Arkansas hospitals grapple with face-to-face visit issue

Harold Jobe of Hensley does not recall the calls with his wife, Andrea, when he was seriously ill with covid-19 and hospitalized at the University of Arkansas for medical sciences in late summer.

The only call he remembers was after he started to recover. He doesn’t remember if it was a FaceTime call or a phone call, but he said his “mind was just raised” for the first time in two and a half weeks.

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“It made me feel good,” he said. “I wanted to live. It was enough to hear his voice for me to be ecstatic.”

The Jobes found themselves in the midst of one of the harshest realities of the pandemic for hospitals and patients: how healthcare facilities should balance the need for patients to see their loved ones with the need to prevent the spread a highly contagious virus?

For patients and their advocates, the presence of a loved one gives patients something that doctors and nurses cannot always provide: the will to live.

Health care providers see the positives as well, but for the most part hospitals have decided that the risks outweigh the benefits. However, a limited number of facilities in the United States have begun to ease visitation restrictions for covid-19 patients.

Hospitals in central Arkansas have allowed family members of covid-19 patients to virtually talk to loved ones, but have limited in-person visits, frustrating both patients and their families.

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The U.S. Centers for Disease Control and Prevention’s recommendation remains against allowing in-person visits for coronavirus patients.

UAMS only allows in-person visits at the end of a covid-19 patient’s life or when there is “a complex medical decision making that the family needs to be a part of,” Dr Stephen said “Steppe “Mette, CEO of UAMS Medical Center in Little Rock.

During these rare in-person visits, the hospital provides visitors with personal protective equipment: an N95 mask, hospital gown, and goggles.

Most people have been “very kind and accepting” of the visitation policy, Mette said, and the hospital listens to every request and assesses it on a case-by-case basis.

“We strongly believe that families are with their loved ones and always weigh the relative risk of covid and what it means for the visitor and the patient versus the benefit for the patient of having a visitor,” Mette said.

Harold Jobe said he understands that “no one needs to suffer from covid”, but he still wishes the hospital had helped him know that his wife contacted him when his illness was most severe and that he was heavily sedated.

When her husband was ill, Andrea Jobe also had covid-19, she said, but she did not need to be hospitalized. At the end of his quarantine period, UAMS transferred Harold Jobe to the intensive care unit. She said she would have “fitted” herself with protective gear for a visit if it had been allowed, especially since the call was not enough.

“If I could have touched him, he could have known I was there,” she said.

SUPPORT PERSON

The No Patient Left Alone Act, which became state law in March, affirms the right of patients in hospitals and palliative care to have a “support person”, whether a parent. , a guardian, a spouse or another member of the family, physically present with them during the treatment. .

“This support person does a lot more than hold their hands and talk to them,” said State Representative Julie Mayberry, R-Hensley, the law’s main sponsor. “It’s a big part, but they keep an eye on the medication, they are often the first person to call for help, they explain to the doctor what is wrong or explain to the patient what happens if they don’t understand it They often know the patient better They look out for the best interests of the patient.

Mayberry said some frustrated voters had previously told him they were not allowed to be with loved ones in hospital, whether for covid-19 or other reasons. Additionally, she was often present when her 19-year-old daughter was a patient for three months at Arkansas Children’s Hospital, which continued to allow parents to be with their children during the covid-19 pandemic. , she said.

“I was like, ‘Why am I allowed to be here when other families are not allowed to be with their loved ones?'” She said.

The law appears to have had the desired effect so far, she said.

“I am not receiving phone calls [anymore] people who say, “My spouse just had a heart attack” or “My spouse was in a car accident and I can’t come in to see them,” “Mayberry said.

The law states that hospitals can limit or restrict visits when in-person contact “would be medically or therapeutically contraindicated,” and Mayberry said that applies to covid-19 patients. The law gives hospitals “some leeway” and does not prohibit them from allowing visitors for covid-19 patients, but it was written with the safety of covid-19 in mind, she said. declared.

“In designing the law, we had to allow some hospitals to make decisions on a case-by-case basis,” Mayberry said. “It’s the only way to get it through.”

Mette said the visitation policy for non-covid patients at UAMS has changed more than once throughout the pandemic, particularly in light of the No Patient Left Alone law. Visiting hours were 10 a.m. to 2 p.m. a year ago, but last until 8 p.m. now, and some family members are allowed to stay overnight in a patient’s room if the patient takes advantage. , Mette said.

Hospitals in the Baptist Health area have implemented virtual visits for covid-19 patients and generally do not allow in-person visits, communications specialist Brandon Riddle said in an email, but with exceptions are allowed “on a case-by-case basis, depending on the nature of the patient’s condition.”

“There were times when it was difficult to enforce these visitation measures,” Riddle said. “However, we take safety very seriously and are committed to protecting patients, visitors and employees.”

Mercy’s healthcare facilities in northwest Arkansas have the same policy as UAMS, according to its website. Covid-19 patients are not allowed to visit except during end-of-life care, and non-covid patients are allowed one visitor at a time.

The Northwest Health System in Bentonville and Springdale allows patients one visitor at a time, including in intensive care, according to the Northwest Health website. The policy on the website did not distinguish between covid and non-covid patients.

Neither hospital responded to requests for comment last week.

‘NO QUALITY TIME’

William Williams of East End said he and his five siblings were only allowed to visit their mother once as she died of covid-19 at Baptist Health Medical Center-North Little Rock .

During the visit, their mother was “so far removed” from bacterial and Covid-induced pneumonia after more than two weeks in hospital, Williams said.

“There was no quality time,” he said. “Every time she tried to talk to us her oxygen would drop very low and we had to make her stop talking. It was really sad and heartbreaking.”

He said he was frustrated that the hospital had not allowed in-person visits earlier, with the required protective gear.

Earlier in her mother’s stay in the hospital, Williams was delivering some items she had requested, including her Bible and reading glasses, when the deposit became an impromptu visit because she was having a panic attack , did he declare. Hospital staff allowed her to put on protective gear, enter the room, and help her mother calm down.

If he and his siblings had been allowed to visit their mother before she was about to die, Williams said, at least one of them would have been there every day.

Williams experienced his own hospital stay for covid-19, he said, but his case was less severe than his mother’s. He was conscious and able to speak, so he spoke with his family on the phone every day, he said.

“People who are badly in the hospital, [who] can’t get up and walk alone, I think it’s more important that their family members come in person and try to cheer them up, ”he said.

Mayberry said she understands the importance of preventing the spread of covid-19, but still finds it “heartbreaking” that safety means limiting contact between patients and their loved ones.

She said one of her constituents had been hospitalized with covid-19 and “was in decline” until an in-person visit from a family member triggered a recovery.

“No medical staff will be able to provide this health care to someone,” Mayberry said. “Only a loved one can do this. They give them the will to live and the desire to keep fighting.”

Mette said UAMS administrators have “struggled” with whether to allow more visits for covid-19 patients as long as visitors wear the necessary protective gear, but they agree that visits should continue to be restricted for the time being.

“As more and more Arkansans are vaccinated, we hope we can safely allow more visits, but we’re not there yet,” Mette said.

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