Nurse Practitioners as back-up to COVID units: a unique story

To face the rough weeks of the second wave of the COVID-19 tsunami, the crew of adult nurse practitioners (NPs) from the McGill University Health Centre (MUHC) are coming to help fellow healthcare professionals in the battle. The MUHC is the first hospital centre to have deployed NPs within its COVID units.

There are 10 adult nurse practitioners and 2 mental health nurse practitioners at the MUHC. Regardless of their speciality area, Cardiology, Cardiac Surgery, Endocrinology, Oncology, or Traumatology all of our adult nurse practitioners have made adjustments to their usual work duties  to assist their peers in the fight against COVID-19. Lucy Wardell, nurse manager, COVID test centre and Advanced Practice Nursing, confirms.

 "Our NPs really stepped up to the plate. It was wonderful to see how willing and eager they all were to help with the pandemic, even those who stayed on to provide care in their speciality areas so as not to compromise care for patients in their home sectors.  We carefully mapped out a plan to ensure the best possible coverage of all sectors, while helping those in greatest need ", says Lucy.

Nurse Practitioners, often referred to as "super nurses", have advanced graduate training in nursing and medical sciences that enables them to diagnose, assess patients, prescribe tests and treatments, and perform certain medical procedures independently. As NPs, they have a holistic vision of the patient's treatment plan and they ensure the continuity of care provided to patients, a great asset for medical units.

From left to right, top to bottom: Lélia Holden (Cardiology), Marsha Guzman (Cardiology), Loredana Talos (Cardiology), Luc-Etienne Boudrias (Traumatology), Andréane Chevrette (Oncology), Ya Jun Liang (Endocrinology), Mélanie Lamontagne (Cardiology), Amale Ghandour (Cardiology), Julie Dicaire (Cardiology), Alexis Parent (Oncology). Missing in the picture: Marie-Joëlle Bédard (Psychiatry).

At the heart of the action

NPs, first deployed during the first wave, are coming back to the rescue with a plan. The goal: to have three NPs on the COVID units at all times for eight consecutive weeks, beginning on the first week of January.

It is real team work: each NP works in a trio with a physician and a resident, in addition to daily collaboration with a multidisciplinary team including, among others, medical specialists, nurses, physiotherapists, occupational therapists and social workers. There is a lot of staff turnover on COVID units, but the NPs are on duty five days a week, which allows them to become acquainted with the patients under their care. "The fact that we're here for several weeks creates stability for the team, patients and families," explains Marsha Guzman, NP in Cardiology.

Despite being immersed in an unfamiliar environment, Lélia Holden, NP in Cardiology, believes that NPs are well supported and guided through this challenge. "Even in the second wave, I feel that there is energy in the team; people are still smiling, they are happy to work together. It's stimulating and refreshing and I feel very fortunate to be working on this team. I find everyone very professional and it's a pleasure to work with them every day," says Lélia.

The spirit of the crew is holding up well, says Loredana Talos, NP in Endocrinology. "What motivates me to fight in this battle is working with my colleagues, like the bedside nurses who are so dedicated to their patients. As NPs we are also there as a resource for them, and being able to help them makes me even more motivated.” Marsha adds: "We are nurses first and foremost. We understand their reality and this creates an easier relationship of trust with them. "

NPs in the intensive care unit

Some NPs offer their help on a part-time basis as nurse clinicians in the intensive care unit (ICU) of the Montreal General Hospital while continuing to provide speciality care to patientson a part-time basis in their respective departments: Mélanie Lamontagne, in Cardiology, and Luc-Étienne Boudrias, in Traumatology.

"For me, intensive care is like finding back my first love. It's like going back to my roots! ,” says Mélanie. "The people are super nice and welcoming, and I feel that we are useful to them. The nurses work very hard, and being able to help them is especially rewarding,” she says.

Holding the fort

In order to continue providing care to patients in core speciality areas, while some NPs take turns helping other departments, some remain full-time in their area, like Marie-Joëlle Bédard in Psychiatry, Amale Ghandour and Julie Dicaire in Cardiology and Cardiac Surgery, and Alexis Parent in Oncology.

"I think it's great to be able to work like this together. There are needs in every unit and, despite COVID, there are also patients waiting for surgery or chemotherapy, says Amale, who joined the COVID unit in the first wave, and is now providing ongoing care in cardiac surgery and at the Cardiology Clinic. We find strength through unity; we are a great team that wants to help as best we can. It's a great opportunity to demonstrate our role to other healthcare professionals."

All of the NPs agree on one point: success comes from mobilizing our team in such a way to be as useful as possible to the system during such difficult times.. They also have a common message to send to all: "We must remain strong!"

Congratulations for your dedication!