I am a big fan of Dr. Seuss. I know that I have really only alluded to this fact in one piece, but I the fact remains that he is an absolute favorite. One of my very favorites was this gem that we read the kids frequently when they were wee:
What is your favorite Seuss book? Enter in the comments 🙂
The title of this book teases out a line that says “If I ran the circus, I think I will call it the Circus McGurkus.” Shortly later, after explaining how he would build his circus, he announces how opening day will play out as follows:
Know How to Make an Entrance
What an Opening Night!
What a night!
What a sight!
I’ll hoist up the curtains! The crowds will crowd in!
And my Circus McGurkis will promptly begin
With a welcoming toot on my Welcoming Horn
By my horn-tooting apes from the Jungles of Jorn
Where the very best horn-tooting apes are all born
‘Cause the very fresh air there is fine for their lungs.
And some of those fellows have two or three tongues!Link
I guess my mind was wandering from thinking, as a disaster response professional, how are we ever going to open the nursing home circus again to the public. It is a very complex problem.
Here are the facts/realities:
- AT LEAST 1/3 of CoronaVirus Deaths have taken place in nursing homes or similar facilities, although the numbers are MUCH higher in many places. Here is a way to look up the numbers: Link.
- There are still limited amounts of PPE. There is not enough to cover every visitor many nursing homes have. Gloves and masks are in short enough supply that visits would have to be limited.
- There are still limited numbers of COVID testing kits.
- Many residents of nursing homes, including my mom, have DNR directives, so a rapid spread through a nursing home will cause many deaths that probably could be prevented.
- Liability concerns are everywhere. It is easier to be in a Shawshank lock down and fight an occasional access lawsuit than it is to fight hundreds of wrongful death lawsuits.
- The health of an already understaffed employee base is also critically important. They are very important folks that we need to support!
Cliff’s Notes Summary: The challenges are real and large and have deadly consequences if done poorly. A stinking 3 ring circus full of problems and the ringleaders are few and far between who are willing to consider much more than a Shawshank approach.
So, what would I do if I ran the circus?
- I would fight for a way to facilitate limited, pre-scheduled visits. The goal of a nursing home isn’t limited to merely keeping people alive and in a bubble. Any organization concerned with wellness understands social isolation isn’t avoided merely by being in proximity to peers. Family and loved one visits are an essential part of wellness. There simply has to be a consideration for quality of life.
- I would establish an isolated, but friendly area, perhaps in a community room or even an outdoor courtyard, that could be used for visits. The outdoor visiting area has an added bonus that the “very fresh air there is fine for their lungs”. Allowing unsupervised…or even supervised in-room visits with free access to others is a nonstarter. There has to be a separate place to meet that will minimize risk to others.
- Screening guests (Temp, Q&A, etc…) and strict PPE (Mask, gloves, face shield) usage would be required in the visiting area.
- Solicit donations and seek grants for the necessary PPE. It is available if you will pay for it. Perhaps a sliding scale requiring the visitor to share the cost?
The “what ifs” abound…
I feel confident the above process will provide even less potential exposure than the employee’s and contractor’s daily lives outside of work would generate. Every employee and contractor visiting is outside of the nursing home at least as much as they are inside of the facility. Their diligence will, necessarily vary. We cannot follow them around to be sure they are following CDC guidelines. Even threats of disciplinary action will not guarantee they are not exposed. They have loved ones and a life…they and their loved ones may be non-symptomatic carriers. The risks are always there.
Lawsuits: Yup. It could happen. Due diligence has to count for something. Unless you quarantine every employee, making them stay on campus 24/7/365, they can bring the virus to the nursing home. We accept a limited risk, we train, and train, and train, and we monitor health carefully. Then we just hope/pray it all works. The same diligence would apply to a limited visiting schedule.
I understand the issues above and that there are many more considerations I have not listed, but I also understand the harm that isolation/loneliness can cause. If I ran the circus, that is a simplified version of my plan. I do still like naming my plan the Circus McMarkus too..but that is more optional than the rest.