nursing Doctor of Nursing Practice faculty and students from the Nurse Practitioner, Executive Nurse Leader and Adult Gerontology Clinical Nurse Specialist concentrations provided COVID-19 virus testing.
“COVID-19 testing is important to provide our campus community members a safe work and education environment,” Dr. Garbee says. “The antibody tests identified individuals who have or had a recent or prior infection, which is especially important for those who do not display symptoms. Those testing positive for antibodies are provided a COVID-19 virus test for active coronavirus via nasal swab. It is important to identify individuals who may be asymptomatic and who could spread the disease to others.”
Overcoming Obstacles to Clinical Education
At a time when more nurses were needed to help an influx of patients, COVID-19 also derailed the nurse education system. At the School of Nursing, that meant postponing clinical education at partner hospitals for two weeks. During clinical experiences, students participate in supervised learning sessions in real-world health care environments, which provide them with the opportunity to put what they have learned in the classroom into practice.
“Clinical experiences provide the pathway to developing appropriate patient care decisions and professional development,” explains Benita Chatmon, PhD, MSN, RN, CNE, Assistant Dean for Clinical Nursing Education at the school. “Clinical experiences give nurses the experiential knowledge needed to function in an autonomous role as patient advocate, as well as the ability to contribute to various health care initiatives.”
That decision to curtail clinicals for two weeks was a difficult one, but it was made for several reasons: to protect the health of the students and the community, to conserve inventories of personal protective equipment, and to develop processes congruent with CDC guidelines. To substitute for missed clinical experiences, students took advantage of several alternatives.
“We were able to quickly offer virtual simulation to help students hone their clinical decision-making,” says Todd Tartavoulle, DNS, APRN, CNS-BC, Program Director for Traditional BSN Program and Associate Professor of Clinical Nursing at the school. The virtual simulation program is screen-based and features scenarios that accurately reflect actual health care settings. Students work through multiple realistic patient scenarios, which challenge them to make important health care decisions that significantly impact patient outcomes, without the need for clinical presence or risk to client safety.
“It was important that we offered an alternative to clinicals as quickly as possible. The virtual simulation option was well-received by students,” Dr. Tartavoulle says.
Along with virtual simulation, many students received practical on-the-job experience during the education shutdown. Because many students are also nurse technicians at area hospitals, they augmented their education while providing much-needed frontline support.
“Many of our students continued to work during the height of the pandemic,” Dr. Tartavoulle says. “They gained invaluable experiences, including learning firsthand the proper way to doff and don personal protective equipment and seeing the assessment findings in COVID-19 patients, all of which will make them better nurses.”
Supporting the Greater Cause
Collaboration will win the war on COVID-19. Academia, including the School of Nursing, is positioned to support that effort by making a difference through improved public health, enhanced health equity for marginalized populations and preparation of future health care workers.
“No one wanted this pandemic to happen. However, it has provided important opportunities,” Dr. Porche says. “Our faculty, staff and students have made important contributions to improving our community’s public health. I couldn’t be prouder.”