Nurse-developed protocol ‘greatly aided’ COVID-19 treatment
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ORLANDO, Fla. — A critical care nurse who served in a New York City ICU recounted how a commitment to lifelong learning helped her develop a treatment protocol that saved lives during the COVID-19 pandemic.
“My expertise lies in critical care,” Jessica Cafaro, MSN, RN, a nurse at Bellevue Hospital and adjunct lecturer at Hunter College, told attendees at the 2024 Rheumatology Nurses Society annual conference. “I may not know about rheumatology — each nursing specialty has its own challenges and gratifications — but there are common threads that unite us as nurses.”
That thread lies in the people nurses treat, according to Cafaro.
“We nurses are in the human business,” she said.
In 2018, the hospital system in which she was employed lacked a standardized protocol for proning patients with acute respiratory distress syndrome (ARDS). She and her colleagues developed a protocol for laying patients down in a way that could redistribute blood and airflow to oversaturated lungs.
“We embarked on creating a systematic protocol,” Cafaro said.
The group conducted in situ simulations in the ICU, and their efforts proved successful.
Cafaro and her colleagues presented the findings in 2019 at a conference for critical care nurses, and a year later the data were published in Critical Care Nurse.
Eight months later, the COVID-19 pandemic hit.
“Our newly established protocol greatly aided the treatment of COVID-19 patients, many of whom had ARDS,” Cafaro said.
Soon, Cafaro and her colleagues began to receive phone calls and emails from around the country from medical professionals who wanted to learn more about the procedure.
“People urgently needed lessons over the phone,” she said. “We spontaneously adapted processes to meet an overwhelming demand.”
In many ways, New York hospitals were the “epicenter” of the first wave of the pandemic, which Cafaro described as an 8-week rush that at times resembled a wartime situation. She urged other RNS attendees who lived and worked through this time to remember it whenever they are experiencing stress in their own jobs.
“I felt a tremendous responsibility to the nurses, physicians and patients coming in one after another,” Cafaro said.
However, she also acknowledged the fatigue many health care professionals feel about the pandemic.
“We are so tired of talking about COVID,” Cafaro said. “I am tired of talking about COVID, but it is impossible to ignore the overwhelming effect it had.”
As the pandemic subsides into the background of daily life, Cafaro offered a closing point for the RNS nurses who survived the blitz but continue to face challenges treating rheumatology patients.
“It is my deepest hope that you all take care of yourselves and each other,” she said.
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Cafaro J. Keynote: A Nurse Journey. Presented at: Rheumatology Nurses Society annual conference; July 17-20, 2024, in Orlando, Florida (hybrid meeting).
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